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Femoroacetabular impingement (FAI) is increasingly recognized as a risk factor for early hip degeneration in young active patients. The diagnosis depends on clinical examination and proper imaging that should be able to identify abnormal and sometimes subtle morphological changes. Labral tears and cartilage lesions rarely occur without underlying bone abnormalities. Surgical approaches to treat FAI are increasing significantly worldwide, even without a clearly defined consensus of what should be accepted as the standard imaging diagnosis for FAI morphology.Hip abnormalities encompass many variations related to the shape, size, and spatial orientation of both sides of the joint and can be difficult to characterize if adequate imaging is not available.This article presents a comprehensive review about the information orthopaedic surgeons need to know from radiologists to plan the most rational approach to a painful hip resulting from a mechanical abnormality.

Background: The ATP7A gene encodes a copper transporter whose mutations cause Menkes disease, occipital horn syndrome (OHS), and, less frequently, ATP7A-related distal hereditary motor neuropathy (dHMN). Here we describe a family with OHS caused by a novel mutation in the ATP7A gene, including a patient with a comorbid dHMN that worsened markedly after being treated with copper histidinate. Methods: We studied in detail the clinical features of the patients and performed a genomic analysis by using TruSight One Expanded Sequencing Panel. Subsequently, we determined the ATP7A and ATP7B expression levels, mitochondrial membrane potential, and redox balance in cultured fibroblasts of Patient 1. Results: We found a novel ATP7A late truncated mutation p.Lys1412AsnfsX15 in the two affected members of this family. The co-occurrence of OHS and dHMN in Patient 1 reveals the variable phenotypic expressivity of the variant. A severe clinical and neurophysiologic worsening was observed in the dHMN of Patient 1 when he was treated with copper replacement therapy, with a subsequent fast recovery after the copper histidinate was withdrawn. Functional studies revealed that the patient had low levels of both ATP7A and ATP7B, the other copper transporter, and high levels of superoxide ion in the mitochondria. Conclusions: Our findings broaden the clinical spectrum of ATP7A-related disorders and demonstrate that two clinical phenotypes can occur in the same patient. The copper-induced toxicity and low levels of both ATP7A and ATP7B in our patient suggest that copper accumulation in motor neurons is the path-ogenic mechanism in ATP7A-related dHMN. (c) 2021 Elsevier Inc. All rights reserved.

Using an extended retinacular flap containing the blood supply for the femoral head, proximal femur osteotomies can be performed at the neck level increasing the potential of correction of complex morphologies. The aim of this study was to analyze the safety, clinical, and radiographic results of this intra-articular surgical technique performed in skeletally mature patients with a minimum follow-up of three years. Fourteen symptomatic adult patients (16 hips) with a mean age of 26 years underwent FNO using surgical hip dislocation and an extended soft tissue flap. Radiographs and radial magnetic resonance imaging (MRI) were obtained before and after surgery to evaluate articular congruency, cartilage damage, and morphologic parameters. Clinical functional evaluation was done using the Nonarthritic Hip Score (NAHS), the Hip Outcome Score (HOS), and the modified Harris Hip Score (mHHS). After surgery, no avascular necrosis was observed, and all the osteotomies healed without complication. The initial neck/shaft angle (range 120 to 150°) improved in all cases to a mean value of 130° ± 4.6 (p < 0.001). In eight of nine valgus hips, the high-positioned fovea capitis changed to a normal position after surgery. The NAHS score improved from a mean of 36.5 ± 14.9 to 82.9 ± 13.9 points after surgery (p < 0.001). After surgery, the mean HOS was 87.1 ± 17.6 points, and the mean mHHS was 78.6 ± 17 points. In this series, femoral neck osteotomy in the adult, although technically more demanding compared with other classic osteotomies, can be considered a safe procedure with considerable potential to correct hip deformities.

