Tannenbaum Eric P, Zhang Peng, Maratt Joseph D, Gombera M Mustafa, Holcombe Sven A, Wang Stewart C, Bedi Asheesh, Goulet James A
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.
Department of Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.
Arthroscopy. 2015 Jul;31(7):1247-54. doi: 10.1016/j.arthro.2015.02.007. Epub 2015 May 13.
To assess the prevalence of acetabular retroversion in a large population of patients with asymptomatic hips. Furthermore, we sought to identify gender differences in acetabular morphology to address the current thinking that retroversion and pincer-type femoroacetabular impingement (FAI) are more common in women.
We retrospectively reviewed morphologic features of acetabula from a consecutive series of trauma-protocol computed tomography scans of patients without pelvis injury. An automated algorithm determined the acetabular rim profile and center of the femoral head, normalized the frontal plane of the pelvis, and calculated version and coverage. We then compared male and female rim profiles, specifically focusing on version and acetabular wall coverage in the 1-o'clock (anterosuperior), 2-o'clock (central), and 3-o'clock (inferior) positions.
Of 1,088 patients in the database, 878 had complete data (i.e., age, ethnicity, and body mass index) and were therefore included in the final analysis. Of these, 34.3% were women and 65.7% were men. Mean global acetabular version was 19.1° for men and 22.2° for women (P < .001). Mean acetabular version for men and women was 15.5° and 18.3°, respectively, in the 1-o'clock position; 21.5° and 24.0°, respectively, in the 2-o'clock position; and 20.2° and 24.3°, respectively, in the 3-o'clock position (P < .001 for all 3). True retroversion (<0°) was observed only in the 1-o'clock position. The prevalence of true acetabular retroversion in the 1-o'clock position for men and women was 4.3% and 3%, respectively (P = .36).
Mean global and focal acetabular anteversion was greater in women, and the prevalence of focal cephalad retroversion in the 1-o'clock position was not significantly different compared with men. Acetabular retroversion and anterior overcoverage are not more prevalent in women in the anterosuperior acetabulum, where femoroacetabular impingement most commonly occurs.
Level III, diagnostic study.
评估大量无症状髋关节患者髋臼后倾的患病率。此外，我们试图确定髋臼形态的性别差异，以回应目前关于后倾和钳夹型股骨髋臼撞击症（FAI）在女性中更为常见的观点。
我们回顾性分析了一系列连续的无骨盆损伤患者的创伤协议计算机断层扫描中髋臼的形态学特征。一种自动算法确定髋臼边缘轮廓和股骨头中心，使骨盆的额状面标准化，并计算髋臼的前倾角度和覆盖范围。然后，我们比较了男性和女性的髋臼边缘轮廓，特别关注1点（前上方）、2点（中央）和3点（下方）位置的前倾角度和髋臼壁覆盖情况。
数据库中的1088例患者中，878例有完整数据（即年龄、种族和体重指数），因此被纳入最终分析。其中，女性占34.3%，男性占65.7%。男性的平均全髋臼前倾角度为19.1°，女性为22.2°（P <.001）。男性和女性在1点位置的平均髋臼前倾角度分别为15.5°和18.3°；在2点位置分别为21.5°和24.0°；在3点位置分别为20.2°和24.3°（所有3个位置的P均<.001）。仅在1点位置观察到真正的后倾（<0°）。男性和女性在1点位置真正髋臼后倾的患病率分别为4.3%和3%（P =.36）。
女性的平均全髋臼和局部髋臼前倾角度更大，1点位置局部头侧后倾的患病率与男性相比无显著差异。在股骨髋臼撞击症最常发生的髋臼前上方，髋臼后倾和前方过度覆盖在女性中并不更常见。
III级，诊断性研究。
