Cho Yoon-Je, Rhyu Kee-Hyung, Chun Young-Soo, Kim Myung-Seo
Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, 23 Kyung Hee Dae-ro, Dongdaemoon-ku, Seoul 02447, Republic of Korea.
Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-ku, Seoul 05278, Republic of Korea.
J Hip Preserv Surg. 2022 Jun 30;9(3):151-157. doi: 10.1093/jhps/hnac026. eCollection 2022 Aug.
The aim of this study was to assess injury patterns and risk factors of the acetabular labrum and associated cartilage in patients with femoroacetabular impingement (FAI) versus dysplasia. We retrospectively reviewed 137 patients diagnosed with labral tears and FAI or dysplasia (74 or 63 cases, respectively) through an arthroscopic procedure. Labral and concomitant cartilage injuries were evaluated. Demographics and radiological variables [lateral center-edge angle (LCEA), anterior center-edge angle, acetabular index (AI), acetabular version and alpha angle] were evaluated as risk factors for labral and cartilage injuries. Detachment of acetabular cartilage with intact labro-cartilaginous junction was the most common in dysplasia, whereas cartilage delamination from the labro-cartilaginous junction was more common in FAI ( < 0.001). A higher body mass index was significantly associated with delamination injury in FAI (odds ratio 1.226; 95% CI 1.043-1.441; = 0.013). A significant correlation was evident between detachment injury and a larger AI in dysplasia (odds ratio 1.127; 95% CI 1.000-1.270; = 0.049). In addition, symptom duration was positively correlated with the extent of labral tearing in FAI (= 0.013), whereas the smaller LCEA was correlated with the larger extent of labral tearing in dysplasia ( = 0.044). FAI and dysplasia patients exhibited different labral and cartilage injury patterns. Increased body mass index was correlated with delamination injury in FAI, whereas an increased AI was associated with detachment injury in dysplasia. Greater tearing was associated with a longer symptom duration in FAI, and a decreased LCEA was a risk factor for the extent of tearing in dysplasia. Level of evidence Level III. Case-control study.
本研究的目的是评估股骨髋臼撞击症(FAI)患者与髋臼发育不良患者髋臼盂唇及相关软骨的损伤模式和危险因素。我们回顾性分析了137例经关节镜手术诊断为盂唇撕裂合并FAI或髋臼发育不良的患者(分别为74例和63例)。评估了盂唇及合并的软骨损伤情况。将人口统计学和放射学变量[外侧中心边缘角(LCEA)、前中心边缘角、髋臼指数(AI)、髋臼扭转角和α角]作为盂唇和软骨损伤的危险因素进行评估。髋臼软骨在盂唇 - 软骨交界处完整时发生分离在髋臼发育不良中最为常见,而在FAI中,软骨从盂唇 - 软骨交界处分层更为常见(<0.001)。较高的体重指数与FAI中的分层损伤显著相关(优势比1.226;95%置信区间1.043 - 1.441;=0.013)。在髋臼发育不良中,分离损伤与较大的AI之间存在显著相关性(优势比1.127;95%置信区间1.000 - 1.270;=0.049)。此外,症状持续时间与FAI中盂唇撕裂程度呈正相关(=0.013),而较小的LCEA与髋臼发育不良中盂唇撕裂程度较大相关(=0.044)。FAI和髋臼发育不良患者表现出不同的盂唇和软骨损伤模式。体重指数增加与FAI中的分层损伤相关,而AI增加与髋臼发育不良中的分离损伤相关。在FAI中,更大的撕裂与更长的症状持续时间相关,而LCEA降低是髋臼发育不良中撕裂程度的一个危险因素。证据级别:III级。病例对照研究。