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也在增加。在我国，大多数髋关节骨关节病的病因被认为是先天性半脱位或脱位。我们从1989年起提出骨盆后倾减少股骨头覆盖的假设，并研究了姿势畸形与髋关节骨关节病的关系。本研究的目的是利用三维重建系统分析X线片，并证明姿势畸形引起的股骨覆盖范围的减少。第一组为20例腰椎后凸畸形且髋关节正常的患者，第二组为8例腰椎后凸畸形并髋关节骨关节病患者。我们测量了骨盆倾斜角， ...更多信息 在直立位的侧位片上检查患者。接下来，我们在直立位的正面视图中测量X线片的中心边缘角。结果：1）骨盆倾斜角：第一组的后倾角平均值和标准差为18.5 ± <plus-minus>7.5，第二组为22.5<plus-minus>; 2）CE角：第一组的CE角平均值和标准差为29.5 ± <plus-minus>7.5，第二组为28.1<plus-minus><plus-minus><plus-minus>;而前半部分股骨头的平均值和标准差分别为67.3 ± <plus-minus>8.2和60.1 ± min。本研究表明，腰椎后凸引起的股骨覆盖率降低可能是其中一个因素。我们先前的研究显示，腰椎后凸畸形患者髋关节周围肌肉（髂腰肌、股四头肌、肱二头肌）的活动增加。因此，在腰椎后凸畸形患者中，骨盆后倾引起的负重区减小和髋关节合力增加被认为是髋关节骨关节病的原因。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