Ng K C Geoffrey, Lamontagne Mario, Beaulé Paul E
Department of Mechanical Engineering, University of Ottawa, Ottawa, ON, Canada.
Department of Mechanical Engineering, University of Ottawa, Ottawa, ON, Canada; School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada.
Clin Biomech (Bristol). 2016 Mar;33:13-19. doi: 10.1016/j.clinbiomech.2016.01.007. Epub 2016 Feb 2.
It is still unclear why many individuals with bilateral cam deformities demonstrate only unilateral symptoms of femoroacetabular impingement, thus symptoms may be attributed to additional anatomical parameters. The purpose was to examine patients with bilateral cam deformities, with unilateral symptoms, and compare anatomical hip joint parameters between their affected (symptomatic) hip and their contralateral, unaffected (asymptomatic) hip.
Twenty participants (n=20) with unilateral symptoms, but bilateral cam deformities, underwent CT imaging to measure their affected and unaffected hip's: axial and radial alpha angles, femoral head-neck offset, femoral neck-shaft angle, medial proximal femoral angle, femoral torsion, acetabular version, center-edge angle; and a physical examination (hip flexion, straight-leg raise, internal rotation, external rotation) to ascertain clinical signs.
The affected hips demonstrated limited motions during physical examination, compared with unaffected hips (effect size=0.550 to 0.955). The affected hips had significantly lower femoral neck-shaft angles (mean 125° (SD 3)) and lower medial proximal femoral angles (mean 79° (SD 4)), compared with the unaffected hips (mean 127° (SD 3), P=0.001, effect size=0.922; and mean 81° (SD 4), P=0.011, effect size=0.632; respectively). There were no differences in cam deformity parameters (axial and radial alpha angles, femoral head-neck offset), femoral torsion, acetabular version, and center-edge angle, between affected and unaffected hips.
A decreased femoral neck-shaft angle or medial proximal femoral angle can be implemented as a diagnostic predictor, to determine which hip may be at a greater risk of developing early symptoms.
目前尚不清楚为何许多双侧凸轮畸形患者仅表现出单侧股骨髋臼撞击症状，因此症状可能归因于其他解剖学参数。本研究旨在检查患有双侧凸轮畸形且有单侧症状的患者，并比较其患侧（有症状）髋关节与对侧未受影响（无症状）髋关节之间的解剖学髋关节参数。
20名有单侧症状但双侧凸轮畸形的参与者接受了CT成像，以测量其患侧和未受影响髋关节的以下参数：轴向和径向α角、股骨头颈偏移、股骨颈干角、股骨近端内侧角、股骨扭转、髋臼旋转、中心边缘角；并进行体格检查（髋关节屈曲、直腿抬高、内旋、外旋）以确定临床体征。
与未受影响的髋关节相比，患侧髋关节在体格检查时活动受限（效应大小为0.550至0.955）。与未受影响的髋关节相比，患侧髋关节的股骨颈干角显著更低（平均125°（标准差3）），股骨近端内侧角也更低（平均79°（标准差4））（分别为平均127°（标准差3），P = 0.001，效应大小 = 0.922；平均81°（标准差4），P = 0.011，效应大小 = 0.632）。患侧和未受影响髋关节之间的凸轮畸形参数（轴向和径向α角、股骨头颈偏移）、股骨扭转、髋臼旋转和中心边缘角没有差异。
股骨颈干角或股骨近端内侧角降低可作为诊断预测指标，以确定哪侧髋关节更易出现早期症状。
