Prevalence of Malformations of the Hip Joint and Their Relationship to Sex, Groin Pain, and Risk of Osteoarthritis A Population-Based Survey
Prevalence of Malformations of the Hip Joint and Their Relationship to Sex, Groin Pain, and Risk of Osteoarthritis A Population-Based Survey
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DOI：
10.2106/jbjs.h.01674
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发表时间：
2010-05-01
影响因子：
5.3
通讯作者：
Troelsen, Anders
中科院分区：
文献类型：
--
作者：
Gosvig, Kasper Kjaerulf;Jacobsen, Steffen;Troelsen, Anders
背景：虽然股骨髋臼撞击的临床后果已得到很好的描述，但人们对普通人群中与这种情况相关的解剖畸形的患病率、这种情况的自然史以及骨关节炎发展的风险估计知之甚少。 方法：研究材料来自哥本哈根 4151 名个体的横断面人群放射学和问卷调查数据库 1991 年至 1994 年间的骨关节炎亚研究队列。受试者主要是白人，全部来自丹麦哥本哈根奥斯特布罗县。 1332 名男性和 2288 名女性符合本研究的纳入标准。根据放射学标准，髋部被分类为无畸形或存在由深髋臼窝、手枪握把畸形或深髋臼窝和手枪握把畸形组合组成的异常。髋骨关节炎在放射学上定义为最小关节间隙宽度为毫米。 结果：在 3620 名研究对象中，男性和女性髋关节畸形的患病率分别为：髋臼发育不良为 4.3% 和 3.6%；深髋臼窝为 15.2% 和 19.4%；手枪握把畸形分别为 19.6% 和 5.2%；深髋臼窝和手枪握把畸形的组合分别为 2.9% 和 0.9%。男性和女性髋臼顶正常患病率分别为80.5%和77.0%。我们发现，X 线照片显示髋关节畸形的受试者腹股沟疼痛的患病率没有显着增加（所有 p > 0.13）。深髋臼窝是发生骨关节炎的重要危险因素（风险比，2.4），手枪式握把畸形（风险比，2.2）也是如此。未发现髋臼发育不良和受试者性别是发生髋骨关节炎的显着危险因素（分别为 p = 0.053 和 p = 0.063）。男性髋骨关节炎的患病率为 9.5%，女性为 11.2%。男性髋骨关节炎患者伴随畸形的患病率为 71.0%，女性髋骨关节炎患者为 36.6%。结论：在我们的研究人群中，深髋臼窝和手枪式握把畸形是常见的影像学表现，并且与髋骨关节炎风险增加相关。与髋关节畸形相关的骨关节炎的高患病率表明，应考虑更多地关注畸形的早期识别。
Background: Although the clinical consequences of femoroacetabular impingement have been well described, little is known about the prevalence of the anatomical malformations associated with this condition in the general population, the natural history of the condition, and the risk estimates for the development of osteoarthritis.Methods: The study material was derived from a cross-sectional population-based radiographic and questionnaire database of 4151 individuals from the Copenhagen Osteoarthritis Substudy cohort between 1991 and 1994. The subjects were primarily white, and all were from the county of Osterbro, Copenhagen, Denmark. The inclusion criteria for this study were met by 1332 men and 2288 women. On the basis of radiographic criteria, the hips were categorized as being without malformations or as having an abnormality consisting of a deep acetabular socket, a pistol grip deformity, or a combination of a deep acetabular socket and a pistol grip deformity. Hip osteoarthritis was defined radiographically as a minimum joint-space width of mm.Results: The male and female prevalences of hip joint malformations in the 3620 study subjects were 4.3% and 3.6%, respectively, for acetabular dysplasia;15.2% and 19.4% for a deep acetabular socket; 19.6% and 5.2% for a pistol grip deformity; and 2.9% and 0.9% for a combination of a deep acetabular socket and pistol grip deformity. The male and female prevalences of a normal acetabular roof were 80.5% and 77.0%. We found no significantly increased prevalence of groin pain in subjects whose radiographs showed these hip joint malformations (all p > 0.13). A deep acetabular socket was a significant risk factor for the development of osteoarthritis (risk ratio, 2.4), as was a pistol grip deformity (risk ratio, 2.2). Acetabular dysplasia and the subject's sex were not found to be significant risk factors for the development of hip osteoarthritis (p = 0.053 and p = 0.063, respectively). The prevalence of hip osteoarthritis was 9.5% in men and 11.2% in women. The prevalence of concomitant malformations was 71.0% in men with hip osteoarthritis and 36.6% in women with hip osteoarthritis.Conclusions: In our study population, a deep acetabular socket and a pistol grip deformity were common radiographic findings and were associated with an increased risk of hip osteoarthritis. The high prevalence of osteoarthritis in association with malformations of the hip joint suggests that an increased focus on early identification of malformations should be considered.