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髋关节撞击综合征:影像学参数、运动活动与软骨损伤的相关性。

Femoroacetabular impingement: correlation between imaging parameters, sport activity and chondral damage.

机构信息

Department of Medicine and Surgery, University of Parma, Parma, Italy.

Santa Maria Hospital, Borgo Val di Taro, Parma, Italy.

出版信息

J Sports Med Phys Fitness. 2022 Jun;62(6):803-811. doi: 10.23736/S0022-4707.21.12274-1. Epub 2021 Apr 19.

DOI:10.23736/S0022-4707.21.12274-1
PMID:33871244
Abstract

BACKGROUND

Femoroacetabular impingement is characterized by an abnormal contact between the acetabulum and the femoral head-neck junction. Femoroacetabular impingement shows three main clinical frameworks: pincer-FAI, cam-FAI and cam-pincer mixed form. The aim of the study was to investigate the correlation between femoroacetabular impingement, imaging, activity and chondral damages.

METHODS

Forty-one patients, undergoing arthroscopic chondroartroplasty for cam and cam-pincer mixed form were considered. All patients underwent an X-Ray hip evaluation (G1 group), while 15 patients also underwent a pelvis MRI evaluation (G2 subgroup). For G1 patients, the superior-inferior offset ratio and alpha angle were calculated from the X-Ray examinations. For G2 patients, the antero-posterior offset ratio was also calculated from pelvis MRI. Chondral damage was classified according to the Outerbridge Classification.

RESULTS

The superior-inferior offset ratio and the antero-posterior offset ratio were respectively 0.50±0.23 and 0.33±0.19. The α angle predictive for a chondral damage of IV degree was 81.5°. The chondral damage of the patients suffering from cam-FAI and cam-pincer mixed form were respectively 3.53±0.80 and 3.00±1.41.

CONCLUSIONS

From the results was possible to: 1) elaborate two tables providing a reliable indirect calculation of the alpha angle; 2) establish an alpha angle cut-off value indicative for a IV degree chondral damage; 3) show that pincer-FAI does not represent an aggravating factor for chondral damage; 4) show that the level of sports activity was related to the severity of chondral damage; and 5) show that a physically demanding occupation was not an aggravating factor for chondral damage.

摘要

背景

髋关节撞击综合征的特征是髋臼和股骨头颈交界处的异常接触。髋关节撞击综合征有三种主要的临床类型:钳夹型髋关节撞击征、凸轮型髋关节撞击征和凸轮-钳夹混合型。本研究旨在探讨髋关节撞击征、影像学、活动和软骨损伤之间的相关性。

方法

共纳入 41 例接受凸轮和凸轮-钳夹混合型关节镜下软骨成形术的患者。所有患者均接受髋关节 X 线评估(G1 组),其中 15 例患者还接受骨盆 MRI 评估(G2 亚组)。对于 G1 组患者,从 X 线检查中计算出上下偏移比和α角。对于 G2 组患者,还从骨盆 MRI 中计算出前后偏移比。软骨损伤根据 Outerbridge 分级进行分类。

结果

上下偏移比和前后偏移比分别为 0.50±0.23 和 0.33±0.19。预测软骨损伤为 IV 度的α角为 81.5°。凸轮型髋关节撞击征和凸轮-钳夹混合型患者的软骨损伤分别为 3.53±0.80 和 3.00±1.41。

结论

从结果中可以得出以下结论:1)制定了两个表格,提供了一种可靠的α角间接计算方法;2)确定了一个 α角的截断值,可预测 IV 度软骨损伤;3)表明钳夹型髋关节撞击征不是软骨损伤的加重因素;4)表明运动水平与软骨损伤的严重程度有关;5)表明体力劳动不是软骨损伤的加重因素。

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