Zhang Sicheng, Song Jun, Wu Qingjie, Fang Jihong, Ning Bo
Department of Pediatric Orthopaedic, Anhui Provincial Children's Hospital, Hefei, China.
Children's Hospital, Fudan University, Shanghai, China.
Front Pediatr. 2022 May 11;10:918660. doi: 10.3389/fped.2022.918660. eCollection 2022.
The aims of the present study is to evaluate the roles of collagen I and III in the hip capsule in the postoperative clinical function of patients with developmental dysplasia of the hip (DDH). Hip capsules from 155 hips of 120 patients were collected during surgery. The patients were divided into three groups according to age: I: 2-3.5 years; II: 3.5-5 years; and III: 5-6 years. Patient clinical function and radiographic outcomes were evaluated with the McKay scores and Severin classification. The expression of collagen I and III was detected through immunohistochemistry and quantitative reverse transcription polymerase chain reaction (RT-PCR) and analyzed according to age, sex, degree of dislocation and McKay classification. All patients received open reduction and pelvic osteotomy and/or femoral shortening osteotomy and achieved good results on the basis of postoperative X-ray imaging. The average follow-up time was 3.4 years (range 2-4.3 years). There were no changes in the expression of collagen III in the different groups. The expression of collagen I according to age and sex was not significantly different. Lower expression of collagen I was observed in DDH patients with a higher degree of dislocation according to the Tonnis grade. The highest expression of collagen I was detected in the group with poor clinical function according to the McKay classification. Collagen I is correlated with the degree of dislocation and is a risk factor for poor clinical function in DDH patients. Collagen I is correlated with the degree of hip dislocation and poor clinical function in DDH patients.
本研究的目的是评估I型和III型胶原蛋白在髋关节囊对发育性髋关节发育不良（DDH）患者术后临床功能中的作用。在手术过程中收集了120例患者155个髋关节的髋关节囊。根据年龄将患者分为三组：I组：2 - 3.5岁；II组：3.5 - 5岁；III组：5 - 6岁。采用麦凯（McKay）评分和塞韦林（Severin）分类法评估患者的临床功能和影像学结果。通过免疫组织化学和定量逆转录聚合酶链反应（RT-PCR）检测I型和III型胶原蛋白的表达，并根据年龄、性别、脱位程度和麦凯分类进行分析。所有患者均接受切开复位及骨盆截骨术和/或股骨短缩截骨术，术后X线影像显示效果良好。平均随访时间为3.4年（范围2 - 4.3年）。不同组间III型胶原蛋白的表达无变化。I型胶原蛋白根据年龄和性别的表达无显著差异。根据托尼尼斯（Tonnis）分级，脱位程度较高的DDH患者中观察到I型胶原蛋白表达较低。根据麦凯分类，临床功能较差的组中检测到I型胶原蛋白表达最高。I型胶原蛋白与脱位程度相关，是DDH患者临床功能不佳的危险因素。I型胶原蛋白与DDH患者的髋关节脱位程度和临床功能不佳相关。
