Paliobeis Christos P, Villar Richard N
Addenbrooke's Hospital, Cambridge - UK.
Hip Int. 2011 Mar-Apr;21(2):141-5. doi: 10.5301/HIP.2011.7422. Epub 2011 Apr 11.
It is unknown how often femoro-acetabular impingement (FAI) and hip dysplasia co-exist and which is more important in the development of intra-articular lesions such as labral tears. This study identified the prevalence of dysplasia on standard radiographs in a group of 76 consecutive patients with symptomatic FAI. The centre-edge (CE) angle of Wiberg, the acetabular angle (AA) of Sharp, FAI type, offset ratio and posterior wall sign were identified. 63 patients, predominantly young adult males (mean age: 34.6 years; 10:4 male-to-female ratio), met our inclusion criteria. Most females (13:18) showed signs of dysplasia based on the AA. No association of dysplasia with FAI group, offset ratio or posterior wall sign was found. 47% of our patients with FAI also had radiographic evidence of dysplasia (3-15% definite and 9-30% borderline, depending on the angle utilised). Surgery for FAI should therefore take into account the presence of co-existing dysplasia. Conversely, surgery for dysplasia should take into consideration the co-existence of FAI. The prime cause of labral pathology in the presence of dysplasia may be co-existent FAI and the latter problem may demand priority, not the former.
目前尚不清楚股骨髋臼撞击症(FAI)与髋关节发育不良共存的频率,以及在诸如盂唇撕裂等关节内病变的发展过程中哪个更为重要。本研究确定了一组76例有症状的FAI连续患者的标准X线片上发育不良的患病率。确定了Wiberg中心边缘(CE)角、Sharp髋臼角(AA)、FAI类型、偏移率和后壁征。63例患者符合纳入标准,主要为年轻成年男性(平均年龄:34.6岁;男女比例为10:4)。根据AA,大多数女性(13:18)表现出发育不良的迹象。未发现发育不良与FAI组、偏移率或后壁征之间存在关联。我们47%的FAI患者也有发育不良的影像学证据(根据所使用的角度,3%-15%为明确发育不良,9%-30%为临界发育不良)。因此,FAI手术应考虑并存发育不良的情况。相反,发育不良手术也应考虑FAI的并存情况。发育不良情况下盂唇病变的主要原因可能是并存的FAI,而后一个问题可能需要优先处理,而非前者。