Trenga Anthony P, LaReau Justin M, Close Mary R, Domb Benjamin G
American Hip Institute, Westmont, IL, USA.
Hinsdale Orthopaedics, Hinsdale, IL, USA.
J Hip Preserv Surg. 2018 Dec 6;5(4):404-409. doi: 10.1093/jhps/hny044. eCollection 2018 Dec.
The purpose of this study was to investigate the association between ligamentum teres (LT) tears with hypertrophy of the acetabular labrum and cartilage and labral damage. Surgeries (1723) were performed from February 2010 to March 2016 with arthroscopic measurement of the labrum and assessment of the LT, labrum and acetabular cartilage. Labral width was measured in the anterosuperior (AS), anteroinferior (AI), posteroinferior (PI) and posterosuperior (PS) quadrants. Grade 2 (50-99% torn) LT tears had larger labra in all four quadrants (AS = 5.64 ± 1.97 mm; AI = 5.23 ± 1.51; PS = 5.58 ± 1.39; PI = 4.60 ± 1.13) than grade 3 (100% torn) (AS = 5.50 ± 1.94; AI 4.90 ± 1.43; PS 5.43 ± 1.32; PI 4.42 ± 1.03), grade 1 (<50% torn) (AS 5.30 ± 1.68; AI 4.96 ± 1.32; PS = 5.38 ± 1.13; PI = 4.45 ± 1.04) and no tear (AS = 5.09 ± 1.51; AI = 4.92 ± 1.24; PS = 5.24 ± 1.09; PI = 4.37 ± .93); < 0.01 in all quadrants. Grade 3 LT tears had more damage to the labrum than grade 2, grade 1 and no tear; < 0.001. ALAD tears were larger in grade 3 and grade 2 than grade 1 and non-torn LTs; < 0.001. Grade 3 tears had a higher percentage of high-grade cartilage tears than grade 2 LT tears; < 0.001. Degenerative tears had larger labra, labral tears and acetabular cartilage tears than full- and partial-thickness LT tears; < 0.01. Patients with partial-thickness LT tears had larger labra in all four quadrants than full-thickness tears in the Percentile and Villar classifications. Full-thickness tears had more severe labral damage and higher-grade chondral damage than partial-thickness tears. Degenerative tears demonstrated the largest labra, labral tears and ALAD tears. The condition of the LT demonstrated an association with acetabular cartilage injury and should be evaluated when considering hip preservation surgery. Level IV Case Series.
本研究的目的是调查髋臼盂唇和软骨肥大及盂唇损伤与圆韧带（LT）撕裂之间的关联。2010年2月至2016年3月期间共进行了1723例手术，术中通过关节镜测量盂唇并评估LT、盂唇和髋臼软骨。在髋臼的前上（AS）、前下（AI）、后下（PI）和后上（PS）象限测量盂唇宽度。2级（50 - 99%撕裂）LT撕裂在所有四个象限的盂唇均比3级（100%撕裂）、1级（<50%撕裂）及无撕裂情况更大（AS：2级为5.64±1.97mm，3级为5.50±1.94mm，1级为5.30±1.68mm，无撕裂为5.09±1.51mm；AI：2级为5.23±1.51mm，3级为4.90±1.43mm，1级为4.96±1.32mm，无撕裂为4.92±1.24mm；PS：2级为5.58±1.39mm，3级为5.43±1.32mm，1级为5.38±1.13mm，无撕裂为5.24±1.09mm；PI：2级为4.60±1.13mm，3级为4.42±1.03mm，1级为4.45±1.04mm，无撕裂为4.37±0.93mm）；所有象限P<0.01。3级LT撕裂比2级、1级及无撕裂情况对盂唇的损伤更大；P<0.001。3级和2级的髋臼盂唇联合损伤（ALAD）撕裂比1级和未撕裂的LT更大；P<0.001。3级撕裂比2级LT撕裂有更高比例的高级别软骨撕裂；P<0.001。退变性撕裂的盂唇、盂唇撕裂和髋臼软骨撕裂比全层和部分厚度LT撕裂更大；P<0.01。在百分位数和维拉尔分类中，部分厚度LT撕裂患者在所有四个象限的盂唇均比全层撕裂患者更大。全层撕裂比部分厚度撕裂有更严重的盂唇损伤和更高级别的软骨损伤。退变性撕裂表现出最大的盂唇、盂唇撕裂和ALAD撕裂。LT的情况与髋臼软骨损伤有关，在考虑保髋手术时应进行评估。IV级病例系列。
