Femoral morphology differs between deficient and excessive acetabular coverage
Femoral morphology differs between deficient and excessive acetabular coverage
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DOI：
10.1007/s11999-008-0141-7
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发表时间：
2008-04-01
影响因子：
4.2
通讯作者：
Siebenrock, K. A.
中科院分区：
文献类型：
--
作者：
Steppacher, S. D.;Tannast, M.;Siebenrock, K. A.
在骨骼发育过程中发生的股骨头结构畸形（如Legg-Calve-Perthes病）与髋臼的个体形状有关，但尚不清楚髋臼形状的差异是否与股骨近端形状的差异有关。我们质疑髋臼覆盖量是否影响股骨形态。我们回顾性比较了50例（50髋）髋关节发育不良（外侧中心-边缘角[LCE] = 14度）患者和45例（50髋）深髋臼（LCE >= 39度）患者的股骨近端解剖结构。使用MRI关节造影，我们测量了头部球形，骨骺形状，骨骺延伸，和股骨头颈偏移。深髋臼与更球形的股骨头形状、骨骺高度增加、骨骺向股骨颈明显延伸以及偏心距增加相关。相比之下，发育不良的髋关节表现为椭圆形股骨头，骨骺高度降低，骨骺延伸不明显，头颈偏移减少。不同髋臼覆盖率的髋关节与不同的股骨近端解剖结构相关。发育不良髋关节的非球形股骨头可能导致髋臼重新定向手术后关节不协调。
Structural deformities of the femoral head occurring during skeletal development (eg, Legg-Calve-Perthes disease) are associated with individual shapes of the acetabulum but it is unclear whether differences in acetabular shape are associated with differences in proximal femoral shape. We questioned whether the amount of acetabular coverage influences femoral morphology. We retrospectively compared the proximal femoral anatomy of 50 selected patients (50 hips) with developmental dysplasia of the hip (lateral center-edge angle [LCE] = 14 degrees) with 45 selected patients (50 hips) with a deep acetabulum (LCE >= 39 degrees). Using MRI arthrography we measured head sphericity, epiphyseal shape, epiphyseal extension, and femoral head-neck offset. A deep acetabulum was associated with a more spherical head shape, increased epiphyseal height with a pronounced extension of the epiphysis towards the femoral neck, and an increased offset. In contrast, dysplastic hips showed an elliptical femoral head, decreased epiphyseal height with a less pronounced extension of the epiphysis, and decreased head-neck offset. Hips with different acetabular coverage are associated with different proximal femoral anatomy. A nonspherical head in dysplastic hips could lead to joint incongruity after an acetabular reorientation procedure.