Gürsan Onur, Açan Ahmet Emrah, Asma Ali, Hapa Onur
Department of Orthopedics and Traumatology, Faculty of Medicine Dokuz Eylül University, Izmir, Turkey.
Jt Dis Relat Surg. 2020;31(1):109-14. doi: 10.5606/ehc.2020.70193.
This study aims to determine if there is an axial plane coverage insufficiency in patients with symptomatic labral tears compared to the contralateral asymptomatic side and healthy control subjects.
This retrospective study was conducted between December 2017 and January 2019. Thirty patients (21 males, 9 females; mean age 28 years; range, 20 to 36 years) operated due to unilateral symptomatic acetabular labral tears secondary to femoroacetabular impingement were evaluated. Twenty asymptomatic patients (13 males, 7 females; mean age 27±9 years; range, 19 to 36 years) were included in the control group. The relationship between acetabular morphology and labral tear was investigated with the comparison of unilateral symptomatic hips with contralateral asymptomatic hips and the control group by using radiological parameters on plain radiographs and computed tomography.
When the patient group symptomatic side was compared to the control group, acetabular anteversion angle (A A A) and alpha (α) angle were higher, while posterior acetabular sector angle and horizontal acetabular sector angle were lower. When the asymptomatic side was compared to the control group, AAA was higher in the patient group. There was no difference between the symptomatic and asymptomatic sides in the patient group; the symptomatic side yielded a higher α; angle.
Posterior axial plane coverage deficiency in combination with cam deformity (increased α angle) seems to play a role in the pathogenesis of symptomatic acetabular labral tears, even creating a side-to-side difference in some individuals.
本研究旨在确定有症状的髋臼唇盂撕裂患者与对侧无症状侧及健康对照者相比,是否存在轴向平面覆盖不足的情况。
本回顾性研究于2017年12月至2019年1月进行。对30例因股骨髋臼撞击继发单侧有症状髋臼唇盂撕裂而接受手术的患者(21例男性,9例女性;平均年龄28岁;范围20至36岁)进行了评估。对照组纳入20例无症状患者(13例男性,7例女性;平均年龄27±9岁;范围19至36岁)。通过使用X线平片和计算机断层扫描上的放射学参数,将单侧有症状髋关节与对侧无症状髋关节及对照组进行比较,研究髋臼形态与唇盂撕裂之间的关系。
将患者组有症状侧与对照组进行比较时,髋臼前倾角(AAA)和α角较高,而后髋臼扇形角和水平髋臼扇形角较低。将无症状侧与对照组进行比较时,患者组的AAA较高。患者组有症状侧和无症状侧之间无差异;有症状侧的α角较高。
后轴向平面覆盖不足与凸轮畸形(α角增加)相结合似乎在有症状的髋臼唇盂撕裂的发病机制中起作用,甚至在某些个体中造成双侧差异。