Objectives The purpose of this study was to report (1) a different but specific pattern of impingement in hips involved with valgus slipped capital femoral epiphysis (valgus SCFE) and (2) the results of surgical treatment using intracapsular realignment techniques. Design Case series. Setting Multiple academic centers. Patients Six patients with 8 involved hips referred for valgus alignment of proximal femoral epiphysis (valgus SCFE). Intervention Intracapsular realignment osteotomy combined with periacetabular osteotomy if needed. Main outcome measurement The clinical and radiographical results and pathophysiology of motion. Results Eight hips in 6 patients were treated with subcapital (5 hips) or femoral neck (3 hips) osteotomy for realignment. The medially prominent metaphysis created an inclusive impingement at the anterior acetabular wall, whereas the high coxa valga favored impacting impingement at the posterior head-neck junction. The mean preoperative epiphyseal-shaft angle of 110.5 (range 90-125 degrees) was reduced to 62 degrees (range 55-70 degrees) postoperatively. At the last follow-up, all but 1 hip were pain-free and impingement-free, with normal range of motion. One hip was replaced after repeated attempts of correction. The overall hip functional result using modified Merle d'Aubigne scoring system was excellent in 5 hips (18-16 points), good in 2 hips (16-15 points), and poor in 1 hip (6 points). Conclusions Impingement in valgus SCFE deformity is specific and complex. Anatomical realignment can lead to favorable results by the restoration of normal morphology and impingement-free range of motion. Level of evidence Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

The purpose of this study was to determine if there were significant differences between patients submitted to hip arthroscopy (HA) and surgical hip dislocation (SHD) to treat femoro-acetabular impingement (FAI), which variables were significantly associated with hip function before surgery and those predictive of the applied functional outcome scale and its variation rate after surgery. We selected 198 patients treated with HA or SHD with a mean follow-up of 59 months. Inclusion criteria were ages 18–50 years, isolated FAI cam morphology and complete clinical and radiologic documentation. The subjective outcome measure used was the nonarthritic hip score (NAHS). We compared pre-operative and post-operative NAHS, alpha angles and complication rates. Multiple linear regression analyses were performed to find which variables could influence NAHS values. The mean alpha-angle value improved from 71.5° to 40.8°, and mean NAHS improved from 50 to 83 points, with no difference between groups (HA/SHD). We found only a 16.9% influence rate on the pre-operative score, explained by variables of gender/pre-operative alpha angle and presence of degenerative changes/age. The influence rate on the NAHS variation ratio after surgery was 62.8%, explained by the variables of pre-operative score, type of surgery and type of surgery/alpha angle. The complication rate was 7%. FAI surgery can be considered effective in improving patient symptoms. There were no differences in clinical or radiographic results between techniques. We could more accurately predict the variation ratio of NAHS after surgery than its pre-operative value.

Knowledge of the vascular supply of the femoral head is crucial for hip-preserving surgical procedures. The critical area for reshaping cam deformity is at the retinacular vessel penetration, an area with ill-defined topographic anatomy. We performed a cadaver study of the extension of the lateral retinaculum near the head-neck junction, distribution of the arterial vascular foramina, and initial intracapital course of these vessels.In 16 fresh proximal parts of the femur without head-neck deformities, the deep branch of the medial femoral circumflex artery was injected with gadolinium for magnetic resonance imaging (MRI) sequences to identify arterial structures.We found a mean number of 4.5 arterial foramina, showing a predominance from 10 to 12 o'clock. The retinaculum extended 20 mm from 1 to 10 o'clock. The surface distance from the cartilage border to the vascular foramina under the synovial fold was 6.5 mm, and the depth from the same cartilage border to the initial intraosseous vessel pathways was 5.3 mm.The data add further precision to the arterial topography at the retinacular foramina, an area that is crucial for the perfusion of the femoral head. It may overlap with the area of anterolateral cam deformity and plays a role in choosing the cuts for subcapital and intracapital osteotomies.The information is taken from normal hips and may not be directly applicable to the deformed hip. Nevertheless, it is a prerequisite for a surgeon to understand the normal anatomy and use those boundaries to prevent mistakes during intra-articular joint-preserving hip surgical procedures.

