Department of Orthopaedics, Oslo University Hospital, Rikshospitalet, 0027 Oslo, Norway.
Skeletal Radiol. 2012 Jul;41(7):811-6. doi: 10.1007/s00256-011-1293-1. Epub 2011 Nov 8.
To assess the reliability of radiographic measurements in adults previously treated for developmental dysplasia of the hip (DDH) and to clarify whether these parameters differ according to position of the patient (supine versus standing).
Fifty-one patients (41 females and 10 males) with 63 affected hips were included in the study. The mean follow-up period was 45 (44-49) years in the patients who had not undergone total hip replacement (THR). Anteroposterior radiographs of the pelvis were taken with the patient in the supine and in the standing position. Measurements used for residual hip dysplasia were center-edge (CE) angle and migration percentage (MP). The joint space width (JSW) was measured at three or four locations of the upper, weight-bearing part of the joint, and the shortest distance was termed the minimum joint space width (minJSW). One radiologist and one orthopaedic surgeon, each with more than 30 years of experience, independently measured the radiographic parameters.
The limits of agreement (LOA) of the CE angle (mean interobserver difference ± 2SD) were within the range -8 to 7°. The LOA of the MP were in the range -8 to 8% and of the minJSW -0.6 to 1.1 mm. The mean differences in CE angle between supine and standing radiographs (supine - standing) ranged from -1.1 to 0.0° and the mean differences in MP between supine and standing positions were below 1%. The mean positional differences in minJSW were below 0.1 mm and were not statistically significant.
The interobserver variations with regard to CE angle, MP, and minJSW were moderate, indicating that these are reliable measurements in clinical practice. Femoral head coverage and JSW did not significantly differ between supine and weight-bearing positions.
评估先前接受发育性髋关节发育不良（DDH）治疗的成年人的放射学测量的可靠性，并阐明这些参数是否因患者的体位（仰卧位与站立位）而有所不同。
本研究纳入了 51 名患者（41 名女性和 10 名男性），共 63 个受累髋关节。未接受全髋关节置换术（THR）的患者的平均随访时间为 45 年（44-49 年）。对患者进行仰卧位和站立位骨盆前后位 X 线摄影。用于评估残余髋关节发育不良的测量指标包括中心边缘（CE）角和移行百分比（MP）。关节间隙宽度（JSW）在关节负重的上、中、下三个或四个部位进行测量，最短距离称为最小关节间隙宽度（minJSW）。一名放射科医生和一名骨科医生进行了独立测量，他们均具有 30 年以上的经验。
CE 角的一致性界限（LOA）（观察者间平均差异±2SD）在-8 至 7°范围内。MP 的 LOA 在-8 至 8%范围内，minJSW 的 LOA 在-0.6 至 1.1mm 范围内。仰卧位与站立位 X 线片之间的 CE 角平均差值（仰卧位-站立位）范围为-1.1 至 0.0°，仰卧位与站立位之间的 MP 平均差值小于 1%。minJSW 的体位差异平均值低于 0.1mm，且无统计学意义。
CE 角、MP 和 minJSW 的观察者间变异程度为中度，表明这些参数在临床实践中具有可靠性。股骨头覆盖和 JSW 在仰卧位和负重位之间无显著差异。
