Department of Orthopedic Surgery, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel.
Arthroscopy. 2013 Jan;29(1):54-63. doi: 10.1016/j.arthro.2012.07.008. Epub 2012 Nov 30.
To compare hip morphology between young men and women who presented with hip pain and labral tears.
A retrospective review of our hip arthroscopy registry from March 2008 to June 2010 was completed. We identified 217 patients (249 hips) who were between the ages of 18 to 30 years. The inclusion criteria were (1) insidious-onset hip pain or worsening pain after low-energy sports trauma, (2) positive hip impingement sign, (3) Tönnis grades 0 to 1, (4) magnetic resonance imaging showing labral tear, and (5) primary hip arthroscopy confirming labral tear. Forty-five patients (52 hips) were excluded for the following reasons: (1) revision hip arthroscopy, (2) high-energy hip trauma, (3) history of surgery involving the femur or pelvis, (4) previous fractures of the femur or pelvis, (5) Tönnis grades 2 or above, (6) proliferative disease of the hip (i.e., synovial chondromatosis, pigmented villonodular synovitis), (7) neuromuscular disease (i.e., cerebral palsy), and (8) deformities related to Legg-Calvé-Perthes disease or developmental dysplasia of the hip. Therefore, the cohort study group included 105 (61%) men (123 [62.4%] hips) and 67 (39%) women (74 [37.6%] hips). Sex comparisons were made for the following variables measured on preoperative hip computed tomography scans: alpha angle, acetabular version, femoral version, lateral center-edge angle, and neck-shaft angle.
Women had smaller alpha angles (47.8°v 63.6°, P < .001), increased acetabular version (17.3°v 13.9°, P < .001), and increased femoral anteversion (14.4°v 12.1°, P = .05).
In young adults with hip pain and labral tears, women have smaller alpha angles and hips that are generally more anteverted. Therefore, in women, cam lesions may be more subtle, preoperative hip version analyses should be encouraged, and rim trimming may need to be cautiously planned to avoid increasing contact stresses at weight-bearing areas after such a procedure.
Level III, retrospective comparative study.
比较髋关节疼痛伴盂唇撕裂的年轻男性和女性的髋关节形态。
对 2008 年 3 月至 2010 年 6 月期间的髋关节镜检查登记处进行回顾性研究。我们确定了 217 名年龄在 18 至 30 岁之间的患者（249 髋）。纳入标准为：（1）隐匿性髋关节疼痛或低能量运动创伤后疼痛加重；（2）髋关节撞击征阳性；（3）Tönnis 分级为 0 至 1 级；（4）磁共振成像显示盂唇撕裂；（5）初次髋关节镜检查证实盂唇撕裂。45 名患者（52 髋）因以下原因被排除在外：（1）髋关节翻修手术；（2）高能量髋关节创伤；（3）股骨或骨盆手术史；（4）股骨或骨盆既往骨折；（5）Tönnis 分级 2 级或以上；（6）髋关节增生性疾病（如滑膜软骨瘤病、色素沉着绒毛结节性滑膜炎）；（7）神经肌肉疾病（如脑瘫）；（8）与 Legg-Calvé-Perthes 病或发育性髋关节发育不良相关的畸形。因此，这项队列研究包括 105 名（61%）男性（123 髋，62.4%）和 67 名（39%）女性（74 髋，37.6%）。对术前髋关节 CT 扫描测量的以下变量进行性别比较：α角、髋臼倾斜度、股骨前倾角、外侧中心边缘角和颈干角。
女性的 α 角较小（47.8°比 63.6°，P<0.001），髋臼倾斜度较大（17.3°比 13.9°，P<0.001），股骨前倾角较大（14.4°比 12.1°，P=0.05）。
在髋关节疼痛伴盂唇撕裂的年轻成年人中，女性的 α 角较小，髋关节通常更前倾。因此，女性的凸轮病变可能更轻微，术前髋关节倾斜分析应受到鼓励，在进行 Rim 修整术时需要谨慎计划，以避免增加承重区域的接触压力。
III 级，回顾性比较研究。
