發(fā)育性髖關(guān)節(jié)發(fā)育不良髖臼旋轉(zhuǎn)角對(duì)髖臼角度的影響研究
發(fā)布時(shí)間：2019-03-03 18:13
【摘要】：目的探討發(fā)育性髖關(guān)節(jié)發(fā)育不良(developmental dysplasia of the hip,DDH)和正常髖關(guān)節(jié)的髖臼旋轉(zhuǎn)角(acetabular tilt angle,ATA)是否存在差異,以及DDH中ATA對(duì)髖臼角度的影響。方法以2009年2月—2015年10月收治并符合選擇標(biāo)準(zhǔn)的31例(39髖)女性DDH患者作為DDH組,患者年齡18~59歲,平均39歲;另選擇31例(31髖)無(wú)髖關(guān)節(jié)疾患的膝關(guān)節(jié)骨性關(guān)節(jié)炎擬行人工膝關(guān)節(jié)置換術(shù)的女性患者作為對(duì)照組,患者年齡52~79歲,平均69歲。兩組均行骨盆CT掃描及三維重建,測(cè)量ATA、髖臼前傾角(acetabular anteversion angle,AAA)、髖臼外展角(acetabular inclination angle,AIA)、髖臼近端前傾角(acetabular cranial anteversion angle,ACAA)及髖臼扇形角(acetabular sector angle,ASA);其中以ASA評(píng)估髖臼對(duì)股骨頭的覆蓋。采用Pearson相關(guān)分析ATA與AAA、AIA、ACAA的相關(guān)性,以及ATA、AAA及AIA與各方向ASA的相關(guān)性。結(jié)果 DDH組ATA、AAA、AIA均大于對(duì)照組,前側(cè)、上側(cè)、后側(cè)ASA均小于對(duì)照組,比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組ACAA差異無(wú)統(tǒng)計(jì)學(xué)意義(t=1.918,P=0.523)。DDH組ATA與AAA和ACAA成正相關(guān)(r=0.439,P=0.001;r=0.436,P=0.002),與AIA無(wú)相關(guān)性(r=0.123,P=0.308);對(duì)照組ATA與AAA、ACAA、AIA均無(wú)相關(guān)性(r= 0.004,P=0.724;r= 0.079,P=0.626;r= 0.058,P=0.724)。髖臼覆蓋方面,DDH組中,ATA、AAA與前側(cè)ASA成負(fù)相關(guān)(P0.05),與后側(cè)ASA成正相關(guān)(P0.05),與上側(cè)ASA無(wú)相關(guān)性(P0.05);AIA與前側(cè)、上側(cè)ASA成負(fù)相關(guān)(P0.05),與后側(cè)ASA無(wú)相關(guān)性(r= 0.092,P=0.440)。對(duì)照組中,ATA與各方向ASA均無(wú)相關(guān)性(P0.05)。DDH前壁缺損18髖(46.2%)、側(cè)方缺損15髖(38.5%)、后壁缺損6髖(15.3%)。前壁、側(cè)方、后壁缺損的ATA分別為(22.91±5.06)、(21.59±3.81)、(15.70±10.00)°,后壁缺損的ATA明顯小于前壁及側(cè)方缺損(P0.05),前壁及側(cè)方缺損的ATA,比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 DDH的ATA影響髖臼角度,因此對(duì)于髖臼前外側(cè)缺損的DDH行髖臼旋前截骨術(shù)合理,對(duì)于髖臼后壁缺損的DDH則應(yīng)避免行髖臼旋前截骨術(shù)。
[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 鹵5.06), (21.59 鹵3.81), (15.70 鹵10.00) 擄, 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.
【作者單位】： 揚(yáng)州大學(xué)第四臨床醫(yī)學(xué)院南通瑞慈醫(yī)院骨科;
【基金】：南通市衛(wèi)生與計(jì)劃生育委員會(huì)青年科研基金項(xiàng)目(WQZ2014002)~~
【分類號(hào)】：R687.4
，
本文編號(hào)：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 鹵5.06), (21.59 鹵3.81), (15.70 鹵10.00) 擄, 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.
【作者單位】： 揚(yáng)州大學(xué)第四臨床醫(yī)學(xué)院南通瑞慈醫(yī)院骨科;
【基金】：南通市衛(wèi)生與計(jì)劃生育委員會(huì)青年科研基金項(xiàng)目(WQZ2014002)~~
【分類號(hào)】：R687.4
，
本文編號(hào)：2433974
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