Wirries Nils, Heinrich Gesche, Derksen Alexander, Budde Stefan, Floerkemeier Thilo, Windhagen Henning
Department of Orthopaedic Surgery at Diakovere Annastift, Hannover Medical School, 30625 Hannover, Germany.
go:h Gelenkchirurgie-Orthopädie: Hannover, 30159 Hannover, Germany.
Children (Basel). 2021 Nov 2;8(11):992. doi: 10.3390/children8110992.
(1) Background: Previous studies have proven a high incidence of a femoro-acetabular impingement (FAI) type cam in patients sustaining a slipped capital femoral epiphysis (SCFE). Thus, the current study analyzed, if a cam deformity is predictable after SCFE treatment; (2) Methods: 113 cases of SCFE were treated between 1 January 2005 and 31 December 2017. The radiological assessment included the slip angle after surgery (referenced to the femoral neck (epiphyseal tilt) and shaft axis as Southwick angle) and the last available lateral center edge angle (LCEA), the acetabular- and alpha angle. A correlation was performed between these parameters and the last alpha angle to predict a FAI type cam; (3) Results: After a mean follow-up of 4.3 years (±1.9; 2.0-11.2), 48.5% of the patients showed a FAI type cam and 43.2% a dysplasia on the affected side. The correlation between the epiphyseal tilt and alpha angle was statically significant ( = 0.017) with a medium effect size of 0.28; (4) Conclusions: The postoperative posterior epiphyseal tilt was predictive factor to determine the alpha angle. However, the cut-off value of the slip angle was 16.8° for a later occurrence of a FAI type cam indicating a small range of acceptable deviations from the anatomical position for SCFE reconstruction.
(1) 背景:先前的研究已证实,在患有股骨头骨骺滑脱(SCFE)的患者中,股骨髋臼撞击症(FAI)凸轮型的发生率很高。因此,本研究分析了SCFE治疗后凸轮畸形是否可预测;(2) 方法:2005年1月1日至2017年12月31日期间治疗了113例SCFE患者。放射学评估包括术后的滑移角(以股骨颈(骨骺倾斜)和股骨干轴线为参照的Southwick角)以及最后可获得的外侧中心边缘角(LCEA)、髋臼角和α角。对这些参数与最后一个α角进行相关性分析,以预测FAI凸轮型;(3) 结果:平均随访4.3年(±1.9;2.0 - 11.2)后,48.5%的患者患侧出现FAI凸轮型,43.2%出现发育异常。骨骺倾斜与α角之间的相关性具有统计学意义(P = 0.017),中等效应量为0.28;(4) 结论:术后骨骺后倾是决定α角的预测因素。然而,对于后期发生FAI凸轮型而言,滑移角的临界值为16.8°,这表明SCFE重建时从解剖位置允许的偏差范围较小。