Shoji Takeshi, Shozen Hideki, Ueki Shinichi, Kaneta Hiroki, Morita Hiroyuki, Kozuma Yosuke, Adachi Nobuo
Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Eur J Orthop Surg Traumatol. 2025 May 20;35(1):206. doi: 10.1007/s00590-025-04336-y.
PURPOSE: To evaluate the morphological and radiographic features of hip instability in hip dysplasia. METHODS: Eighty-four patients who had ultrasonography for the assessment of hip instability and computed tomography scan for the assessment of bony morphology were included. The lateral center-edge angle (LCEA), vertical-center-anterior angle (VCA), acetabular roof obliquity (ARO), acetabular head index (AHI), and acetabular version angle (AVA) were calculated as pelvic parameters. Neck shaft angle (NSA), α-angle, femoral offset (FO), and femoral anteversion (FA) were obtained as femoral parameters. The combined anteversion angle (CAA) was defined as the sum of AVA and FA. RESULTS: Pelvic morphology analysis revealed that LCEA, VCA, and AHI were significantly lower, whereas ARO and AVA were significantly higher in the hip instability group. Furthermore, NSA, FO, and CAA were significantly higher in the hip instability group. The cutoff values for LCEA, VCA, and AHI were 17.6°, 34.7°, and 73.6%, respectively. Multivariate analysis revealed that LCEA and VCA were significantly associated with hip instability, with odds ratios of 1.57 and 1.56, respectively. Hip instabilities were associated with lateral/anterior/superior coverage deficiencies in the pelvis and with the NSA, FO, and CAA in the femur. Furthermore, a correlation between pelvic and femoral morphological parameters suggests that hip instability evaluations should include the evaluation of the anterior/lateral coverage of the acetabulum and femoral parameters. CONCLUSION: Our findings suggest that the LCEA, VCA, and AHI could serve as diagnostic markers for hip instability.
目的:评估髋关节发育不良中髋关节不稳定的形态学和影像学特征。 方法:纳入84例接受超声检查以评估髋关节不稳定及计算机断层扫描以评估骨质形态的患者。计算骨盆参数包括外侧中心边缘角(LCEA)、垂直中心前角(VCA)、髋臼顶倾斜度(ARO)、髋臼头指数(AHI)和髋臼扭转角(AVA)。获取股骨参数包括颈干角(NSA)、α角、股骨偏移(FO)和股骨前倾(FA)。联合前倾角度(CAA)定义为AVA与FA之和。 结果:骨盆形态分析显示,髋关节不稳定组的LCEA、VCA和AHI显著降低,而ARO和AVA显著升高。此外,髋关节不稳定组的NSA、FO和CAA显著更高。LCEA、VCA和AHI的截断值分别为17.6°、34.7°和73.6%。多因素分析显示,LCEA和VCA与髋关节不稳定显著相关,优势比分别为1.57和1.56。髋关节不稳定与骨盆外侧/前方/上方覆盖不足以及股骨的NSA、FO和CAA有关。此外,骨盆和股骨形态学参数之间的相关性表明,髋关节不稳定评估应包括髋臼前/外侧覆盖和股骨参数的评估。 结论:我们的研究结果表明,LCEA、VCA和AHI可作为髋关节不稳定的诊断标志物。
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