Kierkegaard S, Rømer L, Lund B, Dalgas U, Søballe K, Mechlenburg I
H-Hip, Department of Physio and Occupational Therapy.
Department of Radiology, Horsens Hospital, Sundvej 30, DK-8700 Horsens, Denmark.
J Hip Preserv Surg. 2020 Apr 7;7(2):242-248. doi: 10.1093/jhps/hnaa017. eCollection 2020 Jul.
Patients with femoroacetabular impingement syndrome (FAIS) are diagnosed using imaging, but detailed description especially the acetabular shape is lacking and may help give more insight to the pathogenesis of FAIS. Furthermore, associations between patient-reported outcomes (PROs) and the radiological angles might highlight which radiological angles affect outcomes experienced by the patients. Hence, the aims of this study were (i) to describe computer tomography (CT) acquired angles in patients with FAIS and (ii) to investigate the association between radiological angles and the Copenhagen Hip and Groin Outcome Score (HAGOS) in patients with FAIS. Patients scheduled for primary hip arthroscopic surgery for FAIS were included. Based on CT, following angles were measured before and 1 year after surgery; femoral anteversion, alpha, lateral centre edge, acetabular index, anterior sector, posterior sector and acetabular anteversion. All patients completed the HAGOS. Sixty patients (63% females) aged 36 ± 9 were included. One year after surgery, significant alterations in the alpha angle and the acetabular index angle were found. Neither baseline PROs nor changes in PROs were associated with the radiological angles or changes in angles. Since neither changes in CT angles nor baseline scores were associated with HAGOS, the improvements felt by patients must origin from somewhere else. These findings further underlines that morphological changes seen at imaging should not be treated arthroscopically without a patient history of symptoms and clinical findings.
股骨髋臼撞击综合征(FAIS)患者通过影像学进行诊断,但缺乏详细描述,尤其是髋臼形状的描述,而这可能有助于更深入了解FAIS的发病机制。此外,患者报告结局(PROs)与放射学角度之间的关联可能会突出哪些放射学角度会影响患者的结局。因此,本研究的目的是:(i)描述FAIS患者计算机断层扫描(CT)获得的角度;(ii)研究FAIS患者放射学角度与哥本哈根髋关节和腹股沟结局评分(HAGOS)之间的关联。纳入计划接受FAIS初次髋关节镜手术的患者。基于CT,在手术前和手术后1年测量以下角度:股骨前倾、α角、外侧中心边缘角、髋臼指数、前扇区角、后扇区角和髋臼前倾。所有患者均完成HAGOS评分。纳入了60例年龄为36±9岁的患者(63%为女性)。术后1年,发现α角和髋臼指数角有显著变化。基线PROs和PROs的变化均与放射学角度或角度变化无关。由于CT角度的变化和基线评分均与HAGOS无关,患者感觉到的改善肯定另有来源。这些发现进一步强调,在没有患者症状病史和临床检查结果的情况下,影像学上看到的形态学变化不应通过关节镜进行治疗。