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健康人群中存在轻微骨盆倾斜属正常现象:一项横断面研究

Slight pelvic obliquity is normal in a healthy population: a cross-sectional study.

作者信息

Moharrami Alireza, Mirghaderi Peyman, Hoseini Zare Nima, Moazen-Jamshidi Mir Mansour, Ebrahimian Mazaher, Mortazavi Seyed Mohammad Javad

机构信息

Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Exp Orthop. 2023 May 31;10(1):57. doi: 10.1186/s40634-023-00613-z.


DOI:10.1186/s40634-023-00613-z
PMID:37254005
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10229507/
Abstract

PURPOSE: Pelvic obliquity (PO) has not been extensively investigated, and there is no gold standard for measurement. The PO is essential for surgeons in planning hip arthroplasty, which includes the restoration of leg length discrepancy (LLD). We aimed to establish a normative range of PO angles by measuring healthy individuals without musculoskeletal disorders. METHODS: Our study included 134 consecutive cases (70 females) referred to our institution between April 2020 and September 2021 for non-orthopedic problems. Patients were screened for normal gait and posture using the visual observation method (VOM) and the Modified Gait Abnormality Rating Scale (GARS-M). In standing standard radiographs, the PO angle was measured as the angle between the horizontal plane and the inter-teardrop line. RESULTS: Patients' mean age and Body Mass Index (BMI) were 39.7 ± 16.8 and 22.3 ± 3.1, respectively. PO angles did not follow a normal distribution, with a median (IQR) of 2.0° (0.9°-3.1°). According to the Wilcoxon one-sample test, the median PO angle differed significantly from zero (P < 0.001). The PO angle did not differ significantly between males and females (2° vs. 2°, P = 0.46), nor did it correlate significantly with age (P = 0.24). Considering the 95% percentile of PO angles was 5.6°, this range (0°-5.6°) was regarded as a normative value. CONCLUSION: Normative values for PO in the normal healthy population range from 0° to 5.6°, with a median value of 2.0°. The PO angle was independent of age and sex and differed significantly from 0°. Slight pelvic obliquity may be normal, and physicians should not always assume that it is caused by pain, scoliosis, or weakness of the abductors. LEVEL OF EVIDENCE: III.

摘要

目的:骨盆倾斜(PO)尚未得到广泛研究,且测量尚无金标准。PO对于外科医生规划髋关节置换术至关重要,这包括纠正肢体长度差异(LLD)。我们旨在通过测量无肌肉骨骼疾病的健康个体来建立PO角度的正常范围。 方法:我们的研究纳入了2020年4月至2021年9月期间因非骨科问题转诊至我院的134例连续病例(70例女性)。使用视觉观察法(VOM)和改良步态异常评定量表(GARS-M)对患者的步态和姿势进行筛查。在站立位标准X线片上,PO角度测量为水平面与泪滴间线之间的角度。 结果:患者的平均年龄和体重指数(BMI)分别为39.7±16.8和22.3±3.1。PO角度不呈正态分布,中位数(IQR)为2.0°(0.9°-3.1°)。根据Wilcoxon单样本检验,中位数PO角度与零有显著差异(P<0.001)。PO角度在男性和女性之间无显著差异(2°对2°,P=0.46),与年龄也无显著相关性(P=0.24)。考虑到PO角度的第95百分位数为5.6°,该范围(0°-5.6°)被视为正常数值。 结论:正常健康人群中PO的正常数值范围为0°至5.6°,中位数为2.0°。PO角度与年龄和性别无关,且与0°有显著差异。轻微的骨盆倾斜可能是正常的,医生不应总是认为它是由疼痛、脊柱侧弯或外展肌无力引起的。 证据水平:III级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/b0bcc3fa5015/40634_2023_613_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/41ec9e07dd9c/40634_2023_613_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/83c933ad9fbe/40634_2023_613_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/05548d6420ef/40634_2023_613_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/a635d31d2b1e/40634_2023_613_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/8d21ccb66124/40634_2023_613_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/b0bcc3fa5015/40634_2023_613_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/41ec9e07dd9c/40634_2023_613_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/83c933ad9fbe/40634_2023_613_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/05548d6420ef/40634_2023_613_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/a635d31d2b1e/40634_2023_613_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/8d21ccb66124/40634_2023_613_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a847/10229507/b0bcc3fa5015/40634_2023_613_Fig6_HTML.jpg

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[5]
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[6]
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[7]
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[8]
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本文引用的文献

[1]
Effects of pelvic obliquity and limb position on radiographic leg length discrepancy measurement: a Sawbones model.

J Exp Orthop. 2022-7-26

[2]
Restoring femoral medial offset could reduce pelvic obliquity following primary total hip arthroplasty, an observational study.

Int Orthop. 2022-12

[3]
Determining the accuracy of preoperative total hip replacement 2D templating using the mediCAD software.

J Orthop Surg Res. 2022-4-10

[4]
Understanding the role of pelvic obliquity and leg length discrepancy in adult spinal deformity patients with coronal malalignment: unlocking the black box.

J Neurosurg Spine. 2022-1-14

[5]
The Variability of Pelvic Obliquity Measurements in Patients with Neuromuscular Scoliosis.

JB JS Open Access. 2021-3-10

[6]
Impact of pelvic obliquity on coronal alignment in patients with adolescent idiopathic scoliosis.

Spine Deform. 2020-12

[7]
Influence of spino-pelvic and postural alignment parameters on gait kinematics.

Gait Posture. 2019-12-24

[8]
Pelvic obliquity and measurement of hip displacement in children with cerebral palsy.

Acta Orthop. 2018-10-17

[9]
Evaluation of a Novel Method for Determining Transverse Plane Pelvic Obliquity.

Spine Deform. 2014-1

[10]
The radiological assessment of pelvic obliquity in cerebral palsy and the impact on hip development.

Bone Joint J. 2015-10

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