Cartilage Thickness in the Hip Measured by MRI and Stereology Before and After Periacetabular Osteotomy
Cartilage Thickness in the Hip Measured by MRI and Stereology Before and After Periacetabular Osteotomy
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DOI：
10.1007/s11999-010-1310-z
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发表时间：
2010-07-01
影响因子：
4.2
通讯作者：
Troelsen, Anders
中科院分区：
文献类型：
--
作者：
Mechlenburg, Inger;Nyengaard, Jens R.;Troelsen, Anders
未经治疗的髋关节发育不良可导致关节退行性变和早期继发性骨关节炎。虽然大多数髋臼周围截骨术（PAO）是为了缓解症状，但截骨术被认为可以减缓或防止退变，除非已经发生了不可修复的软骨损伤。因此，我们确定了（1）PAO后髋关节软骨厚度是否发生变化，以及（2）有多少患者发生髋臼唇撕裂以及髋臼唇撕裂是否与PAO后软骨变薄有关。我们前瞻性地随访了22名女性，4名髋关节发育不良的男性在PAO前和术后1年和2年半再次进行MRI，以确定是否发生软骨变薄（反映骨关节炎）。用体视学方法测量股骨和髋臼软骨的厚度。术后3.5年，26例患者中有18例接受MR关节造影检查，以确定是否存在髋臼唇撕裂，髋臼软骨厚度在术后1年和2.5年之间存在差异（术前1.40 mm，术后1年1.47 mm，术后2A 1/2年1.35 mm），但股骨软骨在所有时间均相似（术前1.38 mm，术后1年1.43 mm，术后2A 1/2年1.38 mm）。18例患者中有17例发生盂唇撕裂。术后2A 1/2年的肱骨厚度与术前相比没有变化，表明在PAO术后短期随访期间骨关节炎没有进展。
Untreated hip dysplasia can result in a degenerative process joint and secondary osteoarthritis at an early age. While most periacetabular osteotomies (PAOs) are performed to relieve symptoms, the osteotomy is presumed to slow or prevent degeneration unless irreparable damage to the cartilage has already occurred.We therefore determined (1) whether changes in the thickness of the cartilage in the hip occur after PAO, and (2) how many patients had an acetabular labral tear and whether labral tears are associated with thinning of the cartilage after PAO.We prospectively followed 22 women and four men with hip dysplasia with MRI before PAO and again 1 year and 2A1/2 years postoperatively to determine if cartilage thinning (reflecting osteoarthritis) occurred. The thickness of the femoral and acetabular cartilage was estimated with a stereologic method. Three and one-half years postoperatively, 18 of 26 patients underwent MR arthrography to investigate if they had a torn acetabular labrum.The acetabular cartilage thickness differed between 1 and 2A1/2 years postoperatively (preoperative 1.40 mm, 1 year postoperatively 1.47 mm, and 2A1/2 years postoperatively 1.35 mm), but was similar at all times for the femoral cartilage (preoperative 1.38 mm, 1 year postoperatively 1.43 mm, and 2A1/2 years postoperatively 1.38 mm.) Seventeen of 18 patients had a torn labrum. The tears were located mainly superior on the acetabular rim.Cartilage thickness 2A1/2 years after surgery compared with preoperatively was unchanged indicating the osteoarthritis had not progressed during short-term followup after PAO.