Rothman Institute at Thomas Jefferson University, Sheridan Building, 10th Floor, 125 South 9th Street, Philadelphia, Pennsylvania 19107, USA.
Bone Joint J. 2013 Jul;95-B(7):893-9. doi: 10.1302/0301-620X.95B7.31109.
Orthopaedic surgeons have accepted various radiological signs to be representative of acetabular retroversion, which is the main characteristic of focal over-coverage in patients with femoroacetabular impingement (FAI). Using a validated method for radiological analysis, we assessed the relevance of these signs to predict intra-articular lesions in 93 patients undergoing surgery for FAI. A logistic regression model to predict chondral damage showed that an acetabular retroversion index (ARI) > 20%, a derivative of the well-known cross-over sign, was an independent predictor (p = 0.036). However, ARI was less significant than the Tönnis classification (p = 0.019) and age (p = 0.031) in the same model. ARI was unable to discriminate between grades of chondral lesions, while the type of cam lesion (p = 0.004) and age (p = 0.047) were able to. Other widely recognised signs of acetabular retroversion, such as the ischial spine sign, the posterior wall sign or the cross-over sign were irrelevant according to our analysis. Regardless of its secondary predictive role, an ARI > 20% appears to be the most clinically relevant radiological sign of acetabular retroversion in symptomatic patients with FAI.
骨科医生已经接受了各种放射学征象来代表髋臼后倾，这是股骨髋臼撞击症（FAI）患者局限性过度覆盖的主要特征。我们使用经过验证的放射学分析方法，评估了这些征象在 93 例接受 FAI 手术治疗的患者中预测关节内病变的相关性。用于预测软骨损伤的逻辑回归模型表明，髋臼反转指数（ARI）>20%，是众所周知的交叉征的衍生指标，是一个独立的预测因素（p=0.036）。然而，在同一模型中，ARI 不如 Tönnis 分类（p=0.019）和年龄（p=0.031）重要。ARI 无法区分软骨损伤的程度，而凸轮病变的类型（p=0.004）和年龄（p=0.047）则可以。根据我们的分析，其他广泛认可的髋臼后倾征象，如坐骨棘征、后壁征或交叉征，与髋臼后倾无关。无论其预测作用如何，ARI>20%似乎是 FAI 有症状患者髋臼后倾最具临床相关性的放射学征象。
