Weinberg Douglas S, Gebhart Jeremy J, Liu Raymond W, Salata Michael J
Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A..
Department of Orthopaedic Surgery, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A.
Arthroscopy. 2016 May;32(5):806-13. doi: 10.1016/j.arthro.2015.11.047. Epub 2016 Mar 2.
To investigate the relation between cam, acetabular version, and pelvic incidence.
This was a retrospective analysis of 65 patients with symptomatic hip pain and radiographic signs of femoroacetabular impingement (FAI). Twenty-seven patients were used as a control. All patients received a CT scan of the pelvis that included the sacral endplate. Alpha angle, acetabular version, and pelvic incidence (PI) were measured on 2D CT. Patients were then assigned to 1 of 4 groups: control, cam (alpha angle > 55°, version > 15°), retroverted (alpha angle < 55°, version < 15°), or mixed (alpha angle > 55°, version < 15°).
The PI in mixed-type FAI was 46.7° ± 3.7°, which showed a statistically significant decrease from the PI of the control group, 56.1° ± 4.4° (P = .01). The PI for cam-only deformity was 50.8° ± 4.6°, and the PI for retroverted-only deformity was 51.0° ± 4.6°. Neither was statistically different from the control.
This study suggests that mixed-type FAI may develop as a response to decreased PI. This result is consistent with previous reports showing decreased PI associated with cam and retroversion deformities. Although the cause of FAI remains controversial, the potential impact of sagittal balance of the pelvis, and specifically, decreased PI, should not be ignored.
Level IV, therapeutic case series.
探讨凸轮畸形、髋臼旋转角与骨盆入射角之间的关系。
对65例有症状性髋关节疼痛且有股骨髋臼撞击症（FAI）影像学表现的患者进行回顾性分析。27例患者作为对照组。所有患者均接受了包括骶骨终板的骨盆CT扫描。在二维CT上测量阿尔法角、髋臼旋转角和骨盆入射角（PI）。然后将患者分为4组中的1组：对照组、凸轮畸形组（阿尔法角>55°，旋转角>15°）、髋臼后倾组（阿尔法角<55°，旋转角<15°）或混合型（阿尔法角>55°，旋转角<15°）。
混合型FAI患者的PI为46.7°±3.7°，与对照组的PI 56.1°±4.4°相比有统计学意义上显著降低（P = 0.01）。单纯凸轮畸形患者的PI为50.8°±4.6°，单纯髋臼后倾畸形患者的PI为51.0°±4.6°。两者与对照组相比均无统计学差异。
本研究表明，混合型FAI可能是对PI降低的一种反应。这一结果与先前报道的显示PI降低与凸轮畸形和髋臼后倾畸形相关一致。尽管FAI的病因仍存在争议，但骨盆矢状面平衡的潜在影响，特别是PI降低，不应被忽视。
IV级，治疗性病例系列。
