Locks Renato, Guadagnin Eliane C, Adam Guilherme Pradi, Gonzalez Felipe F, Chahla Jorge, de Oliveira Liszt Palmeira, Leporace Gustavo
Instituto Brasil de Tecnologias da Saúde Rio de Janeiro Brazil.
Escola Paulista de Medicina Universidade Federal de São Paulo Brazil.
J Exp Orthop. 2025 Apr 1;12(2):e70215. doi: 10.1002/jeo2.70215. eCollection 2025 Apr.
Traditional radiographic measurements for acetabular dysplasia and femoroacetabular impingement syndrome (FAIS) are typically done in static positions, overlooking dynamic behaviours. This study investigated the reproducibility of a new radiographic method that incorporates pelvic and femoral motion during running.
This cross-sectional retrospective study included 10 patients (5 males/5 females; Mean 42.4, SD: 3.0 years) with symptomatic unilateral FAIS. Participants underwent three-dimensional running analysis and standard supine anteroposterior (AP) pelvis radiographs. Using specialised software, the femur and pelvis were rotated in the coronal plane according to peak angles of contralateral pelvic drop and femoral adduction from the running analysis, preserving the original hip joint centre. Two experienced physicians measured the lateral centre edge angle (LCEA), acetabular index (AI), sharp angle (SA), extrusion index (EI), and femoro-epiphyseal acetabular roof index (FEAR INDEX) on both standard and manipulated (M) radiographs in two rounds, with a 15-day interval. Differences between the original and manipulated measurements (VAR) were also calculated. Intra- and inter-rater reliability were assessed using the intraclass correlation coefficient (ICC) and Bland-Altman method, with a significance level of 5%.
The average contralateral pelvic drop and femoral adduction used for image manipulation were 4.7° (SD: 2.7) and 6.2° (SD: 2.4), respectively. Of the 15 radiographic measurements, 14 showed good to excellent inter-rater reliability in the first assessment (range: 0.76-0.98), which decreased to 11 in the second assessment (range: 0.80-0.96). Intra-rater reliability showed 13 and 12 measurements with good or excellent reliability for raters 1 (range: 0.75-0.97) and 2 (range: 0.79-0.97), respectively.
This study demonstrates that incorporating dynamic motion into femoral head acetabular coverage radiographic measurements provides potential reliable assessments for most parameters. Integrating motion analysis with radiography could improve understanding of acetabular coverage in active individuals and support surgical decision-making.
Diagnostic Study, Level III.
传统的用于髋臼发育不良和股骨髋臼撞击综合征（FAIS）的X线测量通常在静态位置进行，忽略了动态行为。本研究调查了一种新的X线方法的可重复性，该方法纳入了跑步过程中的骨盆和股骨运动。
这项横断面回顾性研究纳入了10例有症状的单侧FAIS患者（5例男性/5例女性；平均42.4岁，标准差：3.0岁）。参与者接受了三维跑步分析和标准仰卧前后位（AP）骨盆X线片检查。使用专门软件，根据跑步分析中对侧骨盆下降和股骨内收的峰值角度，在冠状面旋转股骨和骨盆，保持原始髋关节中心。两名经验丰富的医生在两轮检查中，对标准和处理后的（M）X线片测量了外侧中心边缘角（LCEA）、髋臼指数（AI）、锐角（SA）、挤压指数（EI）和股骨骨骺髋臼顶指数（FEAR INDEX），间隔15天。还计算了原始测量值与处理后测量值之间的差异（VAR）。使用组内相关系数（ICC）和Bland-Altman方法评估评分者内和评分者间的可靠性，显著性水平为5%。
用于图像操作的平均对侧骨盆下降和股骨内收分别为4.7°（标准差：2.7）和6.2°（标准差：2.4）。在15项X线测量中，14项在首次评估中显示出良好至优秀的评分者间可靠性（范围：0.76 - 0.98），在第二次评估中降至11项（范围：0.80 - 0.96）。评分者1（范围：0.75 - 0.97）和评分者2（范围：0.79 - 0.97）的评分者内可靠性分别显示13项和12项测量具有良好或优秀的可靠性。
本研究表明，将动态运动纳入股骨头髋臼覆盖范围的X线测量可为大多数参数提供潜在可靠的评估。将运动分析与X线摄影相结合可以增进对活跃个体髋臼覆盖情况的理解，并支持手术决策。
诊断性研究，III级。