Background:Given the high prevalence of patients with hip deformities and no ongoing hip dysfunction, understanding the anatomic factors predicting the symptomatic state is critical. One such variable is how the spinopelvic parameters (SPPs) may interplay with hip anatomic factors.Hypothesis/Purpose:SPPs and femoral- and acetabular-specific parameters may predict which patients will become symptomatic. The purpose was to determine which anatomic characteristics with specific cutoffs were associated with hip symptom development and how these parameters relate to each other.Study Design:Cohort study (Diagnosis); Level of evidence, 2.Methods:548 participants were designated either symptomatic patients (n = 176, scheduled for surgery with hip pain and/or functional limitation) or asymptomatic volunteers (n = 372, no pain) and underwent 3-dimensional magnetic resonance imaging. Multiple femoral (α angle, Ω angle, neck angle, torsion), acetabular (version, coverage), and spinopelvic (pelvic tilt, sacral slope [SS], pelvic incidence) parameters were measured semiautomatically. Normative values, optimal differentiating thresholds, and a logistic regression analysis were computed.Results:Symptomatic patients had larger cam deformities (defined by increased Ω angle and α angle), smaller acetabular coverage, and larger pelvic incidence and SS angles compared with the asymptomatic volunteers. Discriminant receiver operating characteristic analysis confirmed that radial 2-o’clock α angle (threshold 58°-60°, sensitivity 75%-60%, specificity 80%-84%; area under the curve [AUC] = 0.831), Ω angle (threshold 43°, sensitivity 72%, specificity 70%; AUC = 0.830), acetabular inclination (threshold 6°, sensitivity 65%, specificity 70%; AUC = 0.709), and SS (threshold 44°, sensitivity 72%, specificity 75%; AUC = 0.801) ( P < .005) were the best parameters to classify participants. When parameters were entered into a logistic regression, significant positive predictors for the symptomatic patients were achieved for SS, acetabular inclination, Ω angle, and α angle at 2-o’clock, correctly classifying 85% of cases (model sensitivity 72%, specificity 91%; AUC = 0.919).Conclusion:Complex dynamic interplay exists between the hip and SPPs. A cam deformity, acetabular undercoverage, and increased SPP angles are predictive of a hip symptomatic state. SPPs were significant to discriminate between participants and were important in combination with other hip deformities. Symptomatic patients can be effectively differentiated from asymptomatic volunteers based on predictive anatomic factors.

In this study, three-dimensional finite element models based on the specific anatomy of a patient presenting a femoroacetabular impingement of the "cam" type were developed. The finite element meshes were obtained from arthrographic magnetic resonance images captured before and after hip arthroscopy. All soft tissues were considered linear elastic and isotropic and the bones were assumed as rigid. Physiological loads and rotational motions were applied. Stresses and contact pressures were evaluated in these patient specific models in order to better interpret the mechanism of aggression of the cartilages and of the labrum and to evaluate the effectiveness of the surgery. The results of the analyses are presented and discussed. The values obtained for the stresses and contact pressures in the pathological hip were similar to those reported by other models based on idealised geometries or similar reconstruction methodologies and were larger than the ones obtained in the same hip after the surgical treatment. The surgical treatment effectively reduces the intra-articular pressures and stresses approaching the values of a normal hip. Thus, early surgical treatment may help to prevent, or delay, the joint degeneration.

The alpha angle is used to quantify in a single plane the head-neck junction deformity of cam femoro-acetabular impingement (FAI). When the deformity overlaps the superior retinaculum, femoral head osteoplasty in this area can jeopardise intra-articular vascular structures. This study proposes a new angular measure of the linear radial extension of cam deformity as a planning tool for bone resection and compares the accuracy of femoral head osteoplasty using open and arthroscopic surgery.Twenty-five symptomatic patients operated on for FAI were included in this study. Radial magnetic resonance imaging (MRI) was done before and after surgery. Bi-dimensional coordinates of the vascular foramina and radial extension of the deformity (omega angle) were measured. This extension was correlated with the vascular foramina location and alpha-angle value. Accuracy of resection and hip function were evaluated before and after surgery.The cam lesion frequently extended posteriorly. No relation between values of alpha and omega angles was found. Cam resection was complete in 88 % of cases; there was a significant improvement in outcome score after surgery.This study showed that alpha angle, measured in one plane, was not a predictor of the radial extension of cam deformity. To achieve a full resection, it was frequently necessary to extend the femoral head osteoplasty over the retinacular area. Pre-operative determination of the omega angle and location of the vascular foramina helped improve cam resection safety and accuracy.

