正常闭孔上缘股骨间距及其相关因素：基于计算机断层扫描的研究。
Normal Ischiofemoral Distance and Its Associated Factors: Computed Tomography-Based Study.
机构信息
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Gyeonggido, South Korea.
Department of Orthopedic Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Gyeonggido, South Korea.
出版信息
Arthroscopy. 2020 Jan;36(1):150-155. doi: 10.1016/j.arthro.2019.08.013.
PURPOSE
The purposes of this study are (1) to measure the ischiofemoral distance (IFD) in nondiseased hips and (2) to reveal patient demographic and anatomical factors associated with IFD.
METHODS
In this retrospective study, we identified patients who had unilateral osteonecrosis of the femoral head on computed tomography (CT) scan from November 2005 to July 2018 and assessed the unaffected contralateral hips of the patients. Among the contralateral hips, we excluded hips with hip pain, incomplete or poor-quality CT image, incomplete medical record, degenerative arthritis of the hip, or previous hip surgery. IFD was measured on the axial CT image, and correlated demographic factors (age, sex, height, weight, and body mass index) and anatomical parameters (neck-shaft angle of the femur and femoral anteversion) with IFD were evaluated.
RESULTS
Five hundred seventeen patients (517 hips) were evaluated. There were 302 men and 215 women, and their mean age was 51.7 years (range 15-83 years). The mean IFD was 33.2 (±9.2) mm in men and 24.3 (±8.9) mm in women (P < .001). Interobserver and intraobserver reliability (intraclass correlation coefficients) were 0.99 (95% confidence interval 0.98-1.0) and 0.98 (95% confidence interval 0.97-0.99), respectively. The mean neck-shaft angle was 129.31° ± 5.04° in males and 129.93° ± 6.29° in females. The mean femoral anteversion was 9.72° ± 7.95° in males and 12.61° ± 8.91° in females. IFD was positively correlated with height (correlation coefficient [r] = 0.464, P < .001) and weight (0.286, P < .001), whereas it was negatively correlated with age (-0.198, P < .001), neck-shaft angle (-0.123, P = .005), and femoral anteversion (-0.346, P < .001). There was no correlation between body mass index and IFD (P = .522). In multivariate regression analysis, IFD was positively associated with height (β = .632), and negatively associated with neck-shaft angle of the femur and femoral anteversion (β = -0.155 and -0.328. respectively).
CONCLUSIONS
In asymptomatic hips, the mean IFD was 33.2 ± 9.2 mm in males and 24.3 ± 8.9 mm in females. The IFD was positively correlated with height and negatively with neck-shaft angle of the femur and femoral anteversion.
LEVEL OF EVIDENCE
Level III, retrospective comparative study.
目的
本研究旨在（1）测量非病变髋关节的闭孔内距（IFD），（2）揭示与 IFD 相关的患者人口统计学和解剖学因素。
方法
在这项回顾性研究中，我们从 2005 年 11 月至 2018 年 7 月确定了单侧股骨头坏死的 CT 扫描患者，并评估了患者的对侧未患病的髋关节。在对侧髋关节中，我们排除了髋关节疼痛、CT 图像不完整或质量差、病历不完整、髋关节退行性关节炎或既往髋关节手术的髋关节。在轴向 CT 图像上测量 IFD，并评估与 IFD 相关的人口统计学因素（年龄、性别、身高、体重和体重指数）和解剖学参数（股骨颈干角和股骨前倾角）。
结果
评估了 517 名患者（517 髋）。其中男性 302 例，女性 215 例，平均年龄为 51.7 岁（15-83 岁）。男性的平均 IFD 为 33.2（±9.2）mm，女性为 24.3（±8.9）mm（P<0.001）。观察者间和观察者内可靠性（组内相关系数）分别为 0.99（95%置信区间 0.98-1.0）和 0.98（95%置信区间 0.97-0.99）。男性的平均颈干角为 129.31°±5.04°，女性为 129.93°±6.29°。男性的平均股骨前倾角为 9.72°±7.95°，女性为 12.61°±8.91°。IFD 与身高呈正相关（相关系数[r]为 0.464，P<0.001）和体重（0.286，P<0.001），与年龄呈负相关（-0.198，P<0.001），颈干角（-0.123，P=0.005）和股骨前倾角（-0.346，P<0.001）。体重指数与 IFD 无相关性（P=0.522）。在多元回归分析中，IFD 与身高呈正相关（β=0.632），与股骨颈干角和股骨前倾角呈负相关（β=-0.155 和-0.328）。
结论
在无症状髋关节中，男性的平均 IFD 为 33.2±9.2mm，女性为 24.3±8.9mm。IFD 与身高呈正相关，与股骨颈干角和股骨前倾角呈负相关。
证据水平
III 级，回顾性比较研究。
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