Freiman Serena M, Schwabe Maria T, Fowler Lucas, Clohisy John C, Nepple Jeffrey J
Department of Orthopaedic Surgery, Washington University, St Louis, Missouri, USA.
Orthop J Sports Med. 2022 Feb 9;10(2):23259671211040455. doi: 10.1177/23259671211040455. eCollection 2022 Feb.
Patients with borderline acetabular dysplasia are a controversial patient population in hip preservation, as some have primarily impingement-based symptoms and others have instability-based symptoms. Borderline dysplasia is most commonly defined as a lateral center-edge angle (LCEA) of 20° to 25°. However, its prevalence has not been well established in the literature.
To (1) define the prevalence of borderline hip dysplasia in the general population as well as in populations presenting with hip pain using a systematic review and meta-analysis of the literature and (2) describe differences between male and female patients as well as differences in prevalence from that of classic acetabular dysplasia.
Systematic review; Level of evidence, 3.
A systematic review of the literature was performed using search terms to capture borderline dysplasia, or studies reporting prevalence by LCEA. The search yielded 1932 results, of which 11 articles met inclusion criteria and were included in the final systematic review. Studies were grouped by patient cohort as (1) asymptomatic general population, (2) asymptomatic targeted population (eg, athletes in a specific sport), and (3) symptomatic hip pain population. The reporting of prevalence rates by subject or by hip was recorded. In a study, the rates of borderline dysplasia were compared with those of classic acetabular dysplasia (LCEA, <20°).
The 11 studies included 19,648 hips (11,754 patients). In the asymptomatic general population, the pooled estimate of the prevalence of borderline dysplasia was 19.8% by subject and 23.3% by hip (range, 16.7%-46.0%). The targeted subpopulation group included 236 athletes with subgroups in ballet, football, hockey, volleyball, soccer, and track and field with prevalence ranging from 17.8% to 51.1%. The prevalence of borderline dysplasia in groups presenting with hip pain was 12.8% (range, 12.6%-16.0%). Borderline acetabular dysplasia was 3.5 times more common than classic acetabular dysplasia in the asymptomatic general population.
This study demonstrated a prevalence of borderline dysplasia of 19.8% to 23.3% in the asymptomatic general population. Additionally, an estimated prevalence of 12.8% of hips in symptomatic patients highlights the common decision-making challenges in this population.
髋臼发育不良临界状态的患者在髋关节保留治疗中是一个存在争议的患者群体，因为一些患者主要表现为撞击相关症状，而另一些患者则表现为不稳定相关症状。髋臼发育不良临界状态最常被定义为外侧中心边缘角（LCEA）为20°至25°。然而，其在文献中的患病率尚未得到很好的确立。
（1）通过对文献的系统评价和荟萃分析，确定一般人群以及出现髋关节疼痛人群中髋臼发育不良临界状态的患病率；（2）描述男性和女性患者之间的差异以及与经典髋臼发育不良患病率的差异。
系统评价；证据等级，3级。
使用搜索词对文献进行系统评价，以获取髋臼发育不良临界状态或按LCEA报告患病率的研究。搜索结果为1932条，其中11篇文章符合纳入标准并被纳入最终的系统评价。研究按患者队列分为：（1）无症状一般人群；（2）无症状目标人群（如特定运动项目的运动员）；（3）有症状的髋关节疼痛人群。记录按受试者或按髋关节报告的患病率。在一项研究中，将髋臼发育不良临界状态的患病率与经典髋臼发育不良（LCEA<20°）的患病率进行比较。
11项研究共纳入19648个髋关节（11754例患者）。在无症状一般人群中，按受试者计算髋臼发育不良临界状态的合并患病率估计为19.8%，按髋关节计算为23.3%（范围为16.7%-46.0%）。目标亚人群组包括236名运动员，他们分属芭蕾舞、足球、曲棍球、排球、足球和田径等亚组，患病率范围为17.8%-51.1%。出现髋关节疼痛人群中髋臼发育不良临界状态的患病率为12.8%（范围为12.6%-16.0%）。在无症状一般人群中，髋臼发育不良临界状态比经典髋臼发育不良常见3.5倍。
本研究表明，无症状一般人群中髋臼发育不良临界状态的患病率为19.8%至23.3%。此外，有症状患者中估计髋关节患病率为12.8%，这凸显了该人群常见的决策挑战。
