EP3.6 Sit-to-Stand Adaptations in Pre-Operative Cam-Type Femoroacetabular Impingement: A Kinematic and Coordination Analysis

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ID: 331179
2026
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Abstract
Abstract Purpose Cam-type femoroacetabular impingement (FAI) is a source of hip pain in young adults and is associated with altered joint loading and early osteoarthritis. Prior gait/squat work suggest reduced hip flexion and altered trunk–pelvis coordination in FAI. Sit-to-stand (STS) is a mechanically demanding task, making it sensitive to identifying compensatory mechanisms. We compared (i) spinal and lower-body kinematics and (ii) inter-joint coordination and variability during STS in pre-operative cam-type FAI versus healthy controls. A secondary objective examined phase effects (i.e., early vs. late STS) on these outcomes. Methods FAI patients (n=12; 11 males; mean age=32.7 years, BMI=25.04 kg/m2; iHOT-33=44.3) and healthy controls (n=9; 9 males; mean age=27.7 years; BMI=24.38 kg/m2; iHOT-33=98.45) completed 5 trials of a standardized STS task. Forty-five reflective markers tracked 3-d joint kinematics at 200Hz with a 10-camera system (Vicon MX, UK). Kinetic data were recorded from a bench-embedded force plate and two additional plates underneath the feet, sampled at 1000Hz. Data were synchronized and processed in Nexus (modified Plug-in-Gait), then further processed and analyzed in MATLAB (R2023b). STS was partitioned into early (movement initiation to seat-off) and late (seat-off to upright) phases using force plate data. Outcomes were peak angle and ROM (hip, knee, pelvis, spine; sagittal/frontal planes) and sagittal inter-joint coordination and variability (hip-knee, spine-hip couplings). Coordination and variability were quantified via the Continuous Relative Phase technique. Data were time-normalized, and variables were averaged to a participant mean. The symptomatic limb was mapped to the matched limb in controls. Mixed ANOVAs tested the effects of group (FAI/healthy), phase (early/late) and their interaction (group*phase) on kinematic outcomes. Statistical non-parametric mapping (SnPM) compared group differences in coordination and variability outcomes, across the movement cycle. Statistical analyses were performed in SPSS (IBM, USA) and MATLAB. Results The sole group*phase interaction was for the knee frontal-plane angle (p=0.04). Post hoc tests showed less knee valgus in FAI during the late phase (mean difference −9.1°, p=0.03; Cohen’s d=−1.00). There were trends toward group*phase effects suggesting reduced flexion for the hip (mean difference: −3.1°, p=0.12; d=0.72) and pelvis (mean difference: −3.82°, p=0.08; d=0.82) during the early phase. A main effect of phase across many joints (p<0.05) indicated task-phase dependent kinematics, independent of group. SnPM revealed no significant between-group differences in coordination or variability (p>0.05), though early-phase traces suggested a trend toward more in-phase hip–knee and spine–hip behavior in FAI. Conclusion Pre-operative cam-type FAI was characterized by reduced late-phase knee valgus and trends toward decreased early-phase hip and pelvic flexion during STS, consistent with a cautious movement strategy. Coordination and variability patterns were comparable to healthy controls. These preliminary findings highlight selective sagittal and frontal-plane adaptations in FAI; as the dataset expands, future analyses may clarify subgroup differences and clinical correlates.
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Authors Patrick Ippersiel, Ariane Parisien, Andrew Tucker, Andrew Speirs, Mario Lamontagne, Paul Beaulé
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.291
URL
https://doi.org/10.1093/jhps/hnag043.291
Keywords Keywords not found

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