Goodman D A, Feighan J E, Smith A D, Latimer B, Buly R L, Cooperman D R
Cleveland Museum of Natural History, Ohio, USA.
J Bone Joint Surg Am. 1997 Oct;79(10):1489-97. doi: 10.2106/00004623-199710000-00005.
We examined the femora of 2665 adult human skeletons from an osteological collection to determine the prevalence of post-slip morphology termed femoral head-tilt deformity by Murray and pistol-grip deformity by Stulberg et al. The hypothesis was that primary osteoarthrosis of the hip is a secondary manifestation of a subclinical developmental disorder of the hip. The prevalence of post-slip morphology was 8 per cent (215 of 2665 skeletons). Severe osteoarthrosis was more prevalent in association with post-slip morphology (116 [38 per cent] of 306 hips) than in the matched controls (seventy-nine [26 per cent] of 306 hips) (p < 0.005). In the skeletons that had unilateral post-slip morphology, severe osteoarthrosis was more prevalent in the involved hips (thirty-one [37 per cent] of eighty-three) than in the contralateral, normal hips (eighteen [22 per cent] of eighty-three) (p < 0.05). Post-slip morphology, which was unrelated to age, was found to be a major risk factor for the development of high-grade osteoarthrosis. We noted evidence of high-grade osteoarthrosis in sixty-three (68 percent) of the ninety-three hips with minimum post-slip morphology in skeletons from individuals who had been fifty-six years old or more at the time of death compared with forty-five (48 percent) of the ninety-three control hips. This difference was significant (p < 0.025) [corrected]. The osteoarthrosis in the hips with post-slip morphology was distinctly characterized by anterior flattening of the acetabulum, cystic degeneration in the anterior metaphyseal-epiphyseal region, and progression to global osteoarthrosis of the hip.
我们检查了来自一个骨骼标本库的2665具成年人类骨骼的股骨，以确定一种滑脱后形态的发生率，Murray将其称为股骨头倾斜畸形，而Stulberg等人则称其为手枪柄畸形。我们的假设是，髋关节原发性骨关节炎是髋关节亚临床发育障碍的一种继发表现。滑脱后形态的发生率为8%（2665具骨骼中有215具）。与匹配的对照组相比，严重骨关节炎在伴有滑脱后形态的病例中更为常见（306例髋关节中有116例[38%]），而在对照组中为79例（26%）（p<0.005）。在有单侧滑脱后形态的骨骼中，受累髋关节的严重骨关节炎比另一侧正常髋关节更为常见（83例中有31例[37%]），而另一侧正常髋关节为18例（22%）（p<0.05）。与年龄无关的滑脱后形态被发现是高级别骨关节炎发生的一个主要危险因素。我们注意到，在死亡时年龄在56岁及以上的个体的骨骼中，93例有最小滑脱后形态的髋关节中有63例（68%）出现了高级别骨关节炎的证据，而93例对照髋关节中有45例（48%）出现了这种情况。这种差异具有统计学意义（校正后p<0.025）。伴有滑脱后形态的髋关节的骨关节炎具有明显特征，即髋臼前部扁平、干骺端-骨骺前部区域囊性变，并进展为髋关节全关节骨关节炎。
