Mechlenburg Inger, De Raedt Sepp, Achterberg Hakim C, Stilling Maiken, Rømer Lone, Søballe Kjeld, de Bruijne Marleen
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Department of Orthopaedics, Aarhus University Hospital, Aarhus, Denmark.
Clin Anat. 2025 Jul;38(5):512-522. doi: 10.1002/ca.24174. Epub 2024 May 8.
The dysplastic hip is characterized by incomplete coverage of the femoral head, resulting in increased risk of early osteoarthritis. The morphological variation of the hip joint is diverse and clear differences exist between females and males. The aim of this observational study was therefore to investigate the relationship between the morphology of the hip, sex, and hip dysplasia using a three-dimensional model. Statistical shape models of the combined femur and pelvic bones were created from bilateral hips of 75 patients. Using manual angle measurements and regression analysis, the characteristic shape differences associated with sex and hip dysplasia were determined. The model showed clear differences associated with sex and hip dysplasia. We found that the acetabular anteversion in females was significantly higher (p < 0.0001) than in males while no significant difference in acetabular anteversion was found between normal and dysplastic hips (p = 0.11). The model showed that decreased acetabular anteversion resulted in the appearance of the cross-over sign and the prominent ischial spine sign commonly associated with retroversion. Sex could be predicted with an area under the curve of 0.99 and hip dysplasia could be predicted with an area under the curve of ≥0.73. Our findings suggest that retroversion is a result of decreased anteversion of the acetabulum and is primarily associated with sex. This finding should be taken into account during the reorientation of the acetabulum in the surgical treatment of hip dysplasia.
发育异常的髋关节的特征是股骨头覆盖不完全，导致早期骨关节炎风险增加。髋关节的形态变异多样，女性和男性之间存在明显差异。因此，这项观察性研究的目的是使用三维模型研究髋关节形态、性别和髋关节发育异常之间的关系。从75例患者的双侧髋关节创建了股骨和骨盆联合骨骼的统计形状模型。通过手动角度测量和回归分析，确定了与性别和髋关节发育异常相关的特征形状差异。该模型显示出与性别和髋关节发育异常相关的明显差异。我们发现女性的髋臼前倾角显著高于男性（p < 0.0001），而正常髋关节和发育异常髋关节之间的髋臼前倾角没有显著差异（p = 0.11）。该模型表明，髋臼前倾角减小会导致交叉征和与后倾相关的坐骨棘突出征出现。预测性别的曲线下面积为0.99，预测髋关节发育异常的曲线下面积≥0.73。我们的研究结果表明，髋臼后倾是髋臼前倾角减小的结果，主要与性别有关。在髋关节发育异常的手术治疗中髋臼重新定位时应考虑这一发现。
