Grace Trevor, Neumann Jan, Samaan Michael A, Souza Richard B, Majumdar Sharmila, Link Thomas M, Zhang Alan L
Department of Orthopedic Surgery, University of California, San Francisco, California.
Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
J Orthop Res. 2018 Nov;36(11):3064-3070. doi: 10.1002/jor.24102. Epub 2018 Jul 13.
There is currently no widely accepted classification system of intra-articular damage in the setting of femoroacetabular impingement (FAI). The goal of this study is to correlate the Scoring Hip Osteoarthritis with Magnetic Resonance Imaging (SHOMRI) system with arthroscopic findings in symptomatic FAI patients to justify its use in this setting. Symptomatic FAI patients scheduled for hip arthroscopy were prospectively enrolled. Prior to surgery, radiographs, and an MRI were obtained of the affected hip and all patients completed the Hip disability and Osteoarthritis Outcome Score (HOOS) questionnaire. Each MRI was graded using the SHOMRI system. Intraoperatively, cartilage and labral injury grades were recorded. SHOMRI scores were then correlated with the intraoperative cartilage and labral grades as well as preoperative radiographic findings and HOOS scores. Forty-three patients were analyzed (mean age 35.7 years, 58.1% male). SHOMRI total scores correlated with intraoperative femoral cartilage grade (ρ = 0.42; p = 0.002), acetabular cartilage grade (ρ = 0.30; p = 0.046), and labral tear grade (ρ = 0.42; p = 0.003) as well as with preoperative Tönnis grade (ρ = 0.37, p = 0.013), HOOS pain score (ρ = -0.33; p = 0.039), HOOS ADL score (ρ = -0.39; p = 0.007), and HOOS sports score (ρ = -0.30; p = 0.037). In conclusion, total scores from the SHOMRI system showed significant correlation with arthroscopic findings as well as radiographic gradings and clinical symptoms in patients with FAI. Use of this quantitative system to assess the burden of chondrolabral damage in FAI appears valid. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:3064-3070, 2018.
目前，在股骨髋臼撞击症（FAI）背景下，尚无广泛接受的关节内损伤分类系统。本研究的目的是将髋关节骨关节炎磁共振成像评分（SHOMRI）系统与有症状的FAI患者的关节镜检查结果相关联，以证明其在此情况下的应用合理性。前瞻性纳入计划进行髋关节镜检查的有症状FAI患者。手术前，获取患髋的X线片和磁共振成像（MRI），所有患者均完成髋关节功能障碍和骨关节炎结果评分（HOOS）问卷。每张MRI均使用SHOMRI系统进行分级。术中记录软骨和盂唇损伤分级。然后将SHOMRI评分与术中软骨和盂唇分级以及术前X线片检查结果和HOOS评分相关联。分析了43例患者（平均年龄35.7岁，男性占58.1%）。SHOMRI总分与术中股骨软骨分级（ρ = 0.42；p = 0.002）、髋臼软骨分级（ρ = 0.30；p = 0.046）、盂唇撕裂分级（ρ = 0.42；p = 0.003）以及术前Tönnis分级（ρ = 0.37，p = 0.013）、HOOS疼痛评分（ρ = -0.33；p = 0.039）、HOOS日常生活活动（ADL）评分（ρ = -0.39；p = 0.007）和HOOS运动评分（ρ = -0.30；p = 0.037）相关。总之，SHOMRI系统的总分与FAI患者的关节镜检查结果、X线片分级和临床症状显著相关。使用这个定量系统评估FAI中软骨盂唇损伤的程度似乎是有效的。©2018骨科学研究协会。由威利期刊公司出版。《矫形外科学研究杂志》2018年；36：3064 - 3070。
