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概念验证:在实验性 FAI 羊模型中,髋关节损伤发生在股骨髋臼撞击(FAI)区域。

Proof of concept: hip joint damage occurs at the zone of femoroacetabular impingement (FAI) in an experimental FAI sheep model.

机构信息

Department of Orthopaedic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Department of Orthopaedic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

出版信息

Osteoarthritis Cartilage. 2019 Jul;27(7):1075-1083. doi: 10.1016/j.joca.2019.04.001. Epub 2019 Apr 13.

Abstract

OBJECTIVE

In ovine hips chondrolabral damage as seen in cam-type femoroacetabular impingement (FAI) can be induced via an intertrochanteric varus osteotomy. However, it is yet to proven whether the observed cartilage damage is caused by a dynamic cam type impingement. Thus we asked, (1) whether actual cartilage damage observed after FAI induction in ovine hips occurs at the predicted, computed zone of FAI; (2) whether the extent of cartilage damage increases with ambulation time in this animal model?

DESIGN

In this experimental, controlled, comparative study 20 sheep underwent unilateral FAI induction through an intertrochanteric varus osteotomy. Preoperatively sheep underwent computed tomography to generate three-dimensional models of the osseous pelvis and femur. The models were used to predict impingement zones before and after simulated varus osteotomy using range of motion (ROM) analysis. Sheep were sacrificed after 14-40 weeks of ambulation. At sacrifice cartilage was inspected and (1) location of actual damage and computed impingement zones were compared; (2) Cartilage damage was compared between short- and long ambulation groups.

RESULTS

(1) The average location and the extent of peripheral and central cartilage lesions did not differ with the computed impingement zones (all P > 0.05). (2) Grades of central, posterior cartilage damage were more severe in the long-compared to the short ambulation group (2.2 ± 1.8 vs 0.4 ± 0.5; P = 0.030).

CONCLUSIONS

In this experimental ovine FAI model the surgical induction of an osseous impingement conflict between the femur and acetabulum causes cartilage damage at the zone of simulated FAI.

摘要

目的

在羊髋关节中,如凸轮型股骨髋臼撞击症(FAI)中所见的软骨-盂唇损伤,可以通过转子间内翻截骨术来诱导。然而,目前尚不清楚观察到的软骨损伤是否是由动态凸轮型撞击引起的。因此,我们提出以下问题:(1)在羊髋关节中 FAI 诱导后观察到的实际软骨损伤是否发生在预测的、计算的 FAI 区域;(2)在这种动物模型中,软骨损伤的程度是否随步行时间的增加而增加?

设计

在这项实验性、对照性、比较研究中,20 只羊通过转子间内翻截骨术接受了单侧 FAI 诱导。术前,羊接受了计算机断层扫描,以生成骨盆和股骨的三维模型。使用运动范围(ROM)分析,在模拟内翻截骨术前后,使用这些模型来预测撞击区域。羊在步行 14-40 周后被处死。在处死时,检查软骨并比较:(1)实际损伤的位置和计算的撞击区域;(2)比较短步行和长步行组之间的软骨损伤。

结果

(1)平均位置和外周及中央软骨损伤的程度与计算的撞击区域没有差异(所有 P>0.05)。(2)与短步行组相比,长步行组中央、后软骨损伤的程度更严重(2.2±1.8 与 0.4±0.5;P=0.030)。

结论

在这个羊 FAI 模型的实验中,股骨和髋臼之间的骨性撞击的手术诱导导致模拟 FAI 区域的软骨损伤。

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