Lara Joaquín, Neira Alejandro, Garín Alan, Del Río Javier, Tomic Alexander, García Nicolás, Roby Matías, De la Fuente Carlos
Hip Center, Clinica Las Condes Santiago Chile.
Escuela de Kinesiologia, Facultad de Medicina y Ciencias de la Salud, Universidad Mayor Santiago Chile.
J Exp Orthop. 2025 May 19;12(2):e70268. doi: 10.1002/jeo2.70268. eCollection 2025 Apr.
Borderline hip dysplasia (BhD) may be associated with insufficient acetabular coverage. Thus, we investigated potential differences in acetabular anatomical measurements derived from computerised tomography (CT) that characterise BhD compared with healthy controls.
BhD patients (lateral centre edge angle [LCEA] between 18° and 25°) and healthy controls (LCEA between 25° and 40°) underwent anteroposterior pelvic X-ray and CT scans to study the Wiberg and Tönnis angle, the extrusion and Fear indices, notch width and depth, anterior and posterior wall heights, anterior and posterior articular surfaces, articular circumference, the ratio between the anterior articular surface and the articular circumference, the ratio between the posterior articular surface and the articular circumference, and the ratio between the notch width and the articular circumference. Independent two-tailed -tests, Mann-Whitney tests, and odds ratios were obtained ( = 5%).
Twenty-three BhD patients (aged 31.5 ± 8.3 years and LCEA 21.6° ± 4.0°) and thirty-one healthy controls (aged 34.1 ± 8.0 years and LCEA 33.7° ± 5.5°) were included. The CT features most sensitive for detecting BhD were the anterior acetabular surface ( < 0.001) and ratios of anterior ( = 0.009), anteroposterior ( = 0.008) and posterior ( < 0.008) acetabular surfaces, as well as acetabular notch width ( = 0.002).
CT characterisation showed insufficient acetabular coverage in BhD patients along the superior axis (lower Wiberg angle, and increased Tönnis angle and extrusion index), anterior axis (lower anterior acetabular surface and anteroposterior acetabular surface ratio, and increased posterior acetabular ratio), and inferior axis (increased acetabular notch width). These structural alterations suggest that periacetabular osteotomy may address persistent pathological deformation and stress on soft tissues and cartilage-bone structures more effectively.
Diagnostic III.
边缘性髋关节发育不良（BhD）可能与髋臼覆盖不足有关。因此，我们研究了通过计算机断层扫描（CT）得出的髋臼解剖测量值在BhD患者与健康对照之间的潜在差异，这些测量值可用于表征BhD。
BhD患者（外侧中心边缘角[LCEA]在18°至25°之间）和健康对照（LCEA在25°至40°之间）接受前后位骨盆X线和CT扫描，以研究维伯格角和托尼角、挤压指数和恐惧指数、髋臼切迹宽度和深度、前后壁高度、前后关节面、关节周长、前关节面与关节周长的比值、后关节面与关节周长的比值以及髋臼切迹宽度与关节周长的比值。获得独立的双尾t检验、曼-惠特尼U检验和比值比（α = 5%）。
纳入23例BhD患者（年龄31.5±8.3岁，LCEA 21.6°±4.0°）和31例健康对照（年龄34.1±8.0岁，LCEA 33.7°±5.5°）。对检测BhD最敏感的CT特征是髋臼前表面（P < 0.001）以及髋臼前（P = 0.009）、前后（P = 0.008）和后（P < 0.008）表面的比值，以及髋臼切迹宽度（P = 0.002）。
CT特征显示BhD患者在髋臼上轴（较低的维伯格角、增加的托尼角和挤压指数）、前轴（较低的髋臼前表面和前后髋臼表面比值、增加的髋臼后表面比值）和下轴（增加的髋臼切迹宽度）存在髋臼覆盖不足。这些结构改变表明髋臼周围截骨术可能更有效地解决持续的病理变形以及对软组织和软骨-骨结构的应力问题。
诊断性III级。
