凸轮型髋臼撞击综合征凸轮畸形与髋臼软骨下硬化骨的相关性

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1115 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的通过测量凸轮型髋臼撞击综合征患者髋臼软骨下硬化骨厚度及α角度，分析凸轮畸形与髋臼软骨下骨增厚程度之间的相关性及与髋关节骨关节炎组织学特征相关性。方法对我院2014年3月至2019年5月109例患者髋关节MRI作回顾性分析，其中男65例，女44例；年龄20~40岁，平均(29.4±1.2)岁。对髋臼软骨下骨厚度进行量化，分析存在凸轮畸形与软骨下髋臼硬化程度之间的相关性。结果 α角≥50°诊断为凸轮型髋关节撞击综合征(femoroacetabular impingement，FAI)23例，α角＜50°无凸轮畸形86例，发病率为21.1%。凸轮型畸形软骨下骨比无凸轮型畸形者厚0.71 mm(P＜0.05)。凸轮畸形髋臼软骨下骨增厚形态各异，主要见于髋臼前上方，共有7种畸形。分别为回旋镖形、薄层形、透镜状、钩形、弧形、云雾状、水滴状。结论凸轮畸形与髋臼软骨下骨增厚程度之间存在相关性。伴有凸轮型畸形的髋臼在前上方软骨下骨较正常髋臼软骨下硬化骨厚度增加，与髋关节骨关节炎早期组织学特征相符合。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	尤彬
	林志国
	刘涛
	李存佳
	张晶

关键词 ：髋臼撞击综合征, 软骨下骨, 骨关节炎

Abstract：Objective To analyze the correlation between cam deformity and subchondral bone thickness of acetabulum and histological characteristics of hip osteoarthritis by measuring the thickness and αangle ofacetabulum in patients with cam-type femoroacetabular impingement syndrome.Methods 109 patients with hip joint MRI in our hospital were retrospectively analyzed，including 65 male and 44 female，with an average age of (29.4±1.2).The thickness of the subchondral bone of the acetabulum was quantified，and the correlation between cam deformity and the degree of sclerosis of the subchondral acetabulum was analyzed.Results 23 patients had camtype femoroacetabular impingement syndrome with angle of α≥50°and 86 patients had no cam deformity with angle of alpha ＜50°.The incidence was 21.1%.The thickness of subchondral bone in cam-shaped deformity was 0.71 mm thicker than that in non-cam-shaped deformity(P＜0.05).The subchondral bone thickening of the cam deformity of the acetabulum was different，mainly in the anterior and upper part of the acetabulum.There were 7 deformities in the cam deformity.They were circular darts，thin layers，lenses，hooks，arcs，clouds and droplets.Conclusion There is a correlation between cam deformity and subchondral bone thickness of acetabulum.The thickness of subchondral sclerosis of acetabulum with cam deformity is higher than that of normal acetabulum，which was consistent with the early histological characteristics of hip osteoarthritis.

Key words： femoroacetabular impingement subchondral bone osteoarthritis

作者简介: 尤彬(1982－ )，男，主治医师，德阳市第二人民医院骨科，618000。

引用本文:

尤彬，林志国，刘涛，李存佳，张晶. 凸轮型髋臼撞击综合征凸轮畸形与髋臼软骨下硬化骨的相关性[J]. 实用骨科杂志, 2020, 26(4): 322-326.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2020/V26/I4/322

