Smolders José M H, Speirs Andrew D, Frei Hanspeter, Beaulé Paul E
Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
Department of Mechanical and Aerospace Engineering, Carleton University, Ottawa, ON, Canada.
J Hip Preserv Surg. 2018 Jun 22;5(3):259-266. doi: 10.1093/jhps/hny017. eCollection 2018 Aug.
A cam deformity is proposed as a cause of idiopathic osteoarthritis. Increased subchondral bone mineral density (BMD) is associated with this degenerative process of osteoarthritis, and the patient's activity level may contribute to it. Therefore, the correlation between activity level and subchondral BMD in subjects with cam deformity FAI was studied. In this study, 26 asymptomatic cam deformity subjects (Bump) were compared with 18 subjects with a normal alpha angle (Control). Anterosuperior subchondral femoral neck and acetabular rim BMD were measured using quantitative computed tomography. Activity level was determined using the UCLA activity score. The correlation between BMD and UCLA activity were analysed. The result was a significantly higher BMD for Bump subjects in almost all measured sections. The UCLA score of the Bump versus Control subjects were comparable (8.96 versus 8.77, = 0.740). While the controls showed no correlation between UCLA and BMD, a positive correlation was found for the Bump subjects on several femoral and acetabular impingement locations. These results support the conclusion that mechanical loading causes subchondral stiffening at the anterosuperior head-neck junction of the femur and anterosuperior acetabular rim. The absence of a correlation between BMD versus UCLA in the Controls supports the hypothesis that activity level may serve as a predictor for higher subchondral BMD in a cam deformity hip joint.
凸轮畸形被认为是特发性骨关节炎的一个病因。软骨下骨矿物质密度(BMD)增加与骨关节炎的这种退行性过程相关,并且患者的活动水平可能对此有影响。因此,研究了凸轮畸形型股骨髋臼撞击症(FAI)患者的活动水平与软骨下BMD之间的相关性。在本研究中,将26名无症状凸轮畸形受试者(凸块组)与18名阿尔法角正常的受试者(对照组)进行比较。使用定量计算机断层扫描测量股骨颈前上侧软骨下和髋臼缘的BMD。使用加州大学洛杉矶分校(UCLA)活动评分确定活动水平。分析BMD与UCLA活动评分之间的相关性。结果是,几乎在所有测量部位,凸块组受试者的BMD均显著更高。凸块组与对照组受试者的UCLA评分相当(8.96对8.77,P = 0.740)。虽然对照组中UCLA评分与BMD之间无相关性,但在几个股骨和髋臼撞击部位,凸块组受试者存在正相关。这些结果支持以下结论:机械负荷会导致股骨颈前上交界处和髋臼前上缘的软骨下硬化。对照组中BMD与UCLA评分之间无相关性,这支持了以下假设:活动水平可能是凸轮畸形髋关节中软骨下BMD升高的一个预测指标。