Senior Department of Orthopaedics, the, Fourth Medical Center , PLA General Hospital, Beijing, 100048, China.
BMC Musculoskelet Disord. 2023 Jun 24;24(1):522. doi: 10.1186/s12891-023-06624-2.
Insufficient coverage causes hip joint instability and results in hip pain. Anterior hip coverage can be determined on both pelvic anteroposterior (AP) radiographs and false profile (FP) radiographs. Four parameters are commonly used to determine the anterior coverage on pelvic AP radiographs: the crossover index, crossover sign, anterior wall index (AWI), and rule of thirds. This study aims to clarify the relationship between these 4 parameters on AP radiographs and the anterior center edge angle (ACEA) on FP radiographs.
In this study, 53 patients who underwent periacetabular osteotomy for hip dysplasia at our center between July 2020 and October 2020 were retrospectively reviewed. Four parameters on AP radiographs and the ACEA on FP radiographs before surgery and 6 months after surgery were measured and compared for each hip.
Upon examining the 53 hips in this study, there was no correlation between either the crossover index and the ACEA (P = 0.66) or the crossover sign before surgery. The postoperative correlation between the crossover index and the ACEA was weak (r = 0.36, P = 0.007), and that between the crossover sign and the ACEA was moderate (r = 0.41, P = 0.003). There was a weak correlation between the AWI and ACEA both before (r = 0.288, P = 0.036) and after (r = 0.349, P = 0.011) the operation. Evaluation of the anterior coverage by the rule of thirds was also not consistent when determining the anterior coverage with the ACEA.
Anterior coverage on AP radiographs is largely inconsistent with ACEA on FP radiographs, especially before the surgery. It is recommended to take FP radiographs routinely for determining anterior hip coverage.
覆盖不足会导致髋关节不稳定，并引起髋关节疼痛。髋关节前覆盖度可以通过骨盆前后位（AP）X 线片和假性前后位（FP）X 线片来确定。通常使用 4 个参数来确定骨盆 AP 位 X 线片上的前覆盖度：交叉指数、交叉征、前壁指数（AWI）和三分之一法则。本研究旨在阐明 AP 位 X 线片上的这 4 个参数与 FP 位 X 线片上的前中心边缘角（ACEA）之间的关系。
本研究回顾性分析了 2020 年 7 月至 2020 年 10 月在我院接受髋关节发育不良髋臼周围截骨术的 53 例患者。测量并比较了每个髋关节术前和术后 6 个月 AP 位 X 线片上的 4 个参数和 FP 位 X 线片上的 ACEA。
在研究的 53 个髋关节中，交叉指数与 ACEA 之间（P=0.66）或术前交叉征与 ACEA 之间均无相关性。术后交叉指数与 ACEA 之间的相关性较弱（r=0.36，P=0.007），而交叉征与 ACEA 之间的相关性则较强（r=0.41，P=0.003）。AWI 与 ACEA 之间存在弱相关性，术前（r=0.288，P=0.036）和术后（r=0.349，P=0.011）均如此。三分之一法则评估的前覆盖度与 ACEA 确定的前覆盖度也不一致。
AP 位 X 线片上的前覆盖度与 FP 位 X 线片上的 ACEA 之间存在较大差异，尤其是术前。建议常规拍摄 FP 位 X 线片来确定髋关节前覆盖度。
