Prevalence and characteristics of cam-type femoroacetabular deformity in 100 hips with symptomatic acetabular dysplasia: a case control study
Tóm tắt
Cam-type femoroacetabular deformity in acetabular dysplasia (AD) has not been well clarified. The primary purpose of this study was to determine the prevalence and characteristics of femoroacetabular deformity in symptomatic AD patients. We retrospectively reviewed the cases of 86 women (92 hips) and eight men (eight hips) with symptomatic AD. The mean patient age was 37.9 (range, 14-60) years. All participants underwent lateral cross-table and lateral whole-spine radiographic examinations to measure the alpha angle and pelvic tilt. Pelvic computed tomography scans were used to measure femoral anteversion. The patients were classified into two groups: AD only group, containing hips with an alpha angle less than 55°; and AD with cam-type femoroacetabular deformity (AD + cam-type deformity) group, containing hips with an alpha angle greater than or equal to 55°. Of the patients with AD, 40 hips displayed additional radiographic evidence of cam-type morphology, while 60 hips had exclusive AD morphology. The patients in the AD + cam-type deformity group had significantly increased forward pelvic tilt in the standing position (p =0.023) and decreased femoral anteversion (p =0.047) compared with the AD only group. Our data revealed that 40% of patients with AD also had radiographic evidence of cam-type femoroacetabular deformity. Greater forward pelvic tilt in the standing position and decreased femoral anteversion seemed to be associated with the cam-type deformity in these patients. These results indicate the morphological features that are most likely to induce secondary symptoms to developmental hip dysplasia. It is suggested that the symptoms in the AD + cam-type deformity group could arise through femoroacetabular impingement (FAI) after periacetabular osteotomy, because a predisposition was present preoperatively.
Tài liệu tham khảo
Beck M, Kalhor M, Leunig M, Ganz R: Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005, 87: 1012-1018. 10.1302/0301-620X.87B7.15203.
Beall DP, Sweet CF, Martin HD, Lastine CL, Grayson DE, Ly JQ, Fish JR: Imaging findings of femoroacetabular impingement syndrome. Skeletal Radiol. 2005, 34: 691-701. 10.1007/s00256-005-0932-9.
Leunig M, Beck M, Kalhor M, Kim YJ, Werlen S, Ganz R: Fibrocystic changes at anterosuperior femoral neck: prevalence in hips with femoroacetabular impingement. Radiology. 2005, 236: 237-246. 10.1148/radiol.2361040140.
Kassarjian A, Brisson M, Palmer WE: Femoroacetabular impingement. Eur J Radiol. 2007, 63: 29-35. 10.1016/j.ejrad.2007.03.020.
Tannast M, Siebenrock KA, Anderson SE: Femoroacetabular impingement: radiographic diagnosis—what the radiologist should know. AJR Am J Roentgenol. 2007, 188: 1540-1552. 10.2214/AJR.06.0921.
Wiberg G: Study on dysplastic acetabula and congenital subluxation of the hip joint. With special reference to the complication of osteoarthritis. Acta Chir Scand. 1939, 83 (Suppl 58): 1-35.
Aronson J: Osteoarthritis of the young adult hip: etiology and treatment. Instr Course Lect. 1986, 35: 119-128.
Matsuyama Y, Hasegawa Y, Yoshihara H, Tsuji T, Sakai Y, Nakamura H, Kawakami N, Kanemura T, Yukawa Y, Ishiguro N: Hip-spine syndrome: total sagittal alignment of the spine and clinical symptoms in patients with bilateral congenital hip dislocation. Spine (Phila Pa 1976). 2004, 29: 2432-2437. 10.1097/01.brs.0000143671.67779.14.
Ganz R, Klaue K, Vinh TS, Mast JW: A new periacetabular osteotomy for the treatment of hip dysplasia. Technique and preliminary results. Clin Orthop Relat Res. 1988, 232: 26-36.
Clohisy JC, Barrett SE, Gordon JE, Delgado ED, Schoenecker PL: Periacetabular osteotomy for the treatment of severe acetabular dysplasia. J Bone Joint Surg Am. 2005, 87: 254-259. 10.2106/JBJS.D.02093.
Naito M, Shiramizu K, Akiyoshi Y, Ezoe M, Nakamura Y: Curved periacetabular osteotomy for treatment of dysplastic hip. Clin Orthop Relat Res. 2005, 433: 129-135. 10.1097/01.blo.0000153281.75265.1d.
Myers SR, Eijer H, Ganz R: Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res. 1999, 363: 93-99. 10.1097/00003086-199906000-00012.
Clohisy JC, Nunley RM, Carlisle JC, Schoenecker PL: Incidence and characteristics of femoral deformities in the dysplastic hip. Clin Orthop Relat Res. 2009, 467: 128-134. 10.1007/s11999-008-0481-3.
Paliobeis CP, Villar RN: The prevalence of dysplasia in femoroacetabular impingement. Hip Int. 2011, 21: 141-145. 10.5301/HIP.2011.7422.
Massie WK, Howorth MB: Congenital dislocation of the hip. Part I. Method of grading results. J Bone Joint Surg Am. 1950, 32: 519-531.
Siebenrock KA, Kalbermatten DF, Ganz R: Effect of pelvic tilt on acetabular retroversion: a study of pelves from cadavers. Clin Orthop Relat Res. 2003, 407: 241-248. 10.1097/00003086-200302000-00033.
Tönnis D: Clinical and radiographic schemes for evaluating therapeutic result. Congenital Dysplasia and Dislocation of the Hip in Children and Adults. 1987, Springer-Verlag, New York, 165-171. 10.1007/978-3-642-71038-4_13.
Harris WH: Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969, 51: 737-755.
