Hassan Mahad M, Feroe Aliya G, Douglass Brenton W, Jimenez Andrew E, Kuhns Benjamin, Mitchell Charles F, Parisien Robert L, Maranho Daniel A, Novais Eduardo N, Kim Young-Jo, Kiapour Ata M
Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN 55454, United States.
Department of Orthopedic Surgery, TRIA Orthopaedic Center, Bloomington, MN 55122, United States.
World J Orthop. 2024 Aug 18;15(8):754-763. doi: 10.5312/wjo.v15.i8.754.
The sphericity of the femoral head is a metric used to evaluate hip pathologies and is associated with the development of osteoarthritis and femoral-acetabular impingement.
To analyze the three-dimensional asphericity of the femoral head of asymptomatic pediatric hips. We hypothesized that femoral head asphericity will vary significantly between male and female pediatric hips and increase with age in both sexes.
Computed tomography scans were obtained on 158 children and adolescents from a single institution in the United States (8-18 years; 50% male) without hip pain. Proximal femoral measurements including the femoral head diameter, femoral head volume, residual volume, asphericity index, and local diameter difference were used to evaluate femoral head sphericity.
In both sexes, the residual volume increased by age ( < 0.05). Despite significantly smaller femoral head size in older ages (> 13 years) in females, there were no sex-differences in residual volume and aspherity index. There were no age-related changes in mean diameter difference in both sexes ( = 0.07) with no significant sex-differences across different age groups ( = 0.06). In contrast, there were significant increases in local aspherity (maximum diameter difference) across whole surface of the femoral head and all quadrants except the inferior regions in males ( = 0.03). There were no sex-differences in maximum diameter difference at any regions and age group ( > 0.05). Increased alpha angle was only correlated to increased mean diameter difference across overall surface of the femoral head ( = 0.024).
There is a substantial localized asphericity in asymptomatic hips which increases with age in. While 2D measured alpha angle can capture overall asphericity of the femoral head, it may not be sensitive enough to represent regional asphericity patterns.
股骨头的球形度是用于评估髋关节病变的一项指标，与骨关节炎和股骨髋臼撞击症的发生有关。
分析无症状儿童髋关节股骨头的三维非球形度。我们假设，儿童髋关节股骨头的非球形度在男性和女性之间会有显著差异，且在两性中均会随年龄增长而增加。
对来自美国一家机构的158名无髋关节疼痛的儿童和青少年（8 - 18岁；50%为男性）进行计算机断层扫描。使用包括股骨头直径、股骨头体积、残余体积、非球形度指数和局部直径差在内的股骨近端测量值来评估股骨头的球形度。
在两性中，残余体积均随年龄增加（<0.05）。尽管女性年龄较大（>13岁）时股骨头尺寸明显较小，但残余体积和非球形度指数没有性别差异。两性的平均直径差均无年龄相关变化（=0.07），不同年龄组之间也无显著性别差异（=0.06）。相比之下，男性股骨头整个表面以及除下部区域外的所有象限的局部非球形度（最大直径差）均显著增加（=0.03）。在任何区域和年龄组，最大直径差均无性别差异（>0.05）。增大的α角仅与股骨头整个表面的平均直径差增加相关（=0.024）。
无症状髋关节存在明显的局部非球形度，且随年龄增加。虽然二维测量的α角可以反映股骨头的整体非球形度，但可能不够敏感，无法代表区域非球形度模式。
