发育性髋关节发育不良髋臼旋转角对髋臼角度的影响研究
发布时间：2019-03-03 18:13
【摘要】：目的探讨发育性髋关节发育不良(developmental dysplasia of the hip,DDH)和正常髋关节的髋臼旋转角(acetabular tilt angle,ATA)是否存在差异,以及DDH中ATA对髋臼角度的影响。方法以2009年2月—2015年10月收治并符合选择标准的31例(39髋)女性DDH患者作为DDH组,患者年龄18~59岁,平均39岁;另选择31例(31髋)无髋关节疾患的膝关节骨性关节炎拟行人工膝关节置换术的女性患者作为对照组,患者年龄52~79岁,平均69岁。两组均行骨盆CT扫描及三维重建,测量ATA、髋臼前倾角(acetabular anteversion angle,AAA)、髋臼外展角(acetabular inclination angle,AIA)、髋臼近端前倾角(acetabular cranial anteversion angle,ACAA)及髋臼扇形角(acetabular sector angle,ASA);其中以ASA评估髋臼对股骨头的覆盖。采用Pearson相关分析ATA与AAA、AIA、ACAA的相关性,以及ATA、AAA及AIA与各方向ASA的相关性。结果 DDH组ATA、AAA、AIA均大于对照组,前侧、上侧、后侧ASA均小于对照组,比较差异有统计学意义(P0.05);两组ACAA差异无统计学意义(t=1.918,P=0.523)。DDH组ATA与AAA和ACAA成正相关(r=0.439,P=0.001;r=0.436,P=0.002),与AIA无相关性(r=0.123,P=0.308);对照组ATA与AAA、ACAA、AIA均无相关性(r= 0.004,P=0.724;r= 0.079,P=0.626;r= 0.058,P=0.724)。髋臼覆盖方面,DDH组中,ATA、AAA与前侧ASA成负相关(P0.05),与后侧ASA成正相关(P0.05),与上侧ASA无相关性(P0.05);AIA与前侧、上侧ASA成负相关(P0.05),与后侧ASA无相关性(r= 0.092,P=0.440)。对照组中,ATA与各方向ASA均无相关性(P0.05)。DDH前壁缺损18髋(46.2%)、侧方缺损15髋(38.5%)、后壁缺损6髋(15.3%)。前壁、侧方、后壁缺损的ATA分别为(22.91±5.06)、(21.59±3.81)、(15.70±10.00)°,后壁缺损的ATA明显小于前壁及侧方缺损(P0.05),前壁及侧方缺损的ATA,比较差异无统计学意义(P0.05)。结论 DDH的ATA影响髋臼角度,因此对于髋臼前外侧缺损的DDH行髋臼旋前截骨术合理,对于髋臼后壁缺损的DDH则应避免行髋臼旋前截骨术。
[Abstract]:Objective to investigate the difference of acetabular rotation angle (acetabular tilt angle,ATA) between developmental dysplasia of hip joint (developmental dysplasia of the hip,DDH) and normal hip joint, and the effect of ATA on acetabular angle in DDH. Methods from February 2009 to October 2015, 31 female DDH patients (39 hips) who met the selection criteria were selected as the DDH group. The age of the patients was 18 to 59 years old (mean 39 years old). Another 31 patients (31 hips) with osteoarthritis of the knee without hip joint disease were selected as the control group. The age of the patients was 52 years and 79 years (mean 69 years). ATA, acetabular anteversion (acetabular anteversion angle,AAA (acetabular anteversion angle,AAA), acetabular abduction angle (acetabular inclination angle,AIA), proximal acetabular anteversion angle (acetabular cranial anteversion angle,ACAA) and acetabular fan angle (acetabular sector angle,ASA) were measured in both groups by CT scan and three-dimensional reconstruction. ASA was used to evaluate the acetabular coverage of the femoral head. Pearson correlation analysis was used to analyze the correlation between ATA and AAA,AIA,ACAA, and the correlation between ATA,AAA and AIA and ASA. Results the ATA,AAA,AIA of DDH group was higher than that of control group, the ASA of anterior side, upper side and posterior side were lower than that of control group, the difference was statistically significant (P0.05). There was no significant difference in ACAA between the two groups (t = 1.918, P = 0.523). There was a positive correlation between ATA and AAA and ACAA (r = 0.439, P = 0.001 r = 0.436, P = 0.002), and no correlation between ATA and AIA (r = 0.123, P = 0.308). There was no correlation between ATA and AAA,ACAA,AIA in the control group (r = 0. 004, P = 0. 724, P = 0. 079, P = 0. 626, r = 0. 058, P = 0. 724). In terms of acetabular coverage, in DDH group, ATA,AAA was negatively correlated with anterior ASA (P0.05), positively correlated with posterior ASA (P0.05), and had no correlation with upper ASA (P0.05). AIA was negatively correlated with anterior and superior ASA (P0.05), but not with posterior ASA (r = 0.092, P = 0.440). In the control group, there was no correlation between ATA and ASA (P0.05). The anterior wall defect was found in 18 hips (46.2%), lateral defect in 15 hips (38.5%) and posterior wall defect in 6 hips (15.3%). The ATA of anterior wall, lateral defect and posterior wall defect were (22.91 卤5.06), (21.59 卤3.81), (15.70 卤10.00) 掳, respectively. The ATA of posterior wall defect was significantly smaller than that of anterior wall and lateral wall defect (P0.05). The ATA, of anterior wall and lateral wall defect was significantly lower than that of anterior wall and lateral wall defect. There was no significant difference between the two groups (P0.05). Conclusion the ATA of DDH affects acetabular angle, so the anterior acetabular osteotomy for DDH with acetabular anterior lateral defect is reasonable, and for DDH with acetabular posterior wall defect, acetabular anterior acetabular osteotomy should be avoided.
