Ahn Taesoo, Kim Chul-Ho, Kim Tae Hyung, Chang Jae Suk, Jeong Mi Yeon, Aditya Kekatpure, Yoon Pil Whan
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Clin Orthop Relat Res. 2016 Dec;474(12):2655-2661. doi: 10.1007/s11999-016-5013-y. Epub 2016 Aug 9.
Morphologic features of the proximal femur reminiscent of those seen in patients with femoroacetabular impingement (FAI) have been reported among asymptomatic individuals in Western populations, but whether this is the case in Asian populations is unknown.
QUESTIONS/PURPOSES: The purpose of this study was to determine the prevalence of radiographic findings in the proximal femur that are consistent with FAI in asymptomatic Korean volunteers.
Two hundred asymptomatic volunteers with no prior hip surgery or childhood hip problems underwent three-view plain radiographs (pelvis AP view, Sugioka view, and 45° Dunn view) of both hips. There were 146 hips from male volunteers and 254 hips from female volunteers in the study. The mean age of all participants was 34.7 years (range, 21-49 years). Cam-type morphologic features were defined as the presence of the following on one or more of the three views: pistol-grip morphologic features, an osseous bump at the femoral head-neck junction, flattening of the femoral head-neck offset, or alpha angle greater than 55°. Pincer-type morphologic features were determined by radiographic signs, including crossover sign, deficient posterior wall sign, or lateral center-edge angle greater than 40°.
The prevalence of cam-type morphologic features seen on at least one radiograph was 38% (male, 57%; female, 26%). The prevalence of cam-type features (at least one positive cam-type feature) was 2.0% (male, 6%; female, 0%) on the pelvic AP view, 24% (male, 36%; female, 17%) on the Sugioka view, and 30% (male, 47%; female, 20%) on the 45° Dunn view. The prevalence of pincer-type morphologic features (at least one positive pincer-type feature) was 23% (male, 27%; female, 21%) on the pelvic AP view.
The prevalence of FAI-related morphologic features in asymptomatic Asian populations was comparable to the prevalence in Western populations. Considering the high prevalence of radiographic hip findings reminiscent of FAI in asymptomatic Asian populations, it will be important to determine whether FAI-related morphologic features are a cause of hip pain when considering surgery in Asian patients.
在西方人群的无症状个体中，已报告股骨近端的形态学特征与股骨髋臼撞击症（FAI）患者所见相似，但在亚洲人群中是否如此尚不清楚。
问题/目的：本研究的目的是确定无症状韩国志愿者中与FAI一致的股骨近端影像学表现的患病率。
200名无既往髋关节手术史或儿童期髋关节问题的无症状志愿者接受了双髋的三联位X线平片检查（骨盆前后位片、杉冈位片和45°邓氏位片）。本研究中有146例男性志愿者的髋关节和254例女性志愿者的髋关节。所有参与者的平均年龄为34.7岁（范围21 - 49岁）。凸轮型形态学特征定义为在三张片子中的一张或多张上出现以下情况：手枪柄样形态学特征、股骨头颈交界处的骨性隆起、股骨头颈偏移变平或α角大于55°。钳夹型形态学特征通过影像学征象确定，包括交叉征、后壁缺损征或外侧中心边缘角大于40°。
至少一张X线片上出现凸轮型形态学特征的患病率为38%（男性57%；女性26%）。凸轮型特征（至少一个阳性凸轮型特征）在骨盆前后位片上的患病率为2.0%（男性6%；女性0%），在杉冈位片上为24%（男性36%；女性17%），在45°邓氏位片上为30%（男性47%；女性20%）。钳夹型形态学特征（至少一个阳性钳夹型特征）在骨盆前后位片上的患病率为23%（男性27%；女性21%）。
无症状亚洲人群中与FAI相关的形态学特征患病率与西方人群相当。考虑到无症状亚洲人群中影像学髋关节表现类似于FAI的患病率较高，在考虑亚洲患者手术时，确定与FAI相关的形态学特征是否为髋关节疼痛的原因将很重要。