To determine the reference intervals (RefInt) of the quantitative morphometric parameters of femoroacetabular impingement (FAI) in asymptomatic hips with computed tomography (CT) and determine their dependence on age, side, limb dominance and sex. We prospectively included 590 patients and evaluated 1111 hips with semi-automated CT analysis. We calculated overall, side- and sex-specific parameters for imaging signs of cam [omega and alpha angle (α°)] and pincer-type morphology [acetabular version (ACvers), lateral centre-edge angle (LCEA) and cranio-caudal coverage]. Hip shape was symmetrical and did not depend on limb dominance. The 95% RefInt limits were sex-different for all cam-type parameters and extended beyond current abnormal thresholds. Specifically, the upper limits of RefInt for α° at 12:00, 1:30 and 3:00 o’clock positions were 56°, 70° and 58°, respectively, and 45° for LCEA. Acetabular morphology varied between age groups, with a trend toward an LCEA/ACvers increase over time. Our morphometric measurements can be used to estimate normal hip morphology in asymptomatic individuals. Notably they extended beyond current thresholds used for FAI imaging diagnosis, which was most pronounced for cam-type parameters. We suggest the need to reassess α° RefInt and consider a 60° threshold for the 12:00/3:00 positions and 65-70° for other antero-superior positions. • Hip shape is symmetrical regardless of limb dominance. • Pincer/cam morphology is frequent in asymptomatic subjects (20 and 71%, respectively). • LCEA and acetabular version increases with age (5-7° between opposite age groups). • Femoral morphology is stable after physeal closure (in the absence of pathology). • Alpha and omega angle thresholds should be set according to sex.

BACKGROUND: Pantothenate kinase-associated neurodegeneration is a progressive neurological disorder occurring in both childhood and adulthood. The objective of this study was to design and pilot-test a disease-specific clinical rating scale for the assessment of patients with pantothenate kinase-associated neurodegeneration. METHODS: In this international cross-sectional study, patients were examined at the referral centers following a standardized protocol. The motor examination was filmed, allowing 3 independent specialists in movement disorders to analyze 28 patients for interrater reliability assessment. The scale included 34 items (maximal score, 135) encompassing 6 subscales for cognition, behavior, disability, parkinsonism, dystonia, and other neurological signs. RESULTS: Forty-seven genetically confirmed patients (30 ± 17 years; range, 6-77 years) were examined with the scale (mean score, 62 ± 21; range, 20-106). Dystonia with prominent cranial involvement and atypical parkinsonian features were present in all patients. Other common signs were cognitive impairment, psychiatric features, and slow and hypometric saccades. Dystonia, parkinsonism, and other neurological features had a moderate to strong correlation with disability. The scale showed good internal consistency for the total scale (Cronbach's a = 0.87). On interrater analysis, weighted kappa values (0.30-0.93) showed substantial or excellent agreement in 85% of the items. The scale also discriminated a subgroup of homozygous c.1583C>T patients with lower scores, supporting construct validity for the scale. CONCLUSIONS: The proposed scale seems to be a reliable and valid instrument for the assessment of pediatric and adult patients with pantothenate kinase-associated neurodegeneration. Additional validation studies with a larger sample size will be required to confirm the present results and to complete the scale validation testing. © 2017 International Parkinson and Movement Disorder Society.

There is a wide discrepancy in reported prevalence rates for cam, pincer, and mixed femoroacetabular impingement (FAI), particularly among distinct populations, namely asymptomatic or symptomatic subjects and athletes. No systematic analysis to date has yet compared studies among these groups to determine differences in radiographic signs of FAI.A systematic review of existing literature was performed to determine the prevalence of radiographic signs of FAI among athletes, asymptomatic subjects, and symptomatic patients. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to systematically search PubMed, MEDLINE, CINAHL, and Cochrane databases.We identified 361 studies in our literature search. After considering the exclusion criteria, 60 were included in this systematic review: 15 in athletes, 10 in purely asymptomatic patients, and 35 in symptomatic, non-athlete populations. Cam impingement was significantly (p=0.0003) more common in athletes versus asymptomatic subjects but not compared to symptomatic patients (p=0.107). In addition, cam FAI was significantly more common in symptomatic versus asymptomatic cases (p=0.009). The percentage of patients with cam-type FAI showed significant differences across groups (p=0.006). No significant differences were found between pincer-type FAI morphology prevalence when comparing athletes to symptomatic patients. However, mixed-type FAI was significantly more common in athletes versus asymptomatic subjects (p=0.03) and in asymptomatic versus symptomatic subjects (p=0.015). The percentage of patients with mixed-type FAI showed significant differences across groups (p=0.041). The mean alpha angle was significantly greater in the symptomatic group versus either the asymptomatic or athlete group (p0.001). Significant differences in mean alpha angles were noted across groups (p=0.0000).Imaging suspicion of FAI is common among athletes, asymptomatic, and symptomatic populations. However, significant differences in type and imaging signs of FAI exist among these groups that need to be considered in patients' decision making.

