{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T11:34:57Z","timestamp":1792668897565,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To identify factors associated with ease of hip distraction at the time of hip arthroscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of patients 17\u201350 years old undergoing hip arthroscopy with a single high\u2010volume hip arthroscopist was performed from 2014 to 2020. Demographics, clinical history, examination, and imaging findings were collected. Distractibility was quantified using turns of fine traction (1 turn\u2009=\u20094\u00a0mm axial distraction) with the patient paralyzed on a fracture table with a well\u2010padded perineal post Fine axial traction was applied after the patient\u2019s perineum contacted the post. Demographic and clinical predictors of ease of distractibility were analyzed with simple linear regression models. Significant predictors were subsequently added to a multivariable linear regression model, estimating the effect of each variable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 453 patients were included, with an average age of 31.6 years (\u00b1\u20099.2) and 45.9% females. In univariate analysis, gender, race, BMI, range of motion, hyperextension\u2013external rotation (HEER) test, the abduction\u2013extension\u2013external rotation test, and lateral center edge angle (LCEA) were associated with the number of fine traction turns required to distract the hip. On multivariable analysis, lower LCEA (<jats:italic>p<\/jats:italic>\u2009=\u20090.002), female gender (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and a positive HEER test (<jats:italic>p<\/jats:italic>\u2009=\u20090.045) were associated with decreased turns required for adequate hip distraction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Female gender, decreased LCEA, and a positive HEER test are associated with decreased axial traction required for adequate hip distraction at the time of hip arthroscopy. As ease of distractibility has been associated with hip microinstability, these findings may allow pre\u2010operative identification of hip instability patients and aid in pre\u2010operative counseling, risk stratification and capsular management planning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical relevance<\/jats:title><jats:p>Preoperative identification of risk factors for ease of hip distraction may raise pre\u2010surgical suspicion and, when coupled with other intraoperative findings, may aid in the diagnosis and management of hip microinstability.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-06925-4","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T04:02:30Z","timestamp":1647921750000},"page":"2188-2194","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Female gender, decreased lateral center edge angle and a positive hyperextension\u2013external rotation test are associated with ease of hip distractability at time of hip arthroscopy"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7351-1376","authenticated-orcid":false,"given":"Daniel M.","family":"Curtis","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Reno Orthopedic Center 555 N. Arlington Ave. 89503 Reno NV USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Michael","family":"Pullen","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Medical University of South Carolina Charleston SC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain R.","family":"Murray","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Money","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Rothman Institute Orlando FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Segovia","sequence":"additional","affiliation":[{"name":"<!--<label>5<\/label>--> Stanford University Redwood City CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc R.","family":"Safran","sequence":"additional","affiliation":[{"name":"<!--<label>5<\/label>--> Stanford University Redwood City CA 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November 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 February 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 March 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"DC reports a non-financial interest (Editorial Board: Arthroscopy) unrelated to the current manuscript. IM reports a financial interest (Consultant: Arthrex) and non-financial interests (Editorial Board: Bone & Joint Journal and Bone & Joint Research) unrelated to the current manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study received institutional review board approval at Stanford University.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was not needed for this study since it was a retrospective analysis.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}