Roos Bruno Dutra, Roos Milton Valdomiro, Camisa Júnior Antero, Lima Ezequiel Moreno Ungaretti, Tisatto Darby Lira, Argoud Marcel Cruz
Grupo de Quadril do Hospital Ortopédico de Passo Fundo, Faculdade de Medicina da Universidade de Passo Fundo, Passo Fundo, RS, Brasil.
Rev Bras Ortop (Sao Paulo). 2020 Apr;55(2):239-246. doi: 10.1055/s-0039-3400516. Epub 2020 Jan 28.
The purpose of the present study was to evaluate the pelvic bone deformities and its correlation with the acetabular center-edge (CE) angle. Between August 2014 and April 2015, we prospectively evaluated patients aged between 20 and 60 years old. The exclusion criteria were: metabolic disease, previous hip or spine surgery, radiograph showing hip arthrosis ≥ Tönnis two, severe hip dysplasia, global acetabular overcoverage, acetabular crossover sign, hip deformities from slipped capital femoral epiphysis (SCFE) or Leg-Perthes-Calveé, and bad quality radiographs. At anteroposterior (AP) pelvic radiographs, we have evaluated: the CE angle, the acetabular index (IA), the acetabular crossover sign, the vertical and horizontal superior and inferior pelvic axis (H1: Horizontal line 1, superior pelvic axis; H2: Horizontal line 2, superior pelvic axis; V1: Vertical line, superior pelvic axis; HR: Horizontal line, inferior pelvic axis; VR: Vertical line, inferior pelvic axis). The superior and inferior pelvic axis were considered asymmetric when there was a difference ≥ 5 mm between both sides. Patients were divided into two groups: control and group 1. A total of 228 patients (456 hips) were evaluated in the period. According to the established criteria, 93 patients were included. The mean age was 39.9 years old (20 to 60 years old, standard deviation [SD] = 10,5), and the mean CE angle in the right hip was 31.5° (20 to 40°), and in the left 32.3° (20 to 40°). The control group had 38 patients, with asymmetric H1 in 4 cases (10.5%), H2 in 5 (13.1%), V1 in 7 (18.4%), HR in 5 (13.1%) and VR in 1 (2.63%). Group 1 had 55 patients, with asymmetric H1 in 24 cases (43.6%), H2 in 50 (90.9%), V1 in 28 (50.9%), HR in 16 (29.09%) and VR in 8 (14.5%). Comparing both groups, there was statistical significance for H1, H2 and V1 asymmetry ( < 0.001). In the present paper, we observed the correlation between variation in the acetabular CE angle and asymmetry of the superior hemipelvis. The present authors believe that a better understanding of the pelvic morphologic alterations allows a greater facility in the diagnosis of hip articular deformities.
本研究的目的是评估骨盆骨畸形及其与髋臼中心边缘（CE）角的相关性。2014年8月至2015年4月期间，我们对年龄在20至60岁之间的患者进行了前瞻性评估。排除标准为：代谢性疾病、既往髋部或脊柱手术史、X线片显示髋关节骨关节炎≥托尼斯二级、严重髋关节发育不良、髋臼整体覆盖过度、髋臼交叉征、股骨头骨骺滑脱（SCFE）或勒格-佩尔热-卡尔维病导致的髋部畸形以及质量不佳的X线片。在前后位（AP）骨盆X线片上，我们评估了：CE角、髋臼指数（IA）、髋臼交叉征、骨盆上下垂直和水平轴（H1：水平线1，骨盆上轴；H2：水平线2，骨盆上轴；V1：垂直线，骨盆上轴；HR：水平线，骨盆下轴；VR：垂直线，骨盆下轴）。当两侧差异≥5 mm时，认为骨盆上下轴不对称。患者分为两组：对照组和1组。在此期间，共评估了228例患者（456髋）。根据既定标准，纳入93例患者。平均年龄为39.9岁（20至60岁，标准差[SD]=10.5），右髋平均CE角为31.5°（20至40°），左髋为32.3°（20至40°）。对照组有38例患者，H1不对称4例（10.5%），H2不对称5例（13.1%），V1不对称7例（18.4%），HR不对称5例（13.1%），VR不对称1例（2.63%）。1组有55例患者，H1不对称24例（43.6%），H2不对称50例（90.9%），V1不对称28例（50.9%），HR不对称16例（29.09%），VR不对称8例（14.5%）。比较两组，H1、H2和V1不对称具有统计学意义（<0.001）。在本文中，我们观察到髋臼CE角变化与上半骨盆不对称之间的相关性。本文作者认为，更好地了解骨盆形态学改变有助于更准确地诊断髋关节畸形。