Acute ischaemic stroke has significant attendant morbidity and is one of the top ten causes of childhood death. It requires prompt investigation and management, however little is known about the safety and efficacy of acute thrombolytic therapies in childhood arterial ischaemic stroke. The authors report a case of a 13-year-old girl with an acute basilar thrombosis, successfully treated with intravenous recombinant tissue plasminogen activator and discuss the management of paediatric arterial ischaemic stroke. info:eu-repo/semantics/publishedVersion

Several microsurgical techniques have been described for the treatment of osteonecrosis of the talus (ONT). Recently reported in children, vascularized periosteal grafts showed promising revascularizing properties. We report a novel technique using a pedicled periosteal graft from the first metatarsal bone to treat steroid-induced early Ficat-Arlet stage III ONT in an 11-year-old boy. The patient presented initial favorable clinical and radiological results which were maintained at 34 months during the last follow-up. Through this original technique, and basing on the powerful osteogenic and vasculogenic propreties of periosteal flaps, we could effectively induce bone revascularization and prevent further collapse of the talar dome.

Literature on the reconstruction of the proximal femur in skeletally immature patients with the use of an epiphyseal transplant is scarce and with variable results depending on the indication. We report successful outcomes using a modified vascularized fibular epiphyseal transplant in a 4-year-old boy with an oncologic lesion. We discuss the advantages of supplementing the standard graft with a vascularized fibular periosteal tissue. The vascularized fibular epiphyseal transplant (VFET) is an effective option in the reconstruction of the epiphysis in skeletally immature patients, owing to the advantage of restoring both the joint function and the growth potential in a single surgical operation. Multiple reported cases demonstrate the effectiveness of this complex technique in upper extremity reconstruction. However, literature is scarce regarding its use for the reconstruction of the proximal femur and hip joint. Through this article, we report the use of a VFET in the reconstruction of a proximal femur in a 4-year-old boy after an intra-articular wide excision of an epithelioid hemangioendotelioma. We also discuss the advantages of designing the flap as a composite vascularized epiphyseo-osteo-periosteal flap.

Antiphospholipid antibodies are a recognised prothrombotic risk factor associated with acute ischaemic infarction. Most autoimmune diseases are rare in infants, and in the neonatal period, autoimmunity is related to transplacental passage of maternal immunoglobulin G autoantibodies. Distinguishing between de novo and acquired autoimmunity has important therapeutic implications and is crucial for determining the prognosis. We present a case of a neonatal thrombotic stroke associated with de novo synthesis of antiphospholipid antibodies, a homozygous 1298C/C methylene-tetrahydrofolate reductase mutation and a double-homozygous plasminogen activator inhibitor 1 polymorphism (PAI-1 844A/A and 675 4G/4G), which may have increased the final thrombotic risk. Her mother was not positive for antiphospholipid antibodies. The authors highlight an unequivocal evidence of a de novo case of paediatric antiphospholipid antibody syndrome and emphasise the need for a thorough investigation in cases of neonatal stroke including molecular thrombophilia study. info:eu-repo/semantics/publishedVersion

Atrial flutter is a rare but potentially lethal arrhythmia, characterized by a rapid regular atrial rate, accompanied by variable degrees of atrioventricular block. Two cases of neonatal atrial flutter are described. The first case was diagnosed in utero at 38 weeks of gestation and converted to sinus rhythm by electric shock on the eighth day of life. Case two, diagnosed at 11 days old, with a background of acute bronchiolitis and tachycardia associated with a cardiac tumor, was refractory to electrical cardioversion. Both cases proved difficult to convert to sinus rhythm, but there was clinical improvement and no recurrence. These two cases exemplify the variability of outcomes achieved with anti-arrhythmic agents and direct current cardioversion.

