Steppacher S D, Tannast M, Werlen S, Siebenrock K A
Department of Orthopaedic Surgery, Inselspital, University of Bern, Murtenstrasse, 3010, Bern, Switzerland.
Clin Orthop Relat Res. 2008 Apr;466(4):782-90. doi: 10.1007/s11999-008-0141-7. Epub 2008 Feb 21.
Structural deformities of the femoral head occurring during skeletal development (eg, Legg-Calvé-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] < or = 25 degrees ; acetabular index > or = 14 degrees ) with 45 selected patients (50 hips) with a deep acetabulum (LCE > or = 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.
Level IV, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidence.
骨骼发育过程中出现的股骨头结构畸形（如Legg-Calvé-Perthes病）与髋臼的个体形状有关，但髋臼形状的差异是否与股骨近端形状的差异相关尚不清楚。我们质疑髋臼覆盖量是否会影响股骨形态。我们回顾性比较了50例选定的髋关节发育不良患者（50髋，外侧中心边缘角[LCE]≤25°；髋臼指数≥14°）与45例选定的髋臼较深患者（50髋，LCE≥39°）的股骨近端解剖结构。使用磁共振关节造影，我们测量了股骨头球形度、骨骺形状、骨骺延伸以及股骨头颈偏移。髋臼较深与更球形的头部形状、骨骺高度增加且骨骺向股骨颈明显延伸以及偏移增加有关。相比之下，发育不良的髋关节表现为椭圆形股骨头、骨骺高度降低且骨骺延伸不明显以及头颈偏移减少。髋臼覆盖不同的髋关节与不同的股骨近端解剖结构相关。发育不良髋关节中的非球形股骨头可能导致髋臼重新定向手术后关节不匹配。
IV级，回顾性比较研究。有关证据水平的完整描述，请参阅作者指南。
