Hayashi Shinya, Kuroda Yuichi, Nakano Naoki, Matsumoto Tomoyuki, Kamenaga Tomoyuki, Maeda Toshihisa, Kuroda Ryosuke
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
J Hip Preserv Surg. 2022 Nov 1;9(4):252-258. doi: 10.1093/jhps/hnac046. eCollection 2022 Dec.
This study aimed to evaluate the relationship between the radiographical features of combination of the acetabular coverage and the femoral head-neck shape and the occurrence of femoroacetabular impingement (FAI). In this study, 114 patients who had FAI with or without labral tear and mild osteoarthritis were analyzed. Plain radiographs and computed tomography (CT) were taken for evaluation of acetabular coverage and femoral head-neck measurements. The relationship between the combination angle of acetabular coverage and femoral head-neck measurements and the occurrence of FAI was evaluated. The prevalence of FAI patients with the combination angle of CT-anterior CE + angle ≥100° was 6.1% (7/114 patients). Receiver operator characteristic curve analysis demonstrated a higher area under the curve for combination of CT-anterior center edge angle (ACEA) with the angle at 0.94 (CT-ACEA + angle). A threshold for the occurrence of FAI was determined using the combination CT-ACEA + angle at 100°. The frequency of FAI surgery was significantly higher in patients with a combination angle ≥100° than in those with a smaller angle. The average modified Harris hip score was significantly lower in patients with a combination angle ≥100° than in those with a smaller angle. We suggest that the combination of lateral center edge angle ≥40°, angle ≥50° and combined angles of CT-ACEA and angle ≥100° may help diagnosis of FAI. Level of evidence III: retrospective cohort study.
本研究旨在评估髋臼覆盖与股骨头颈形态组合的影像学特征与股骨髋臼撞击症（FAI）发生之间的关系。本研究分析了114例患有或未患有盂唇撕裂及轻度骨关节炎的FAI患者。拍摄X线平片和计算机断层扫描（CT）以评估髋臼覆盖情况和股骨头颈测量数据。评估髋臼覆盖与股骨头颈测量数据的组合角度与FAI发生之间的关系。CT-前中心边缘角（CE）+角≥100°的FAI患者患病率为6.1%（7/114例患者）。受试者操作特征曲线分析显示，CT-前中心边缘角（ACEA）与该角度组合的曲线下面积较高，为0.94（CT-ACEA +角）。使用CT-ACEA +角为100°确定FAI发生的阈值。组合角度≥100°的患者进行FAI手术的频率显著高于角度较小的患者。组合角度≥100°的患者平均改良Harris髋关节评分显著低于角度较小的患者。我们建议，外侧中心边缘角≥40°、该角度≥50°以及CT-ACEA与该角度的组合角度≥100°可能有助于FAI的诊断。证据等级III：回顾性队列研究。
