To the Editor: We appreciated reading the article entitled “Pelvic Tilt and Range of Motion in Hips With Femoroacetabular Impingement Syndrome (FAI)” by Patel et al.1 The authors stated that abduction and posterior pelvic tilt increased the impingement-free range of motion in the hips with FAI. We agree with the conclusion. However, the study has several shortcomings that need to be explored. First, the study sample only included male specimens and lacked female specimens. We think the results removed the potential confounding effect of gender, but it may mean that their findings were not generalizable to females. Second, this study had a small sample size and only focused primarily on Cam-type FAI and they did not include subgroups with acetabular pathology (Pincer-type FAI). Third, the specimens with other hip diseases and previous hip surgery were excluded in this study. However, the authors did not evaluate the lumbosacral spine pathology. The relation between the lumbar spine and hip kinematics is well recognized clinically. Previous studies suggested that lumbar spine disorders may alter the hip kinematics and kinetics.2,3 Therefore, specimens with a history of lumbosacral pathology including lumbosacral fusion, disk pathology (eg, disk herniation and degenerative disc changes), diskectomy, or vertebral pathology (eg, foraminal stenosis) or a history of lumbosacral fractures should also not be selected. Finally, the CT scans were performed in a supine position without reproducing the weight-bearing forces. Obviously, the study did not take into account the pelvic posture and kinematics in the standing position.
展开▼
