Oprișan Andrei, Feier Andrei Marian, Zuh Sandor Gyorgy, Russu Octav Marius, Pop Tudor Sorin
Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania.
Department of Orthopaedics and Traumatology, Clinical County Hospital of Mureș, 540139 Targu Mures, Romania.
Diagnostics (Basel). 2025 Jun 27;15(13):1647. doi: 10.3390/diagnostics15131647.
: Rapidly progressive osteoarthritis of the hip (RPOH) has unique diagnostic and surgical challenges due to rapid joint degeneration and acetabular structural alterations. This study aimed to investigate correlations between preoperative spinopelvic geometry and anterior acetabular wall bone stock deficiency in RPOH patients and introduce an advanced imaging measurement techniques for cases with amputated femoral heads. : A prospective observational study was conducted that enrolled 85 patients, comprising 40 with unilateral RPOH (Zazgyva Grade II or III) and 45 controls with primary osteoarthritis (OA). Preoperative spino-pelvic parameters (pelvic tilt-PT, sacral slope-SS, lumbar lordosis-LL, and T1 pelvic angle) and acetabular anterior wall characteristics (anterior center edge angle-ACEA, anterior wall index-AWI, and anterior acetabular surface area-AASA) were measured using standardized radiographic and CT imaging protocols, including a new methodology for acetabular center estimation in femoral head-amputated cases. : Significant differences were identified between RPOH and primary OA patients in the PT (22.5° vs. 18.9°, = 0.032), SS (37.8° vs. 41.1°, = 0.041), T1 pelvic angle (14.3° vs. 11.8°, = 0.018), and anterior center edge angle (25.3° vs. 29.7°, = 0.035). RPOH patients exhibited pronounced spinopelvic misalignment and anterior acetabular deficiencies. : RPOH is associated with spinopelvic misalignment and anterior acetabular wall deficiency. Accurate preoperative diagnosis imaging and personalized surgical approaches specifically addressing acetabular bone stock deficiencies are mandatory in these cases.
髋关节快速进展性骨关节炎（RPOH）由于关节快速退变和髋臼结构改变，具有独特的诊断和手术挑战。本研究旨在探讨RPOH患者术前脊柱骨盆几何形态与髋臼前壁骨量不足之间的相关性，并为股骨头切除病例引入一种先进的影像测量技术。：进行了一项前瞻性观察性研究，纳入85例患者，其中40例为单侧RPOH（Zazgyva II级或III级），45例为原发性骨关节炎（OA）对照。使用标准化的放射学和CT成像方案测量术前脊柱骨盆参数（骨盆倾斜度-PT、骶骨倾斜度-SS、腰椎前凸-LL和T1骨盆角）以及髋臼前壁特征（前中心边缘角-ACEA、前壁指数-AWI和髋臼前表面积-AASA），包括一种用于股骨头切除病例髋臼中心估计的新方法。：RPOH患者与原发性OA患者在PT（22.5°对18.9°，P = 0.032）、SS（37.8°对41.1°，P = 0.041）、T1骨盆角（14.3°对11.8°，P = 0.018）和前中心边缘角（25.3°对29.7°，P = 0.035）方面存在显著差异。RPOH患者表现出明显的脊柱骨盆失准和髋臼前部缺损。：RPOH与脊柱骨盆失准和髋臼前壁缺损相关。在这些病例中，准确的术前诊断成像和专门针对髋臼骨量不足的个性化手术方法是必不可少的。
