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髋关节软骨损伤及凸轮型股骨髋臼撞击与运动模式关联的差异:一项初步研究。

Differences in the association of hip cartilage lesions and cam-type femoroacetabular impingement with movement patterns: a preliminary study.

作者信息

Kumar Deepak, Dillon Alexander, Nardo Lorenzo, Link Thomas M, Majumdar Sharmila, Souza Richard B

机构信息

Musculoskeletal Quantitative Imaging Research Group, Radiology and Biomedical Imaging, University of California-San Francisco, 1700 4th St, Suite 203, Byers Hall, UCSF Mission Bay, San Francisco, CA 94158(∗).

Musculoskeletal Quantitative Imaging Research Group, Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA(†).

出版信息

PM R. 2014 Aug;6(8):681-9. doi: 10.1016/j.pmrj.2014.02.002. Epub 2014 Feb 14.

Abstract

OBJECTIVE

To investigate the differences in hip movement patterns during different daily and athletic activities in persons with cam-type femoroacetabular impingement (FAI) with and without cartilage lesions compared with control subjects in a preliminary study.

DESIGN

Controlled laboratory study using a cross-sectional design.

SETTING

Research institution with a tertiary care medical center.

PARTICIPANTS

Fifteen subjects [M:F, 13:2; age, 31.6 ± 9.7 years (range, 22-52 years); body mass index, 24.9 ± 4.6 (range, 18.8-38.4); FAI:control, 7:8].

METHODS

All subjects had 3-Tesla magnetic resonance imaging of the hip and also underwent 3-dimensional motion capture during walking, deep-squat, and drop-landing tasks. Experienced radiologists graded cartilage lesions on clinical magnetic resonance images.

OUTCOMES

Peak kinematic and kinetic variables were compared between subjects who did and did not have FAI, and subjects who had FAI and cartilage lesions were compared with subjects who did not have cartilage lesions.

RESULTS

Subjects who had FAI demonstrated no significant differences for walking or drop landing compared with control subjects. However, during the deep-squat task, subjects with FAI adducted more and had a greater internal rotation moment. Subjects who had cartilage lesions in the presence of a cam lesion demonstrated (1) no difference for walking; (2) greater adduction, greater internal rotation moment, and lower transverse plane range of motion during the deep-squat task; and (3) greater adduction and lower internal rotation during the drop-landing task compared with subjects who did not have cartilage lesions.

CONCLUSIONS

We observed differences in movement patterns between subjects who had FAI compared with control subjects. However, the differences were more pronounced between subjects with FAI who had cartilage lesions compared with subjects who did not have cartilage lesions. These findings highlight the importance of understanding the complex interplay between bony morphologic features, cartilage lesions, and movement patterns in persons with cam-type FAI.

摘要

目的

在一项初步研究中,调查伴有和不伴有软骨损伤的凸轮型股骨髋臼撞击症(FAI)患者在不同日常和体育活动中的髋关节运动模式与对照受试者之间的差异。

设计

采用横断面设计的对照实验室研究。

地点

设有三级医疗中心的研究机构。

参与者

15名受试者[男:女,13:2;年龄,31.6±9.7岁(范围,22 - 52岁);体重指数,24.9±4.6(范围,18.8 - 38.4);FAI:对照,7:8]。

方法

所有受试者均接受了髋关节的3特斯拉磁共振成像检查,并在行走、深蹲和落地任务期间进行了三维运动捕捉。经验丰富的放射科医生在临床磁共振图像上对软骨损伤进行分级。

结果

患有FAI的受试者与对照受试者相比,在行走或落地任务中未显示出显著差异。然而,在深蹲任务期间,患有FAI的受试者内收更多且具有更大的内旋力矩。在存在凸轮病变的情况下患有软骨损伤的受试者表现为:(1)行走时无差异;(2)在深蹲任务期间内收更大、内旋力矩更大且横向平面运动范围更小;(3)与没有软骨损伤的受试者相比,在落地任务期间内收更大且内旋更小。

结论

我们观察到患有FAI的受试者与对照受试者之间的运动模式存在差异。然而,与没有软骨损伤的FAI受试者相比,患有软骨损伤的FAI受试者之间的差异更为明显。这些发现突出了了解凸轮型FAI患者的骨形态特征、软骨损伤和运动模式之间复杂相互作用的重要性。

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