［1］Ganz R，Parvizi J，Beck M，eta1.Femoroacetabular im—pingement：a cause for osteoarthritisof the hip［J］.Clin Orthop Relat Res，2003(417)：112-120.
［2］Griffin DR，Dickenson EJ，O'donnell J，et al.The Warwick agreement on femoroacetabular impingement syndrome(FAI syndrome)：an international consensus statement［J］.Br J Sports Med，2016，50(19)：1169-1176.
［3］Nwachukwu BU，Rebolledo BJ，McCormick F，et al.Arthroscopic versus open treatment of femoroacetabular impingement：a systematic review of medium-to long-term outcomes［J］.Am J Sports Med，2016，44(4)：1062-1068.
［4］Lund B，Mygind-Klavsen B，Grønbech Nielsen T，et al.Danish hip arthroscopy registry(DHAR)：the outcome of patients with femoroacetabular impingement(FAI)［J］.J Hip Preserv Surg，2017，4(2)：170-177.
［5］Ganz R，Leunig M，LeunigGanz K，et al.The Etiology of osteoarthritis of the hip［J］.Clin Orthop Relat Res，2008(466)：264-272.
［6］Reichenbach S，Juni P，Werlen S，et al.Prevalence of cam-type deformity on hip magnetic resonance imaging in young males：a cross-sectional study［J］.Arthritis Care & Research，2010，62(9)：1319-1327.
［7］Speirs AD，Beaulé PE，Rakhra KS，et al.Increased acetabular subchondral bone density is associated with cam-type femoroacetabular impingement［J］.Osteoarthritis Cartilage，2013，21(4)：551-558.
［8］Menge TJ，Briggs KK，Dornan GJ，et al.Survivorship and outcomes 10 years following hip arthroscopy for femoroacetabular impingement：labral debridement compared with labral repair［J］.J Bone Joint Surg(Am)，2017，99(12)：997-1004.
［9］甘浩然，程楷，赵文胜，等.膝骨关节炎中骨性力线改变的影像学及临床研究［J］.实用骨科杂志，2019，25(8)：709-712.
［10］吴宗方，秦江辉，蒋青，等.膝关节骨关节炎患者行单侧膝关节置换术后对侧膝关节力线的变化［J］.实用骨科杂志，2019，25(2)：117-122.
［11］Stupina TA，Stepanov MA，Teplen’kii MP.Role of subchondral bone in the restoration of articular cartilage［J］.Bull Exp Biol Med，2015，158(6)：820-823.
［12］Speirs AD，Beaulé，Paul E，Ferguson SJ，et al.Stress distribution and consolidation in cartilage constituents is influenced by cyclic loading and osteoarthritic degeneration［J］.J Biomech，2014，47(10)：2348-2353.
［13］Burr DB，Radin EL.Microfractures and microcracks in subchondral bone：are they relevant to osteoarthrosis?［J］.Rheum Dis Clin North Am，2003，29(4)：675-685.
［14］Diamond LE，Wrigley TV，Hinman RS，et al.Isometric and isokinetic hip strength and agonist/antagonist ratios in symptomatic femoroacetabular impingement［J］.J Sci Med Sport，2016，19(9)：696-701.
［15］Nawabi DH，Degen RM，Fields KG，et al.Outcomes after arthroscopic treatment of femoroacetabular impingement for patients with borderline hip dysplasia［J］.Am J Sports Med，2016，44(4)：1017-1023.
［16］Siebenrock KA，Anna Behning MD.Growth plate alteration precedes cam-type deformity in elite basketball players［J］.Clin Orthop Relat Res，2013(471)：1084-1091.
［17］Carsen S，MBA，Moroz P J，et al.The Otto aufranc award.On the etiology of the cam deformity：A cross-sectional pediatric MRI study［J］.Clin Orthop Relat Res，2014(472)：430-436.
［18］Casartelli NC，Leunig M，Maffiuletti NA，et al.Return to sport after hip surgery for femoroacetabular impingement：a systematic review［J］.Br J Sports Med，2015，49(12)：819-824.
［19］Sansone M，Ahldén M，Jonasson P，et al.Outcome after hip arthroscopy for femoroacetabular impingement in 289 patients with minimum 2-year follow-up［J］.Scand J Med Sci Sports，2017，27(2)：230-235.
［20］Pierannunzii L，Di Benedetto P，Carulli C，et al.Mid-term outcome after arthroscopic treatment of femoroacetabular impingement：development of a predictive score［J］.HIP International，2019，29(3)：303-309.
［21］Hashimoto S，Rai MF，Gill CS，et al.Molecular characterization of articular cartilage from young adults with femoroacetabular impingement［J］.J Bone Joint Surg(Am)，2013，95(16)：1457-1464.
［22］Frank JM，Harris JD，Erickson BJ，et al.Prevalence of femoroacetabular impingement imaging findings in asymptomatic volunteers：a systematic review［J］.Arthroscopy，2015，31(6)：1199-1204.
［23］Bayraktar HH，Morgan EF，Niebur GL，et al.Comparison of the elastic and yield properties of human femoral trabecular and cortical bone tissue［J］.J Biomech，2004，37(1)：27-35.
［24］Chegini S，Beck M，Ferguson SJ.The effects of impingement and dysplasia on stress distributions in the hip joint during sitting and walking：A finite element analysis［J］.J Orthop Res，2009，27(2)：195-201.
［25］Levy DM，Kuhns BD，Frank RM，et al.High rate of return to running for athletes after hip arthroscopy for the treatment of femoroacetabular impingement and capsular plication［J］.Am J Sports Med，2017，45(1)：127-134.
［26］Manske SL，Liu-Ambrose T，Bakker PMD，et al.Femoral neck cortical geometry measured with magnetic resonance imaging is associated with proximal femur strength［J］.Osteoporos Int，2006，17(10)：1539-1545.
［27］Leunig M，Jüni P，Werlen S，et al.Prevalence of cam and pincer-type deformities on hip MRI in an asymptomatic young Swiss female population：a cross-sectional study［J］.Osteoarthritis Cartilage，2013，21(4)：544-550.
［28］Goodwin KJ，Sharkey NA.Material properties of interstitial lamellae reflect local strain environments［J］.Orthop Res，2002，20(3)：600-606.