【作者单位】： 扬州大学第四临床医学院南通瑞慈医院骨科;
【基金】：南通市卫生与计划生育委员会青年科研基金项目(WQZ2014002)~~
【分类号】：R687.4
，
本文编号：2433974
[Abstract]:Objective to investigate the difference of acetabular rotation angle (acetabular tilt angle,ATA) between developmental dysplasia of hip joint (developmental dysplasia of the hip,DDH) and normal hip joint, and the effect of ATA on acetabular angle in DDH. Methods from February 2009 to October 2015, 31 female DDH patients (39 hips) who met the selection criteria were selected as the DDH group. The age of the patients was 18 to 59 years old (mean 39 years old). Another 31 patients (31 hips) with osteoarthritis of the knee without hip joint disease were selected as the control group. The age of the patients was 52 years and 79 years (mean 69 years). ATA, acetabular anteversion (acetabular anteversion angle,AAA (acetabular anteversion angle,AAA), acetabular abduction angle (acetabular inclination angle,AIA), proximal acetabular anteversion angle (acetabular cranial anteversion angle,ACAA) and acetabular fan angle (acetabular sector angle,ASA) were measured in both groups by CT scan and three-dimensional reconstruction. ASA was used to evaluate the acetabular coverage of the femoral head. Pearson correlation analysis was used to analyze the correlation between ATA and AAA,AIA,ACAA, and the correlation between ATA,AAA and AIA and ASA. Results the ATA,AAA,AIA of DDH group was higher than that of control group, the ASA of anterior side, upper side and posterior side were lower than that of control group, the difference was statistically significant (P0.05). There was no significant difference in ACAA between the two groups (t = 1.918, P = 0.523). There was a positive correlation between ATA and AAA and ACAA (r = 0.439, P = 0.001 r = 0.436, P = 0.002), and no correlation between ATA and AIA (r = 0.123, P = 0.308). There was no correlation between ATA and AAA,ACAA,AIA in the control group (r = 0. 004, P = 0. 724, P = 0. 079, P = 0. 626, r = 0. 058, P = 0. 724). In terms of acetabular coverage, in DDH group, ATA,AAA was negatively correlated with anterior ASA (P0.05), positively correlated with posterior ASA (P0.05), and had no correlation with upper ASA (P0.05). AIA was negatively correlated with anterior and superior ASA (P0.05), but not with posterior ASA (r = 0.092, P = 0.440). In the control group, there was no correlation between ATA and ASA (P0.05). The anterior wall defect was found in 18 hips (46.2%), lateral defect in 15 hips (38.5%) and posterior wall defect in 6 hips (15.3%). The ATA of anterior wall, lateral defect and posterior wall defect were (22.91 卤5.06), (21.59 卤3.81), (15.70 卤10.00) 掳, respectively. The ATA of posterior wall defect was significantly smaller than that of anterior wall and lateral wall defect (P0.05). The ATA, of anterior wall and lateral wall defect was significantly lower than that of anterior wall and lateral wall defect. There was no significant difference between the two groups (P0.05). Conclusion the ATA of DDH affects acetabular angle, so the anterior acetabular osteotomy for DDH with acetabular anterior lateral defect is reasonable, and for DDH with acetabular posterior wall defect, acetabular anterior acetabular osteotomy should be avoided.
【作者单位】： 扬州大学第四临床医学院南通瑞慈医院骨科;
【基金】：南通市卫生与计划生育委员会青年科研基金项目(WQZ2014002)~~
【分类号】：R687.4
，
本文编号：2433974
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