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[2023年髋关节发育不良的定义：宏观和微观不稳定的体征]

[Definition of hip dysplasia in 2023 : Signs of macro and micro instability].

作者信息

Heimann Alexander Frank, Zurmühle Corinne Andrea, Stetzelberger Vera Marie, Galley Julien, Schwab Joseph M, Tannast Moritz

机构信息

Klinik für Orthopädische Chirurgie und Traumatologie, HFR Kantonsspital Freiburg, Universität Freiburg, Chemin des pensionnats 2-6, 1700, Freiburg, Schweiz.

Klinik für Radiologie, HFR Kantonsspital Freiburg, Universität Freiburg, Freiburg, Schweiz.

出版信息

Orthopadie (Heidelb). 2023 Apr;52(4):261-271. doi: 10.1007/s00132-023-04353-x. Epub 2023 Mar 7.

DOI:10.1007/s00132-023-04353-x
PMID:36881127
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10063496/
Abstract

BACKGROUND

Hip dysplasia is a complex static-dynamic pathology leading to chronic joint instability and osteoarthritis. Because our understanding of the underlying pathomorphologies of hip dysplasia, both on the macro and micro levels, has evolved, an updated definition is needed.

QUESTION

What is the definition of hip dysplasia in 2023?

METHODS

By summarizing and reviewing relevant literature, we provide an up-to-date definition of hip dysplasia with a guide to appropriately making the diagnosis.

RESULTS

In addition to the pathognomonic parameters, supportive and descriptive indicators, as well as secondary changes are used to fully characterize instability inherent in hip dysplasia. The primary diagnostic tool is always the plain anteroposterior pelvis radiograph, which can be supplemented by additional investigations (MRI of the hip with intraarticular contrast agent; CT) if necessary.

CONCLUSION

The complexity, subtlety, and diversity of the pathomorphology of residual hip dysplasia requires careful, multilevel diagnosis and treatment planning in specialized centers.

摘要

背景

髋关节发育不良是一种复杂的静态-动态病理状况，可导致慢性关节不稳定和骨关节炎。由于我们对髋关节发育不良在宏观和微观层面的潜在病理形态学的理解不断发展，因此需要一个更新的定义。

问题

2023年髋关节发育不良的定义是什么？

方法

通过总结和回顾相关文献，我们提供了髋关节发育不良的最新定义以及进行正确诊断的指南。

结果

除了特征性参数外，还使用支持性和描述性指标以及继发性改变来全面描述髋关节发育不良固有的不稳定情况。主要诊断工具始终是骨盆前后位X线平片，必要时可辅以其他检查（髋关节磁共振成像并使用关节内造影剂；CT）。

结论

残余髋关节发育不良病理形态学的复杂性、细微性和多样性需要在专业中心进行仔细的、多层面的诊断和治疗规划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46a3/10063496/f6f995e8f1ad/132_2023_4353_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46a3/10063496/18fb77c284b7/132_2023_4353_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46a3/10063496/ed7c59868a58/132_2023_4353_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46a3/10063496/473fb793577e/132_2023_4353_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46a3/10063496/9ae44a6ad8dd/132_2023_4353_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46a3/10063496/f6f995e8f1ad/132_2023_4353_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46a3/10063496/18fb77c284b7/132_2023_4353_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46a3/10063496/fcdc4bded9ae/132_2023_4353_Fig2_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46a3/10063496/473fb793577e/132_2023_4353_Fig5_HTML.jpg
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Does the Rule of Thirds Adequately Detect Deficient and Excessive Acetabular Coverage?三分之一法则能否充分检测髋臼覆盖不足和过度？
Clin Orthop Relat Res. 2021 May 1;479(5):974-987. doi: 10.1097/CORR.0000000000001598.
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Prevalence of combined abnormalities of tibial and femoral torsion in patients with symptomatic hip dysplasia and femoroacetabular impingement.
症状性髋关节发育不良和股骨髋臼撞击症患者胫骨和股骨扭转联合异常的患病率。
Bone Joint J. 2020 Dec;102-B(12):1636-1645. doi: 10.1302/0301-620X.102B12.BJJ-2020-0460.R1.
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The "Outside-In" Lesion of Hip Impingement and the "Inside-Out" Lesion of Hip Dysplasia: Two Distinct Patterns of Acetabular Chondral Injury.髋关节撞击症的“外向内”损伤和髋关节发育不良的“内向外”损伤：两种不同类型的髋臼软骨损伤模式。
Am J Sports Med. 2019 Oct;47(12):2978-2984. doi: 10.1177/0363546519871065. Epub 2019 Sep 6.
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