Wako Masanori, Koyama Kensuke, Takayama Yoshihiro, Haro Hirotaka
Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Chuo-shi, Yamanashi, Japan.
Medicine (Baltimore). 2020 Apr;99(14):e19600. doi: 10.1097/MD.0000000000019600.
Slipped capital femoral epiphysis (SCFE) is a very common disorder affecting the adolescent hip. The etiology of SCFE is multifactorial and mechanical force associated with the characteristic morphology of the hip is considered one of the causes of SCFE. We investigated the characteristics of whole pelvic morphology including pelvic incidence (PI) in patients with SCFE and compared it with pelvic morphology in healthy children. We retrospectively assessed the whole pelvic morphology of 17 patients with SCFE and 51 healthy children using their pelvic computed tomography data. We measured superior iliac angle, inferior iliac angle, and ischiopubic angle as the parameters of pelvic rotation. Additionally, we measured acetabular anteversion of the superior acetabulum (AVsup) and of the center of the acetabulum (AVcen), and measured anterior acetabular sector angle (AASA), posterior acetabular sector angle, and the superior acetabular sector angle (SASA) as parameters of acetabular coverage and PI. Each measurement was compared between the 2 groups. AASA and SASA of patients with SCFE were significantly greater than that of controls, and AVsup of patients with SCFE was significantly smaller. There were no significant differences in pelvic rotation, PI, or AVcen between the 2 groups. This is the 1st report to evaluate SCFE patients' whole pelvic morphology including PI and pelvic rotation. Our results showed that patients with SCFE have excessive coverage of the anterior and superior acetabulum, and a more retroverted cranial acetabulum as compared with healthy control subjects. Such characteristic pelvic morphology may be involved in the onset of SCFE. To clarify the mechanical forces involved in SCFE onset, further investigations of pelvic morphology and alignment, including the femur and spine, are needed.
股骨头骨骺滑脱（SCFE）是一种影响青少年髋关节的常见疾病。SCFE的病因是多因素的，与髋关节特征形态相关的机械力被认为是SCFE的病因之一。我们研究了SCFE患者全骨盆形态的特征，包括骨盆倾斜角（PI），并将其与健康儿童的骨盆形态进行比较。我们回顾性评估了17例SCFE患者和51例健康儿童的全骨盆形态，使用他们的骨盆计算机断层扫描数据。我们测量了髂骨上角、髂骨下角和耻骨坐骨角作为骨盆旋转的参数。此外，我们测量了上髋臼（AVsup）和髋臼中心（AVcen）的髋臼前倾角，并测量了前髋臼扇形角（AASA）、后髋臼扇形角和上髋臼扇形角（SASA）作为髋臼覆盖和PI的参数。对两组之间的每项测量进行了比较。SCFE患者的AASA和SASA显著大于对照组，SCFE患者的AVsup显著较小。两组之间在骨盆旋转、PI或AVcen方面没有显著差异。这是第一篇评估包括PI和骨盆旋转在内的SCFE患者全骨盆形态的报告。我们的结果表明，与健康对照受试者相比，SCFE患者的前髋臼和上髋臼覆盖过度，颅骨髋臼更后倾。这种特征性的骨盆形态可能与SCFE的发病有关。为了阐明SCFE发病过程中涉及的机械力，需要进一步研究包括股骨和脊柱在内的骨盆形态和对线情况。
