Pollard T C B, Villar R N, Norton M R, Fern E D, Williams M R, Murray D W, Carr A J
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Headington, Oxford OX3 7LD, UK.
J Bone Joint Surg Br. 2010 Feb;92(2):209-16. doi: 10.1302/0301-620X.92B2.22850.
Femoroacetabular impingement causes pain in the hip in young adults and may predispose to the development of osteoarthritis. Genetic factors are important in the aetiology of osteoarthritis of the hip and may have a role in that of femoroacetabular impingement. We compared 96 siblings of 64 patients treated for primary impingement with a spouse control group of 77 individuals. All the subjects were screened clinically and radiologically using a standardised protocol for the presence of cam and pincer deformities and osteoarthritis. The siblings of those patients with a cam deformity had a relative risk of 2.8 of having the same deformity (66 of 160 siblings hips versus 23 of 154 control hips, p < 0.00001). The siblings of those patients with a pincer deformity had a relative risk of 2.0 of having the same deformity (43 of 116 sibling hips versus 29 of 154 control hips, p = 0.001). Bilateral deformity occurred more often in the siblings (42 of 96 siblings versus 13 of 77 control subjects, relative risk 2.6, p = 0.0002). The prevalence of clinical features in those hips with abnormal morphology was also greater in the sibling group compared with the control group (41 of 109 sibling hips versus 7 of 46 control hips, relative risk 2.5, p = 0.007). In 11 sibling hips there was grade-2 osteoarthritis according to Kellgren and Lawrence versus none in the control group (p = 0.002). Genetic influences are important in the aetiology of primary femoroacetabular impingement. This risk appears to be manifested through not only abnormal joint morphology, but also through other factors which may modulate progression of the disease.
股骨髋臼撞击症会导致年轻成年人髋关节疼痛，并可能促使骨关节炎的发展。遗传因素在髋关节骨关节炎的病因中很重要，在股骨髋臼撞击症的病因中可能也起作用。我们将64例接受原发性撞击症治疗患者的96名兄弟姐妹与77名个体组成的配偶对照组进行了比较。所有受试者均按照标准化方案进行临床和放射学检查，以确定是否存在凸轮和钳夹畸形以及骨关节炎。患有凸轮畸形患者的兄弟姐妹出现相同畸形的相对风险为2.8（160例兄弟姐妹髋关节中有66例，154例对照髋关节中有23例，p<0.00001）。患有钳夹畸形患者的兄弟姐妹出现相同畸形的相对风险为2.0（116例兄弟姐妹髋关节中有43例，154例对照髋关节中有29例，p = 0.001）。双侧畸形在兄弟姐妹中更常见（96名兄弟姐妹中有42例，77名对照受试者中有13例，相对风险2.6，p = 0.0002）。与对照组相比，兄弟姐妹组中形态异常髋关节的临床特征患病率也更高（109例兄弟姐妹髋关节中有41例，46例对照髋关节中有7例，相对风险2.5，p = 0.007）。根据凯尔格伦和劳伦斯分级，11例兄弟姐妹髋关节中有2级骨关节炎，而对照组中无（p = 0.002）。遗传影响在原发性股骨髋臼撞击症的病因中很重要。这种风险似乎不仅通过异常的关节形态表现出来，还通过其他可能调节疾病进展的因素表现出来。
