Suarez-Ahedo Carlos, Gui Chengcheng, Rabe Stephanie M, Chandrasekaran Sivashankar, Lodhia Parth, Domb Benjamin G
American Hip Institute, Westmont, Illinois, USA.
Hinsdale Orthopaedics, Hinsdale, Illinois, USA.
Am J Sports Med. 2017 Sep;45(11):2501-2506. doi: 10.1177/0363546517708192. Epub 2017 Jun 7.
Hip pain remains a challenge given the multiple factors that can cause damage to the articular cartilage, such as traumatic injury, metabolic damage, and morphologic variations such as femoroacetabular impingement (FAI) and that can contribute to progression of osteoarthritis. However, a direct relationship between patient characteristics, the extent of acetabular chondral damage, and topologic characteristics of chondral lesions has not been established.
To compare the grade of acetabular chondral damage, measured in terms of acetabular labrum articular disruption (ALAD) classification, to the size and position of the chondral lesions, matching patients' demographic factors such as age and body mass index (BMI).
Cross-sectional study; Level of evidence, 3.
This study included all hip arthroscopies performed by the corresponding author from August 7, 2008, to November 19, 2014, in which acetabular chondral lesions were intraoperatively identified and measured in terms of ALAD grade, clockface location, and size. Bivariate analyses and multiple logistic regression were used to identify the demographic factors, characteristics of the acetabular chondral lesion, and other anatomic characteristics that were related to the ALAD grade of the acetabular chondral lesion.
Acetabular chondral lesions were measured in 1502 patients during the study period. Multivariate analysis showed that higher ALAD grade of acetabular chondral damage was significantly related to male sex, more advanced age, the area of the acetabular chondral lesion, anterior extension of the acetabular chondral lesion within the anterosuperior quadrant, labral detachment from the acetabular cartilage, and posterior extension of the labral tear.
Higher grades of acetabular chondral damage were related to male sex, increased age, height, weight, BMI, and the size of the lesion. Chondral lesions were generally found in the anterosuperior region of the acetabulum, consistent with labral lesions and the weightbearing area of the acetabulum.
鉴于多种因素可导致关节软骨损伤，如创伤性损伤、代谢损伤以及诸如股骨髋臼撞击症（FAI）等形态学变异，且这些因素可促使骨关节炎进展，髋部疼痛仍是一个挑战。然而，患者特征、髋臼软骨损伤程度与软骨损伤的拓扑特征之间尚未建立直接关系。
根据髋臼盂唇关节破坏（ALAD）分类来比较髋臼软骨损伤的分级与软骨损伤的大小和位置，并匹配患者的人口统计学因素，如年龄和体重指数（BMI）。
横断面研究；证据等级，3级。
本研究纳入了2008年8月7日至2014年11月19日由相应作者进行的所有髋关节镜检查病例，术中对髋臼软骨损伤进行识别，并根据ALAD分级、钟面位置和大小进行测量。采用双变量分析和多因素逻辑回归来确定与髋臼软骨损伤的ALAD分级相关的人口统计学因素、髋臼软骨损伤特征及其他解剖学特征。
在研究期间对1502例患者的髋臼软骨损伤进行了测量。多因素分析显示，髋臼软骨损伤的ALAD分级较高与男性、年龄较大、髋臼软骨损伤面积、髋臼软骨损伤在前上象限内的前部延伸、盂唇与髋臼软骨分离以及盂唇撕裂的后部延伸显著相关。
较高等级的髋臼软骨损伤与男性、年龄增加、身高、体重、BMI以及损伤大小有关。软骨损伤通常见于髋臼的前上区域，与盂唇损伤及髋臼的负重区域一致。
