站立和动态活动期间的髋关节旋转以及股骨前倾的代偿作用：使用三维计算机断层扫描模型和双荧光透视对无症状年轻成年人进行的体内分析
Hip rotation during standing and dynamic activities and the compensatory effect of femoral anteversion: An in-vivo analysis of asymptomatic young adults using three-dimensional computed tomography models and dual fluoroscopy.
作者信息
Uemura Keisuke, Atkins Penny R, Fiorentino Niccolo M, Anderson Andrew E
机构信息
Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA; Department of Bioengineering, University of Utah, James LeVoy Sorenson Molecular Biotechnology Building, 36 S. Wasatch Drive, Rm. 3100, Salt Lake City, UT 84112 USA.
出版信息
Gait Posture. 2018 Mar;61:276-281. doi: 10.1016/j.gaitpost.2018.01.016. Epub 2018 Jan 31.
BACKGROUND
Individuals are thought to compensate for femoral anteversion by altering hip rotation. However, the relationship between hip rotation in a neutral position (i.e. static rotation) and dynamic hip rotation is poorly understood, as is the relationship between anteversion and hip rotation.
RESEARCH OBJECTIVE
Herein, anteversion and in-vivo hip rotation during standing, walking, and pivoting were measured in eleven asymptomatic, morphologically normal, young adults using three-dimensional computed tomography models and dual fluoroscopy.
METHODS
Using correlation analyses, we: 1) determined the relationship between hip rotation in the static position to that measured during dynamic activities, and 2) evaluated the association between femoral anteversion and hip rotation during dynamic activities. Hip rotation was calculated while standing (static-rotation), throughout gait, as a mean during gait (mean gait rotation), and as a mean (mid-pivot rotation), maximum (max-rotation) and minimum (min-rotation) during pivoting.
RESULTS
Static-rotation (mean ± standard deviation; 11.3° ± 7.3°) and mean gait rotation (7.8° ± 4.7°) were positively correlated (r = 0.679, p = 0.022). Likewise, static-rotation was strongly correlated with mid-pivot rotation (r = 0.837, p = 0.001), max-rotation (r = 0.754, p = 0.007), and min-rotation (r = 0.835, p = 0.001). Strong positive correlations were found between anteversion and hip internal rotation during all of the stance phase (0-60% gait) and during mid- and terminal-swing (86-100% gait) (all r > 0.607, p < 0.05).
CONCLUSIONS
Our results suggest that the static position may be used cautiously to express the neutral rotational position of the femur for dynamic movements. Further, our results indicate that femoral anteversion is compensated for by altering hip rotation. As such, both anteversion and hip rotation may be important to consider when diagnosing hip pathology and planning for surgical procedures.
背景
人们认为个体通过改变髋关节旋转来代偿股骨前倾。然而，中立位髋关节旋转（即静态旋转）与动态髋关节旋转之间的关系，以及前倾与髋关节旋转之间的关系，目前仍知之甚少。
研究目的
本研究使用三维计算机断层扫描模型和双荧光透视法，对11名无症状、形态正常的年轻成年人在站立、行走和转身过程中的前倾和体内髋关节旋转情况进行测量。
方法
通过相关性分析，我们：1）确定静态位置的髋关节旋转与动态活动中测量的髋关节旋转之间的关系，以及2）评估动态活动期间股骨前倾与髋关节旋转之间的关联。髋关节旋转在站立时（静态旋转）、整个步态过程中、作为步态平均值（平均步态旋转）以及在转身过程中作为平均值（转身中点旋转）、最大值（最大旋转）和最小值（最小旋转）进行计算。
结果
静态旋转（平均值±标准差；11.3°±7.3°）与平均步态旋转（7.8°±4.7°）呈正相关（r = 0.679，p = 0.022）。同样，静态旋转与转身中点旋转（r = 0.837，p = 0.001）、最大旋转（r = 0.754，p = 0.007）和最小旋转（r = 0.835，p = 0.001）密切相关。在整个站立期（0 - 60%步态）以及摆动中期和末期（86 - 100%步态），前倾与髋关节内旋之间均发现强正相关（所有r > 0.607，p < 0.05）。
结论
我们的结果表明，在表达股骨在动态运动中的中立旋转位置时，可谨慎使用静态位置。此外，我们的结果表明，股骨前倾可通过改变髋关节旋转来代偿。因此，在诊断髋关节病变和制定手术方案时，考虑前倾和髋关节旋转两者可能都很重要。
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