髋臼发育不良的髋关节中联合外侧骨唇覆盖是正常的。
Combined Lateral Osseolabral Coverage Is Normal in Hips With Acetabular Dysplasia.
机构信息
Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey, U.S.A..
Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, U.S.A.
出版信息
Arthroscopy. 2019 Mar;35(3):800-806. doi: 10.1016/j.arthro.2018.10.133. Epub 2019 Feb 4.
PURPOSE
To compare the lateral osseolabral coverage between groups of patients with different degrees of acetabular bony coverage using a magnetic resonance imaging parameter known as the combined lateral center-edge angle (cLCEA).
METHODS
The cLCEA was measured among a consecutive series of patients presenting to a dedicated hip preservation surgeon with a magnetic resonance imaging scan. The cLCEA was measured using a coronal T1 or proton density image and was defined as the angle subtended by (1) a line through the center of the femoral head and orthogonal to the transverse line passing through the teardrops of both hips and (2) an oblique line drawn from the center of the femoral head to the free edge of the lateral acetabular labrum. The average difference between the lateral center-edge angle (LCEA) and the cLCEA was calculated and compared between groups based on acetabular bony coverage: dysplasia (LCEA <20°), borderline dysplasia (LCEA 20°-24.9°), normal coverage (LCEA 25°-39.9°), and overcoverage (LCEA ≥40°).
RESULTS
In total, 341 patients (386 hips) were included. There were no significant differences in cLCEA between hips with normal acetabular coverage and dysplasia (P = .10) or borderline dysplasia (P = .46). Despite the large difference in mean LCEA between dysplasia (14.8° ± 3.9°) and acetabular overcoverage (43.1° ± 2.8°), the mean cLCEA values exhibited only a modest difference (44.7° ± 4.9° vs 52.7° ± 4.5°, respectively). Concordantly, hips with dysplasia exhibited the largest difference between mean LCEA and cLCEA (delta = 29.9° ± 4.7°) and hips with acetabular overcoverage had the smallest difference between measures (9.6° ± 5.2°).
CONCLUSIONS
With decreasing acetabular bony coverage, there is increasing labral size such that the total osseolabral coverage, measured by the combined LCEA, remains equivalent between hips with normal acetabular coverage versus dysplasia.
LEVEL OF EVIDENCE
Level III, retrospective comparative study.
目的
使用一种称为联合外侧中心边缘角（cLCEA）的磁共振成像参数，比较不同髋臼骨覆盖程度患者组之间的外侧骨唇覆盖程度。
方法
通过向专门的髋关节保护外科医生进行磁共振成像扫描，对连续系列患者进行 cLCEA 测量。cLCEA 是在冠状 T1 或质子密度图像上测量的，定义为（1）通过股骨头中心并与穿过双侧泪滴的横向线垂直的线和（2）从股骨头中心到外侧髋臼唇游离缘的斜线上所夹的角度。根据髋臼骨覆盖程度计算并比较了外侧中心边缘角（LCEA）和 cLCEA 之间的平均差异：发育不良（LCEA <20°），临界发育不良（LCEA 20°-24.9°），正常覆盖（LCEA 25°-39.9°）和覆盖过度（LCEA≥40°）。
结果
总共纳入 341 名患者（386 髋）。正常髋臼覆盖和发育不良（P=.10）或临界发育不良（P=.46）之间的 cLCEA 无显着差异。尽管发育不良（14.8°±3.9°）和髋臼过度覆盖（43.1°±2.8°）之间的平均 LCEA 差异很大，但 cLCEA 值仅显示出适度差异（分别为 44.7°±4.9°和 52.7°±4.5°）。相应地，发育不良的髋关节表现出平均 LCEA 和 cLCEA 之间最大的差异（差值为 29.9°±4.7°），而髋臼过度覆盖的髋关节之间的差异最小（9.6°±5.2°）。
结论
随着髋臼骨覆盖程度的降低，唇大小增加，因此通过联合 LCEA 测量的总骨唇覆盖在具有正常髋臼覆盖的髋关节与发育不良的髋关节之间保持相等。
证据水平
III 级，回顾性比较研究。
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