de Pina Cabral Fernando, Figueiredo Felipe, Todorski Inga, Toledo de Araujo Lucio C, Locks Renato, Aguiar Diego Pinheiro
Department of Orthopaedics, SOS Cardio Hospital, Rodovia SC 401, 121 Itacorubi, Florianópolis, SC, Brazil.
Department of Reserch, National Institute of Traumatology and Orthopaedics Jamil Haddad, Av. Brasil, 500 Caju, Rio de Janeiro, RJ, Brazil.
J Orthop. 2019 Oct 31;18:32-35. doi: 10.1016/j.jor.2019.10.005. eCollection 2020 Mar-Apr.
The aim of the study was to evaluate femoral torsion (FT) by computed tomography (CT) in young patients with hip pain and femoroacetabular impingement (FAI) in a Brazilian population. After the diagnosis of impingement, the complete analysis from the hip biomechanics and morphology has become essential.
Forty-one patients from 18 to 45 years presenting hip pain without arthrosis (Tönnis2) were evaluated by CT scan from February 2017 to February 2018. All patients presented hip pain for at least 3 months and FAI. They have followed the same radiographic protocol and modified Harris Hip Score (mHHS) evaluation. Statistical analyses by software version 3.4.4. with significance p < 0,05.
After exclusion criterias, twenty-six patients (9 bilateral) were included, mostly man (73%). The average age was 35 years for both genders. BMI was 19 kg/m2 for women and 24 kg/m2 for men and the mean modified Harris Hip Score was 67 points. We have found femoral torsion changes in 11 hips with pain (31%) and high variability (60%). The mean FT was 14,5°, ranging from 0 to 39°. Patients with hip pain, CAM impingement and altered FT had no correlation when compared to controls (without pain) (p = 0.234), neither Mixed impingement (p = 0.314). Patients with Pincer impingement and painful hips had higher FT (16,63°) than controls (11,77°) (p = 0.045). : The presence of torsional alterations in almost 1/3 of the patients with FAI and the high variability reveal the importance of measuring FT at this disease.
本研究的目的是通过计算机断层扫描（CT）评估巴西人群中患有髋关节疼痛和股骨髋臼撞击症（FAI）的年轻患者的股骨扭转（FT）情况。在诊断出撞击症后，对髋关节生物力学和形态进行全面分析变得至关重要。
2017年2月至2018年2月期间，对41名年龄在18至45岁、无关节病（Tönnis2）的髋关节疼痛患者进行了CT扫描评估。所有患者髋关节疼痛至少3个月且患有FAI。他们遵循相同的放射学方案和改良Harris髋关节评分（mHHS）评估。使用3.4.4版本软件进行统计分析，显著性p<0.05。
经过排除标准后，纳入了26名患者（9例双侧），大多数为男性（73%）。男女平均年龄均为35岁。女性BMI为19kg/m²，男性为24kg/m²，平均改良Harris髋关节评分为67分。我们发现11例疼痛髋关节存在股骨扭转变化（31%），且变异性高（60%）。平均FT为14.5°，范围为0至39°。与对照组（无疼痛）相比，髋关节疼痛、凸轮撞击且FT改变的患者无相关性（p=0.234），与混合撞击患者也无相关性（p=0.314）。钳夹撞击且髋关节疼痛的患者FT（16.63°）高于对照组（11.77°）（p=0.045）。几乎三分之一的FAI患者存在扭转改变且变异性高，这揭示了在这种疾病中测量FT的重要性。
