Guangzhou University of Chinese Medicine, Guangzhou, China.
People's hospital of YangDong district YangJiang city, YangJiang, China.
Sci Rep. 2024 Nov 19;14(1):28638. doi: 10.1038/s41598-024-79805-1.
Early treatment of Legg-Calve´-Perthes disease (LCPD)can improve hip joint activity and life management in adulthood. However, the current classification of LCPD is based on imaging findings in the fragmented stage of the disease, which is prone to delay treatment. Therefore the aim of this study is to evaluate the potential risk factors associated with poor radiological outcomes of LCPD, and to develop a new index for hip consistency evaluation, which can be used to speculate radiographic outcomes at the time of the first visit. The acetabular-femoral head match index (AFMI) of each enrolled subject was measured in standard anterior-posterior radiograph images. In the study of patients presenting during necrosis and fragmentation stage, a significant correlation was established between AFMI and modified Stulberg classification (P<0.05). The results of binary logistic regression analyses showed that Herring classification of fragmentation stage and AFMI were the main risk factors for flat hips. Thus, we provide evidence suggesting that AFMI has a potential role in predicting patients who do not respond well to conservative treatment. Although prospective multicenter studies are needed, these results provide useful clinical clues for the early treatment of LCPD.
早治疗 Legg-Calve´-Perthes 病(LCPD)可以改善髋关节活动度和成年后的生活质量。然而,目前 LCPD 的分类是基于疾病碎裂期的影像学表现,这容易导致治疗延误。因此,本研究旨在评估与 LCPD 不良影像学结果相关的潜在风险因素,并开发一种新的髋关节一致性评估指数,可用于推测初次就诊时的影像学结果。在标准的前后位 X 线片上测量了每个纳入患者的髋臼股骨头匹配指数(AFMI)。在坏死和碎裂期就诊的患者研究中,AFMI 与改良 Stulberg 分类之间存在显著相关性(P<0.05)。二项逻辑回归分析结果显示,碎裂期的 Herring 分类和 AFMI 是髋关节变平的主要危险因素。因此,我们提供了证据表明,AFMI 有可能预测对保守治疗反应不佳的患者。虽然需要前瞻性多中心研究,但这些结果为 LCPD 的早期治疗提供了有用的临床线索。