Orthopedic and Traumatology Surgery Department, CHU de Nîmes, University Montpellier 1, Nîmes, France.
Orthopedic and Traumatology Surgery Department, CHU de Nîmes, University Montpellier 1, Nîmes, France.
Orthop Traumatol Surg Res. 2023 Dec;109(8S):103719. doi: 10.1016/j.otsr.2023.103719. Epub 2023 Oct 18.
With the recent interest in hip-spine relationship, the link between femoroacetabular impingement (FAI) and the lumbar-pelvic-femoral complex (LPFC) appears decisive. The objectives of this study were (1) to compare the pelvic version, as well as (2) all the parameters of the LPFC between two populations of healthy subjects, comparing those with radiological signs of FAI to those without and finally, (3) to evaluate the LPFC parameters according to the type of FAI.
Asymptomatic subjects with radiological signs of FAI had superior pelvic anteversion.
This retrospective study was based on a prospective cohort of 118 voluntary asymptomatic patients including 62 men (52.5%) with a mean age of 25.6 years±4.4 (19-39). The following parameters: pelvic version (PV), pelvic incidence (PI), lumbar lordosis (LL), sacral slope (SS), hip flexion, intrinsic (IER) and extrinsic (EER) extension reserve were measured using EOS imaging™ in the reference standing position and the lunge position. The radiological signs of FAI (cam, pincer, mixed) were identified on these acquisitions then separated into 2 groups. The first was the group presenting with one or more images of FAI (FAI+) and the second group with no images of FAI (FAI-).
There were 143 hips in the FAI+ group compared to 93 hips in the FAI- group. There were 36.4% cams and 45% pincers. With an average of 9.08°±7.81 (-11.0; 27.0) versus 12.33°±8.94 (-5.0; 55.0), the PV was significantly lower (p=0.022) in the FAI+ group compared to the FAI- group. A post-hoc power analysis on the primary outcome (PV) confirmed sufficient power (1-β=0.809). Compared to the FAI- group, the cam group presented a significantly lower IER and EER (respectively p=0.014 and p=0.047). The comparative analysis between the FAI- and pincer groups found a significant difference in PI (p=0.001), PV (p<0.001), IER (p=0.017) and hip flexion (p<0.001), SS in lunge position (p=0.031) and EER (p=0.039).
Asymptomatic subjects with radiographic signs of FAI present with weak pelvic version when standing. This pelvic hyper-anteversion is mainly found in the event of a radiological pincer sign.
III, retrospective comparative study.
随着人们对髋关节-脊柱关系的兴趣日益浓厚，股髋撞击症（FAI）与腰椎骨盆股骨复合体（LPFC）之间的联系似乎至关重要。本研究的目的是：（1）比较两组健康受试者的骨盆倾斜度，以及（2）LPFC 的所有参数，比较有放射学 FA 迹象的组与无放射学 FA 迹象的组，最后，（3）根据 FA 的类型评估 LPFC 参数。
有放射学 FA 迹象的无症状受试者的骨盆前倾角更大。
这是一项回顾性研究，基于一个前瞻性队列的 118 名自愿无症状患者，包括 62 名男性（52.5%），平均年龄 25.6 岁±4.4（19-39）。使用 EOS 成像™在参考站立位和弓步位测量以下参数：骨盆倾斜度（PV）、骨盆入射角（PI）、腰椎前凸（LL）、骶骨倾斜度（SS）、髋关节屈曲、固有（IER）和外在（EER）伸展储备。在这些采集的图像上识别出 FAI（凸轮、钳夹、混合）的放射学征象，然后将其分为两组。第一组为有一个或多个 FAI 图像（FAI+）的组，第二组为无 FAI 图像（FAI-）的组。
FAI+组有 143 个髋关节，FAI-组有 93 个髋关节。有 36.4%的凸轮和 45%的钳夹。与 FAI-组相比，FAI+组的 PV 明显更低（p=0.022），平均为 9.08°±7.81（-11.0；27.0）对 12.33°±8.94（-5.0；55.0）。与 FAI-组相比，凸轮组的 IER 和 EER 明显更低（分别为 p=0.014 和 p=0.047）。FAI-组与钳夹组的比较分析发现 PI（p=0.001）、PV（p<0.001）、IER（p=0.017）和髋关节屈曲（p<0.001）、弓步位 SS（p=0.031）和 EER（p=0.039）存在显著差异。
有放射学 FAI 迹象的无症状受试者在站立时骨盆倾斜度较弱。这种骨盆过度前倾角主要发生在影像学钳夹征象时。
III，回顾性比较研究。
