The Risk of Impingement With Sexual Activity in Femoroacetabular Impingement Syndrome Due to Cam Morphology: Shape Matters

Kyle R. Sochacki, Thomas R. Yetter, Hannah Morehouse, Domenica Delgado, Shane J. Nho, Joshua D. Harris

Research output: Contribution to journalArticle

Abstract

Background: Sexual difficulties and dysfunction are common in patients with femoroacetabular impingement syndrome (FAIS) secondary to hip pain and stiffness. Purpose: To determine the risk of impingement in patients with FAIS during common sexual positions using 3-dimensional computer-simulated collision detection before and after cam correction. Study Design: Descriptive laboratory study. Methods: Ten computed tomography scans of the pelvis and femur from patients with FAIS due to isolated cam morphology were retrospectively reviewed. Three-dimensional osseous models were developed using Mimics software. The cam deformity was then completely corrected. Simulations of hip range of motion for the most common sexual positions for men (n = 15) and women (n = 14) were conducted before and after cam resection. Impingement was determined for each sexual position. Position safety was defined as ≤20% of models demonstrating impingement in a position. Descriptive and simple comparative statistics were calculated. Results: There was no sexual position that was impingement free in all models before cam correction. After cam correction, 11 (37.9%) of 29 total positions were impingement free. There was a significant decrease in impingement from before to after cam correction (40.7% vs 11.4%, respectively, of all female positions [P <.0001]; 26.0% vs 6.7%, respectively, of all male positions [P <.0001]). There was a significant increase in the number of “safe” positions from before to after cam correction (4 vs 11, respectively, of all female positions [P =.008]; 7 vs 15, respectively, of all male positions [P =.001]). Conclusion: After cam correction, there was a significant reduction in the impingement rate and a significant increase in the number of “safe” sexual positions. Clinical Relevance: Impingement in patients with cam morphology is common during sexual activity. Surgical correction of cam morphology significantly reduces the rate of impingement. Although this laboratory imaging-only study did not account for patient symptoms, this likely translates to significant symptomatic improvement during sexual activity after surgical cam correction.

Original languageEnglish (US)
JournalOrthopaedic Journal of Sports Medicine
Volume6
Issue number8
DOIs
StatePublished - Aug 1 2018

Keywords

  • FAI
  • cam
  • femoroacetabular impingement syndrome
  • hip arthroscopic surgery
  • sex

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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