Klaue K, Dumin CW, Ganz R: The acetabular rim syndrome. A clinical presentation of dysplasia of the hip. J Bone Joint Surg Br. 1991, 73: 423-429.
Heyman CH, Herndon CH: Legg-Perthes disease; a method for the measurement of the roentgenographic result. J Bone Joint Surg Am. 1950, 32: 767-778.
Tönnis D, Heinecke A: Diminished femoral antetorsion syndrome: a cause of pain and osteoarthritis. J Pediatr Orthop. 1991, 11: 419-431. 10.1097/01241398-199107000-00001.
Nötzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J: The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br. 2002, 84: 556-560. 10.1302/0301-620X.84B4.12014.
Lequesne M, de S: False profile of the pelvis. A new radiographic incidence for the study of the hip. Its use in dysplasias and different coxopathies. Rev Rhum Mal Osteoartic. 1961, 28: 643-652. [Article in French]
Okuda T, Fujita T, Miaki K, Yasuda Y, Matsumoto T: Stage-specific sagittal spinopelvic alignment changes in osteoarthritis of the hip secondary to developmental hip dysplasia. Spine (Phila Pa 1976). 2007, 32: E816-E819. 10.1097/BRS.0b013e31815ce695.
Jackson RP, Peterson MD, McManus AC, Hales C: Compensatory spinopelvic balance over the hip axis and better reliability in measuring lordosis to the pelvic radius on the standing lateral radiographs of adult volunteers and patients. Spine (Phila Pa 1976). 1998, 23: 1750-1767. 10.1097/00007632-199808150-00008.
Wiltse LL, Winter RB: Terminology and measurement of spondylolisthesis. J Bone Joint Surg Am. 1983, 65: 768-772.
Botser IB, Ozoude GC, Martin DE, Kuppuswami S, Domb BG: Femoral anteversion in the hip: comparison of measurement by computed tomography, magnetic resonance imaging, and physical examination. Arthroscopy. 2012, 28: 619-627. 10.1016/j.arthro.2011.10.021.
Audenaert EA, Peeters I, Vigneron L, Baelde N, Pattyn C: Hip morphological characteristics and range of internal rotation in femoroacetabular impingement. Am J Sports Med. 2012, 40: 1329-1336. 10.1177/0363546512441328.
Eijer H, Myers SR, Ganz R: Anterior femoroacetabular impingement after femoral neck fractures. J Orthop Trauma. 2001, 15: 475-481. 10.1097/00005131-200109000-00003.
Kassarjian A, Yoon LS, Belzile E, Connolly SA, Millis MB, Palmer WE: Triad of MR arthrographic findings in patients with cam-type femoroacetabular impingement. Radiology. 2005, 236: 588-592. 10.1148/radiol.2362041987.
Clohisy JC, Zebala LP, Nepple JJ, Pashos G: Combined hip arthroscopy and limited open osteochondroplasty for anterior femoroacetabular impingement. J Bone Joint Surg Am. 2010, 92: 1697-1706. 10.2106/JBJS.I.00326.
Yoshimoto H, Sato S, Masuda T, Kanno T, Shundo M, Hyakumachi T, Yanagibashi Y: Spinopelvic alignment in patients with osteoarthrosis of the hip: a radiographic comparison to patients with low back pain. Spine (Phila Pa 1976). 2005, 30: 1650-1657. 10.1097/01.brs.0000169446.69758.fa.
Bedi A, Dolan M, Leunig M, Kelly BT: Static and dynamic mechanical causes of hip pain. Arthroscopy. 2011, 27: 235-251. 10.1016/j.arthro.2010.07.022.
Barger WL, Jamali AA, Nejad AH: Femoral anteversion in THA and its lack of correlation with native acetabular anteversion. Clin Orthop Relat Res. 2010, 468: 527-532. 10.1007/s11999-009-1040-2.
Akiyama M, Nakashima Y, Fujii M, Sato T, Yamamoto T, Mawatari T, Motomura G, Matsuda S, Iwamoto Y: Femoral anteversion is correlated with acetabular version and coverage in Asian women with anterior and global deficient subgroups of hip dysplasia: a CT study. Skeletal Radiol. 2012, 41: 1411-1418. 10.1007/s00256-012-1368-7.
Troelsen A, Elmengaard B, Soballe K: Medium-term outcome of periacetabular osteotomy and predictors of conversion to total hip replacement. J Bone Joint Surg Am. 2009, 91: 2169-2179. 10.2106/JBJS.H.00994.
Nassif NA, Schoenecker PL, Thorsness R, Clohisy JC: Periacetabular osteotomy and combined femoral head-neck junction osteochondroplasty: a minimum two-year follow-up cohort study. J Bone Joint Surg Am. 2012, 94: 1959-1966. 10.2106/JBJS.K.01038.
Naito M, Nakamura Y: Curved periacetabular osteotomy for the treatment of dysplastic hips. Clin Orthop Relat Res. 2014, 6: 127-137.
Wiles P: Postural deformities of the anteroposterior curves of the spine. Lancet. 1937, 229: 911-919. 10.1016/S0140-6736(00)86663-5.
Meyer DC, Beck M, Ellis T, Ganz R, Leunig M: Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop Relat Res. 2006, 445: 181-185.
Johnston TL, Schenker ML, Briggs KK, Philippon MJ: Relationship between offset angle alpha and hip chondral injury in femoroacetabular impingement. Arthroscopy. 2008, 24: 669-675. 10.1016/j.arthro.2008.01.010.
Laborie LB, Lehmann TG, Engesaeter IO, Eastwood DM, Engesaeter LB, Rosendahl K: Prevalence of radiographic findings thought to be associated with femoroacetabular impingement in a population-based cohort of 2081 healthy young adults. Radiology. 2011, 260: 494-502. 10.1148/radiol.11102354.