Ito Hiroshi, Matsuno Takeo, Hirayama Teruhisa, Tanino Hiromasa, Yamanaka Yasuhiro, Minami Akio
Department of Orthopaedic Surgery, Asahikawa Medical College, Midorigaoka Higashi 2-1-1-1, Asahikawa 078-8510, Japan.
Skeletal Radiol. 2009 Feb;38(2):131-9. doi: 10.1007/s00256-008-0601-x. Epub 2008 Oct 1.
Little data exists on the original morphology of acetabular dysplasia obtained from patients without radiographic advanced osteoarthritic changes. The aim of this study was to investigate the distribution and degree of acetabular dysplasia in a large number of patients showing no advanced degenerative changes using three-dimensional computed tomography (3DCT).
Eighty-four dysplastic hips in 55 consecutive patients were studied. All 84 hips were in pre- or early osteoarthritis without radiographic evidence of joint space narrowing, formation of osteophytes or cysts, or deformity of femoral heads. The mean age at the time of CT scan was 35 years (range 15-64 years). 3D images were reconstructed and analyzed using recent computer imaging software (INTAGE Realia and Volume Player). Deficiency types and degrees of acetabular dysplasia were precisely evaluated using these computer software.
The average Harris hip score at CT scans was 82 points. Twenty-two hips (26%) were classified as anterior deficiency, 17 hips (20%) as posterior deficiency, and 45 hips (54%) as lateral deficiency. No significant difference was found in the Harris hip score among these groups. The analysis of various measurements indicated wide variations. There was a significant correlation between the Harris hip score and the acetabular coverage (p < 0.001).
Our results indicated wide variety of deficiency type and degree of acetabular dysplasia. Hips with greater acetabular coverage tended to have a higher Harris hip score.
关于未出现影像学上晚期骨关节炎改变的患者髋臼发育不良的原始形态，现有数据较少。本研究的目的是使用三维计算机断层扫描（3DCT）来调查大量未出现晚期退变改变的患者髋臼发育不良的分布及程度。
对连续55例患者的84个发育不良髋关节进行研究。所有84个髋关节均处于骨关节炎前期或早期，无关节间隙变窄、骨赘或囊肿形成、或股骨头畸形的影像学证据。CT扫描时的平均年龄为35岁（范围15 - 64岁）。使用最新的计算机成像软件（INTAGE Realia和Volume Player）重建并分析3D图像。使用这些计算机软件精确评估髋臼发育不良的缺陷类型和程度。
CT扫描时的平均Harris髋关节评分是82分。22个髋关节（26%）被归类为前侧缺陷，17个髋关节（20%）为后侧缺陷，45个髋关节（54%）为外侧缺陷。这些组之间的Harris髋关节评分未发现显著差异。各种测量分析显示差异很大。Harris髋关节评分与髋臼覆盖率之间存在显著相关性（p < 0.001）。
我们的结果表明髋臼发育不良的缺陷类型和程度多种多样。髋臼覆盖率较高的髋关节往往具有较高的Harris髋关节评分。
