Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Clin Orthop Relat Res. 2011 Mar;469(3):831-8. doi: 10.1007/s11999-010-1539-6. Epub 2010 Oct 1.
Acetabular labral tears are being diagnosed with increasing frequency and there is a growing consensus that these tears rarely occur in the absence of osseous abnormalities.
QUESTIONS/PURPOSES: We therefore determined the presence of structural abnormalities in patients with acetabular labral tears using a standardized CT protocol.
We evaluated 135 consecutive patients with labral tears diagnosed by MRI with CT scans of the symptomatic hip. The CT scans were evaluated in a standardized fashion to determine acetabular and femoral pathomorphologic features. Acetabular evaluation included version measurements and anterior and lateral center-edge angles. Femoral parameters evaluated included version, alpha angle, and neck-shaft angle.
One hundred twenty-two (90%) of the 135 hips had structural abnormalities. One hundred two (76%) had an alpha angle greater than 50°, 18 (13%) had femoral version less than 5°, 22 (16%) had femoral version greater than 25º, and five (4%) had coxa valga. Fifty-eight (43%) patients had acetabular retroversion and five (4%) had a lateral center-edge angle less than 20º. Of the 58 patients with acetabular retroversion, 23 had isolated cranial retroversion, 12 had isolated central retroversion, and 23 had combined cranial and central retroversion. Sixty-seven of the 121 hips (55%) with bony abnormalities had a combination of abnormalities.
Ninety percent of patients with labral tears had structural abnormalities seen on CT scans. These structural abnormalities frequently occur in combination, and understanding these underlying morphologic features of the hip can help guide treatment.
Level IV, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
髋臼唇撕裂的诊断频率越来越高，越来越多的共识认为，这些撕裂很少在没有骨异常的情况下发生。
问题/目的：因此，我们使用标准化 CT 方案确定髋臼唇撕裂患者的结构异常。
我们评估了 135 例连续的 MRI 诊断为髋臼唇撕裂的患者，对其进行了 CT 扫描。以标准化的方式评估 CT 扫描，以确定髋臼和股骨的病理形态特征。髋臼评估包括髋臼角测量、前侧和外侧中心边缘角。股骨参数评估包括髋臼角、α角和颈干角。
135 髋中有 122 髋（90%）存在结构异常。102 髋（76%）的α角大于 50°，18 髋（13%）的股骨角小于 5°，22 髋（16%）的股骨角大于 25°，5 髋（4%）有髋外翻。58 髋（43%）存在髋臼后倾，5 髋（4%）存在外侧中心边缘角小于 20°。在 58 例髋臼后倾患者中，23 例为单纯颅侧后倾，12 例为单纯中央后倾，23 例为颅侧和中央联合后倾。121 髋（55%）的骨异常中有 67 髋存在多种异常。
90%的髋臼唇撕裂患者在 CT 扫描中存在结构异常。这些结构异常常以组合形式出现，了解髋关节的这些潜在形态特征有助于指导治疗。
IV 级，诊断研究。有关证据水平的完整描述，请参见作者指南。
