Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Arthroscopy. 2013 Aug;29(8):1292-6. doi: 10.1016/j.arthro.2013.05.012.
The purpose of this study was to validate additional radiographic parameters that detect changes within the acetabular cavity during acetabular rim trimming for pincer-type femoroacetabular impingement in an in vivo setting.
Patients who met the inclusion criteria and underwent arthroscopic acetabular rim trimming had their preoperative and postoperative anteroposterior radiographs measured. Intraoperatively, these patients had their labrums detached, acetabular walls trimmed by roughly 3 to 5 mm, and then labrums reattached. Radiographic measurements were subsequently obtained by use of the anterior rim angle (ARA), anterior wall angle (AWA), and anterior margin ratio (AMR).
Statistically significant changes were seen in the postoperative ARA, AWA, and AMR. Mean pre- and post-trimming changes were 83.8° and 87.9°, respectively, for the ARA; 38.8° and 35.8°, respectively, for the AWA; and 0.57 and 0.53, respectively, for the AMR. There were no postoperative complications. No patients had any instability events.
This study shows that significant changes in anterior acetabular anatomy can be evaluated radiographically in the in vivo setting for treatment of pincer-type femoroacetabular impingement. We saw a significant, consistent decrease in both the AWA and AMR and increase in the ARA. This research serves to guide surgeons with preoperative and intraoperative templating while providing the groundwork to investigate these radiographic parameters in an asymptomatic patient population.
These novel radiographic measurements can be used by hip arthroscopists to better characterize their surgical role in altering acetabular morphology. In addition, these measurements will be able to better describe acetabular anatomy.
本研究旨在验证在活体环境中,针对钳夹型股骨髋臼撞击症行髋臼缘修整术时,能够检测髋臼腔内变化的其他放射学参数。
符合纳入标准并接受关节镜下髋臼缘修整术的患者,对其术前和术后的前后位 X 线片进行了测量。术中,这些患者的盂唇被分离,髋臼壁被修整约 3 至 5 毫米,然后盂唇被重新附着。随后使用前缘角(ARA)、前壁角(AWA)和前缘比(AMR)进行放射学测量。
术后 ARA、AWA 和 AMR 均有统计学意义的变化。ARA 的术前和术后平均变化分别为 83.8°和 87.9°;AWA 分别为 38.8°和 35.8°;AMR 分别为 0.57 和 0.53。术后无并发症发生。无患者发生不稳定事件。
本研究表明,在活体环境中,通过影像学可以评估髋臼前侧解剖结构的显著变化,用于治疗钳夹型股骨髋臼撞击症。我们观察到 AWA 和 AMR 显著且一致地下降,ARA 显著增加。该研究为术前和术中模板规划提供指导,并为在无症状患者人群中研究这些放射学参数奠定基础。
髋关节关节镜医生可以使用这些新的放射学测量方法,更好地描述其在改变髋臼形态方面的手术作用。此外,这些测量方法将能够更好地描述髋臼解剖结构。