Relationship between offset angle alpha and hip chondral injury in femoroacetabular impingement
Relationship between offset angle alpha and hip chondral injury in femoroacetabular impingement
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DOI：
10.1016/j.arthro.2008.01.010
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发表时间：
2008-06-01
影响因子：
4.7
通讯作者：
Philippon, Marc J.
中科院分区：
文献类型：
--
作者：
Johnston, Todd L.;Schenker, Mara L.;Philippon, Marc J.
目的：本研究的目的是检查凸轮病变的大小与软骨损伤、盂唇损伤或髋关节活动范围变化之间的关系，并伴有股骨髋臼撞击（FAI）的体征和症状。方法：对102例连续出现FAI体征和症状的患者进行交叉床侧位X线片检查。排除了X线片显示过度外旋、发育不良、严重关节炎、缺血性坏死或Legg-Calve-Perthes综合征的患者，留下82例患者进行分析（47例男性，35例女性;平均年龄25岁[范围，12 - 55岁]）。用数字测角仪从膜测量偏移角α。患者随后接受髋关节镜检查，并前瞻性记录手术结果和髋关节活动度。结果如下：偏角α越大，髋臼边缘软骨缺损（P = 0.044）和髋臼软骨全层分层（P = 0.034）的出现越明显。盂唇基底脱离的患者具有更高的偏移角α（P = 0.016）。偏角α偏高与男性相关（P = 0.001），与关节活动度减少相关（P <0.05），但与年龄无关。结论：凸轮型FAI，通过增加偏角α测量，与增加的软骨损伤、盂唇损伤和活动范围减少相关。证据等级：II级，基于普遍适用的金标准的连续患者制定诊断标准。
Purpose: The purpose of this study was to examine the relationship between the size of cam lesions and the presence of cartilage damage, labral damage, or changes in range of motion in the hips with signs and symptoms of femoroacetabular impingement (FAI). Methods: Cross-table lateral radiographs were available for 102 consecutive patients presenting with signs and symptoms of FAI. Radiographs with excessive external rotation, dysplasia, severe arthritis, avascular necrosis, or Legg-Calve-Perthes syndrome were excluded, leaving 82 patients available for analysis (47 men, 35 women; average age, 25 yr [range, 12 to 55 yr]). Offset angle alpha was measured from the films with a digital goniometer. Patients subsequently underwent hip arthroscopy and the surgical findings and hip range of motion were prospectively recorded. Results: Higher offset angle alpha was associated with the presence of acetabular rim chondral defects (P = .044) and full-thickness delamination of the acetabular cartilage (P = .034). Patients with detachment of the base of the labrum had a higher offset angle alpha (P = .016). Higher offset angle alpha was related to male sex (P = .001) and decreased range of motion (P < .05), but not to age. Conclusions: Cam-type FAI, as measured by an increased offset angle alpha, was correlated with increased chondral damage, labral injury, and decreased range of motion. Level of Evidence: Level II, development of diagnostic criteria on basis of consecutive patients with universally applied gold standard.