Shozen Hideki, Shoji Takeshi, Ueki Shinichi, Kaneta Hiroki, Adachi Nobuo
Orthopedic Surgery, Hiroshima University Hospital, Hiroshima, JPN.
Cureus. 2025 Mar 29;17(3):e81410. doi: 10.7759/cureus.81410. eCollection 2025 Mar.
Purpose Developmental dysplasia of the hip (DDH) is a precursor of secondary osteoarthritis, with borderline DDH (BDDH) often overlooked. This study explores three-dimensional (3D) proximal femoral morphology in DDH and BDDH and examines their distinctions from normal hips (NH), emphasizing new correlations between femoral parameters and hip instability. Methods We retrospectively analyzed 130 hips from 120 patients categorized as DDH (lateral center-edge angle (LCEA) < 20°), BDDH (20°-25°), or NH (>25°). Detailed 3D analyses using advanced CT imaging measured unique femoral parameters such as femoral neck anteversion (FAV), lesser trochanter version (LTV), and femoral head morphology. Statistical methods assessed differences among groups and identified novel correlations. Results The study confirmed that DDH is associated with increased FAV and decreased LTV, alongside reduced femoral head-lesser trochanter distance (FH-LT) and an elliptical femoral head. BDDH displayed intermediate morphological changes, highlighting its biomechanical significance. Correlations revealed new insights into the relationship between hip morphology and clinical symptoms. Discussion External rotational abnormalities, such as increased FAV and decreased LTV, may predispose DDH patients to ischiofemoral impingement, psoas bursitis, and joint degeneration. The shortened FH-LT and elliptical femoral head further contribute to instability and early osteoarthritis. These findings underscore the role of 3D proximal femoral morphology in DDH biomechanics and clinical symptoms. Conclusion This study extends previous research by identifying previously unreported associations between proximal femoral abnormalities and hip biomechanics in DDH and BDDH. These findings inform diagnostic and therapeutic strategies for early intervention.
目的 发育性髋关节发育不良（DDH）是继发性骨关节炎的前驱疾病，边缘性发育性髋关节发育不良（BDDH）常被忽视。本研究探讨DDH和BDDH中股骨近端的三维（3D）形态，并研究它们与正常髋关节（NH）的差异，重点关注股骨参数与髋关节不稳定之间的新关联。方法 我们回顾性分析了120例患者的130个髋关节，这些髋关节被分类为DDH（外侧中心边缘角（LCEA）<20°）、BDDH（20°-25°）或NH（>25°）。使用先进的CT成像进行详细的3D分析，测量独特的股骨参数，如股骨颈前倾角（FAV）、小转子倾角（LTV）和股骨头形态。采用统计方法评估组间差异并确定新的相关性。结果 研究证实，DDH与FAV增加、LTV降低相关，同时股骨头-小转子距离（FH-LT）缩短，股骨头呈椭圆形。BDDH表现出中间形态变化，突出了其生物力学意义。相关性揭示了髋关节形态与临床症状之间关系的新见解。讨论 外部旋转异常，如FAV增加和LTV降低，可能使DDH患者易患坐骨股骨撞击、腰大肌滑囊炎和关节退变。FH-LT缩短和椭圆形股骨头进一步导致不稳定和早期骨关节炎。这些发现强调了股骨近端3D形态在DDH生物力学和临床症状中的作用。结论 本研究通过识别DDH和BDDH中股骨近端异常与髋关节生物力学之间以前未报道的关联扩展了先前的研究。这些发现为早期干预的诊断和治疗策略提供了依据。
