Causal factors of hip arithrosis-relation with spinal kyphosis

随着老年人口的增加，髋关节骨关节病的患者数量一直在增加。在我国，髋关节骨关节病的病因大多被认为是先天性半脱位或脱位。在我科，我们提出了骨盆后倾会减少股骨头覆盖率的假说，并从1989年开始研究了姿势畸形与髋关节病的相关性。本研究的目的是利用三维重建系统对X线片进行分析，并显示体位畸形引起的股骨覆盖率的降低。第一组为20例正常髋关节的腰椎后凸患者，第二组为8例腰椎后凸并髋关节骨关节病患者。我们测量了…的骨盆倾斜角Se患者在X线片上多处于侧位直立位置。接下来，我们测量了正位正位X线片上的中心-边缘角度。结果：1)骨盆倾斜角：第一组后倾角和标准差平均值为18.5；正负7.5，第二组为22.5；正负；2)CE角：第一组CE角和标准差平均值为29.5；正负7.5，第二组为28.1；正负；13)股骨头覆盖率：第一组股骨头覆盖率平均为75.1；正负6.3，第二组为71.3；正负10.5。然而，集中在股骨头前半部分，平均和标准差为67.3；正负8.2，第二组为60.1；正分讨论：许多因素被认为是髋关节骨关节病的原因。本研究表明，腰椎后凸引起的股骨覆盖率降低可能是其中的一个因素。我们先前的研究表明，腰椎后凸患者髋关节周围的肌肉活动(髂腰肌、股四头肌、二头肌)肌电活动增加。因此，在腰椎后凸患者中，骨盆后倾引起的负重区的减少和髋关节合力的增加被认为是髋关节骨关节病的原因。较少

+++Accumpaning with a increse of the population of old aged poole, number of patients with osteoarthrosis of the hip has been increasing. In our country, most of causes of osteoarthrosis of the hip are considered to be a congenital subluxation or dislocation. However, the patients whose radiographies showed no structual abnormalities is increasing recently.In our department, we made a hypothesis that posterior pelvic tilt decreases femoral head coverage and have studied the correlation between postural deformity and osteoarthrosis of the hip from 1989. The purpose of this study is to analyze the radiography using three dimensional reconstruction system and demonstrate the decrease of femoral coverage caused by postural deformity.PATIENTS and METHODS : Patients were devided two groups. Group one consisted of 20 patients with lumber kyphosis and normal hip joints and group two consisted of 8 patients with lumber kyphosis and osteoarthrosis of the hip. We measured pelvic tilt angle of the … More se patients on the radiographies in the lateral view of upright position. Next we measured center-edge angle on the radiographies in the frontal view of upright position. Furthermore, we analyzed femoral head coverage on the radiography using computer program ACX made by Konishi.RESULTS : 1) Pelvic tilt angel : The average of postrior tilt angle and standard deviation in the group one was 18.5<plus-minus>7.5 and that of group two was 22.5<plus-minus>2) CE angle : The average of CE angle and standard deviation in the group one was 29.5<plus-minus>7.5 and that of group two was 28.1<plus-minus>13) Femoral head coverage : The average of femoral head coverage in the group one was 75.1<plus-minus>6.3 and that of group two was 71.3<plus-minus>10.5. Focused on part of anrerior half oh femoral head, however, the average and standard deviation was 67.3<plus-minus>8.2 and that of group two was 60.1<plus-minDISCUSSION : Many fctors have been considered to be cause of osteoarthrosis of the hip. The present study demonstrated the decrease of femoral coverage caused by lumber kyphosis might be one of these factors. Our previous study showed an muscle activities (iliopsoas, quadriceps, biceps muscles) around hip joint increased electromyographically in the patients with lumber kyphosis. Therefore, in the patients with lumber kyphosis, the decrease of weight bearing zone caused by posterior pelvic tilt and the incrsase of resultant force at the hip joint are considered to be causes for osteoarthrosis of the hip. Less