Idiopathic congenital chylothorax is defined as an abnormal accumulation of lymphatic fluid within the pleural space and is a relatively rare condition. It is a cause of progressive respiratory distress with nutritional and immunological consequences. Treatment of congenital chylothorax has been conservative management and cases unresponsive usually require surgery. We report a case of idiopathic congenital chylothorax treated with octreotide (a somatostatin analogue), avoiding surgery after failed conservative medical treatment. The patient promptly improved after initiation of endovenous octreotide treatment (10 µg/kg/h) with no observed side effects. info:eu-repo/semantics/publishedVersion

Endothelium-derived vasoactive factors are produced by the endothelium activated by effective stimulus, and with paracrine regulatory activity of the tone/proliferation of the vascular smooth muscle and platelet function. They are divided in two groups: endothelium-derived relaxing and contracting factors. Among the endothelium-derived relaxing factors, PG I2, EDRF (NO or other nitrous compound) and EDHF (still unidentified) have been considered Synthetized by the endothelium after stimulation by plasmatic, platelet-derived and endothelium-derived substances and mechanisms, towards the vascular smooth muscle (myorelaxing/cytostatic) and the platelets (antiaggregation). The endothelium-derived contracting factors include the EDCF1 (endothelins, 21 amino acids peptides), EDCF2 (O2-) and TxA2. Its production, induced by stimulus similar to those for relaxing factors, promotes constriction/mitogenesis of the vascular smooth muscle and platelet aggregation. Probably, endothelin-1 has indirect actions over hormonal mechanisms of cardiovascular and renal regulation. The vascular system establishes a tight regulation over the production of these endothelium-derived vasoactive factors. Its loss (usually due to alteration of endothelial responsiveness to stimulation) allows local or generalized modifications of the vascular tone. These can depend on hypertension, atherosclerosis, ischemia-reperfusion lesion, diabetes, inflammation and situations of farmacotoxicity (all developing vasoconstriction/vasospasm) or by septicemia (leading to vasodilation). This disregulation is also involved in the pathogenesis of hypertension, atherosclerosis and ischemia-reperfusion. The vascular tone regulation by endothelium also leads to systemic consequences. Essentially by decreasing cardiac, cerebral and renal blood flow it implies morphologic and functional modifications of these organs.

OBJECTIVE: Our objectives were to use 3D computed tomography (CT) to define head-neck morphologic gender-specific and normative parameters in asymptomatic individuals and use the omega angle (Ω°) to provide quantification data on the location and radial extension of a cam deformity. METHODS: We prospectively included 350 individuals and evaluated 188 asymptomatic hips that underwent semiautomated CT analysis. Different thresholds of alpha angle (α°) were considered in order to analyze cam morphology and determine Ω°. We calculated overall and gender-specific parameters for imaging signs of cam morphology (Ω° and circumferential α°). RESULTS: The 95 % reference interval limits were beyond abnormal thresholds found in the literature for cam morphology. Specifically, α° at 3/1 o´clock were 46.9°/60.8° overall, 51.8°/65.4° for men and 45.7°/55.3° for women. Cam prevalence, magnitude, location, and epicenter were significantly gender different. Increasing α° correlated with higher Ω°, meaning that higher angles correspond to larger cam deformities. CONCLUSION: Hip morphometry measurements in this cohort of asymptomatic individuals extended beyond current thresholds used for the clinical diagnosis of cam deformity, and α° was found to vary both by gender and measurement location. These results suggest that α° measurement is insufficient for the diagnosis of cam deformity. Enhanced morphometric evaluation, including 3D imaging and Ω°, may enable a more accurate diagnosis. KEY POINTS: • 95% reference interval limits of cam morphotype were beyond currently defined thresholds. • Current morphometric definitions for cam-type morphotype should be applied with care. • Cam prevalence, magnitude, location, and epicenter are significantly gender different. • Cam and alpha angle thresholds should be defined according to sex/location. • Quantitative 3D morphometric assessment allows thorough and reproducible FAI diagnosis and monitoring. info:eu-repo/semantics/publishedVersion

In this study, a three-dimensional finite element (FE) model based on the specific anatomy of a patient presenting a femoroacetabular impingement of the 'cam'-type is developed. The FE meshes of the structures of interest are obtained from arthrographic magnetic resonance images. All soft tissues are considered linear elastic and isotropic, and the bones were assumed rigid. A compression of the femur on the acetabular cavity as well as flexural movements and internal rotations are applied. Stresses and contact pressures are evaluated in this patient-specific model in order to better interpret the mechanism of aggression of the femoral and acetabular cartilages. The corresponding results are presented and discussed. The values obtained for the contact pressures are similar to those reported by other models based on idealised geometries. An FE analysis of a non-cam hip is also performed for comparison with the pathological case.