Department of Hip and Knee Surgeries, Shalby Hospital, Ahmedabad, Gujarat, India.
Department of Orthopaedics, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India; Department of Orthopedics, Sir HN Reliance Foundation Hospital and Research Center, Mumbai, Maharashtra, India.
J Arthroplasty. 2018 Oct;33(10):3190-3195. doi: 10.1016/j.arth.2018.06.006. Epub 2018 Jun 12.
Femoroacetabular impingement (FAI) is an overlooked entity in India, as primary osteoarthritis of hip is uncommon in Indian population. The purpose of this study is to find out the prevalence of radiographic morphology of FAI in young asymptomatic population in India.
This is a multicenter, cross-sectional study. Radiographs of 500 young asymptomatic volunteers were taken from 10 centers across India. Suboptimal imaging lead to exclusion of 48 radiographs. Crossover sign, ischial spine sign, and posterior wall sign were included in "acetabular rotation abnormalities (R)," lateral center-edge angle and acetabular index were included in "acetabular overcoverage abnormalities (O)" while pistol grip deformity and alpha angle in "femoral abnormalities (F)." Furthermore, all the hips were divided into 4 types: normal hips (N); type I hip with single abnormality (R/O/F); type II with combination of any 2 (RO/RF/OF), and type III with all 3 abnormalities.
Sixty-eight percent of 904 hips had at least 1 type of abnormality with 47.5% hips having signs of pincer impingement, 7.9% with signs of cam impingement, and 10.8% with mixed signs. Type I.R hips (32%) were the most common hips followed by type I.O hips (18%) and type I.F (8%). Males had higher percentage of abnormalities (1.5 times) compared to females. Interobserver reliability was 0.55 to 0.81 for all the parameters. Power of study was 0.98.
Radiographic morphology of FAI exists with high prevalence in young asymptomatic Indian population similar to other ethnicities except for low prevalence of cam morphology. Long-term follow-up of this cohort will reveal the natural history of these morphologies.
在印度，髋关节撞击综合征（FAI）是一种被忽视的疾病，因为原发性髋关节骨关节炎在印度人群中并不常见。本研究旨在探讨印度年轻无症状人群中 FAI 的放射学形态学的流行情况。
这是一项多中心、横断面研究。从印度 10 个中心招募了 500 名年轻无症状志愿者进行放射检查。由于影像学质量不佳，有 48 张图像被排除在外。在“髋臼旋转异常（R）”中包括了交叉征、坐骨棘征和后壁征，在“髋臼覆盖异常（O）”中包括了外侧中心边缘角和髋臼指数，在“股骨异常（F）”中包括了手枪柄畸形和α角。此外，所有髋关节分为 4 种类型：正常髋关节（N）；单一异常的 I 型髋关节（R/O/F）；两种异常的 II 型（RO/RF/OF），三种异常的 III 型（所有 3 种异常）。
904 个髋关节中有 68%至少存在 1 种异常，其中 47.5%存在钳夹撞击征，7.9%存在凸轮撞击征，10.8%存在混合征。最常见的是 I.R 型髋关节（32%），其次是 I.O 型髋关节（18%）和 I.F 型髋关节（8%）。男性异常发生率高于女性（1.5 倍）。所有参数的观察者间信度为 0.55 至 0.81。研究的效能为 0.98。
在年轻无症状的印度人群中，FAI 的放射学形态与其他种族一样存在较高的流行率，除了凸轮形态的低流行率外。对该队列的长期随访将揭示这些形态的自然史。
