Lyon Ortho Clinic, Clinique de La Sauvegarde, Ramsay Santé, Lyon, France.
Orthopaedic Centre Antwerp, Antwerp, Belgium.
Arch Orthop Trauma Surg. 2024 Sep;144(9):4405-4410. doi: 10.1007/s00402-024-05540-x. Epub 2024 Sep 16.
To determine repeatability of pelvic mobility, calculated as both change in sacral slope (∆SS) and pelvic tilt (∆PT), and evaluate their correlations with pelvic incidence (PI) in non-arthritic patients with hip pain and positive impingement test.
The cohort comprised 82 patients aged 31.8 ± 7.4, with hip pain and positive impingement test. Stereo-radiographic images were acquired in three positions (neutral standing, neutral sitting, and flexed-forward-sitting). PI, pelvic tilt (PT), and sacral slope (SS) were measured. Repeatability was evaluated. Pelvic mobility was calculated as ΔPT and ΔSS from (i) standing to sitting, (ii) neutral to flexed-forward-sitting, and (iii) maximum to minimum values. Correlations of PI with PT, SS, ΔPT, and ΔSS were assessed.
Repeatability was excellent for all pelvic mobility measurements (intraclass correlation coefficients, ICC > 0.97). ΔPT was 25.9 ± 8.3º from standing to sitting, 14.4 ± 11.2º from standing to flexed-forward-sitting, and 37.8 ± 13.7º from maximum to minimum values. ΔSS was 24.0 ± 7.6º from standing to sitting, 14.2 ± 11.6º from standing to flexed-forward-sitting, and 35.9 ± 13.7º from maximum to minimum values. PI was strongly correlated with PT in standing (r = 0.7) and SS in standing (r = 0.7), and moderately correlated with PT in sitting (r = 0.6) and SS in sitting (r = 0.5), but was not correlated with neither ΔPT nor ΔSS (r < 0.3).
Pelvic mobility, calculated as ΔPT and ΔSS, has excellent repeatability, and is not correlated with PI in non-arthritic patients with hip pain. Therefore, PI is of limited value for diagnosis and treatment of painful hips with positive impingement test, as well as to distinguish hip users from spine users; pelvic mobility should be used instead.
Level IV.
目的：确定无关节炎髋痛且伴有阳性撞击试验患者的骨盆活动度（以骶骨倾斜角变化[∆SS]和骨盆倾斜度[∆PT]表示）的重复性，并评估其与骨盆入射角（PI）的相关性。
该队列纳入了 82 例年龄 31.8±7.4 岁的患者，均有髋痛和阳性撞击试验结果。在中立位站立、中立位坐和前屈坐三种体位下采集脊柱侧位片。测量 PI、骨盆倾斜度（PT）和骶骨倾斜度（SS）。评估重复性。通过以下三种方式计算骨盆活动度：（i）站立位到坐位，（ii）中立位到前屈位，（iii）最大到最小。评估 PI 与 PT、SS、∆PT 和 ∆SS 的相关性。
所有骨盆活动度测量的重复性均极好（组内相关系数 ICC>0.97）。从站立位到坐位，骨盆倾斜度的变化为 25.9±8.3°；从站立位到前屈位，骨盆倾斜度的变化为 14.4±11.2°；从最大到最小，骨盆倾斜度的变化为 37.8±13.7°。从站立位到坐位，骶骨倾斜度的变化为 24.0±7.6°；从站立位到前屈位，骶骨倾斜度的变化为 14.2±11.6°；从最大到最小，骶骨倾斜度的变化为 35.9±13.7°。PI 与站立位时的 PT（r=0.7）和 SS（r=0.7）高度相关，与坐位时的 PT（r=0.6）和 SS（r=0.5）中度相关，但与∆PT 和 ∆SS 均不相关（r<0.3）。
在无关节炎髋痛且伴有阳性撞击试验的患者中，骨盆活动度（以∆PT 和 ∆SS 表示）具有极好的重复性，且与 PI 不相关。因此，PI 对诊断和治疗伴有阳性撞击试验的疼痛性髋关节以及区分髋部使用者和脊柱使用者的价值有限；应使用骨盆活动度进行评估。
IV 级。
