摘要
[目的]通过比较Crowe IV型髋关节发育不良患者(developmental dysplasia of hip,DDH)与正常人和原发性髋骨性关节炎患者(hip osteoarthritis,HOA)的矢状面相关参数,探讨DDH患者矢状面形态异常及其临床意义。[方法]研究收集正常人40例、HOA患者30例和双侧Crowe IV型DDH患者16例的站立位全脊柱侧位X线片并测量下列参数:(1)骨盆矢状面参数:骨盆投射角(pelvic incidence,PI)、骶骨倾斜角(sacral slope,SS)、骨盆倾斜角(pelvic tilt,PT)、骶骨骨盆角(sacrum pubic incidence,SPI)、骶骨股骨角(sacrum femoral angle,SFA)、骨盆股骨角(pelvic femoral angle,PFA);(2)脊柱矢状面参数:脊柱前倾角(spinal tilt,ST)、腰椎前凸角(lumbar lordosis,LL);(3)下肢矢状面参数:股骨倾斜角(femoral inclination,FI)。采用ANOVA检验分析各组间各矢状面参数间的差异性,同时进行各组间各个参数的可信度比较分析。[结果]三组间年龄、性别分布差异无统计学意义。DDH组的PI可信度(a=0.008)较正常对照组(a=0.350)及HOA组(a=0.276)低。DDH组SS(45.6±12.09)、PT(16.7±8.81)、PI(55.3±16.63)、PFA(12.7±15.15)、SPI(76.4±10.87)、FI(14.3±7.12)均较HOA组增大,差异有统计学意义(P<0.05);LL(37.3±15.87)、ST(87.8±5.43)均与HOA组相近,差异无统计学意义,但与正常对照组相比差异均有统计学意义(P<0.05)。[结论]DDH患者较HOA患者骨盆更加前倾,导致其脊柱前倾,髋、膝关节屈曲。DDH患者的这些矢状面形态在行全髋关节置换术设计时需要加以考虑。
[Objective] To document the sagittal morphological abnormalities and their clinical significance of patients with Crowe type IV developmental dysplasia of the hip（ DDH） by comparing with normal population and patients with primary hip osteoarthritis（ HOA）. [Methods] The up-right standing lateral spinal-pelvic radiographs were collected from normal people,30 patients with HOA and 16 cases with bilateral Crowe IV type DDH and measurements of the following parameters were carried out by two independent observers：（ 1） pelvic sagittal parameters： pelvic incidence（ PI）,sacral slope（ SS）,pelvic tilt（ PT）,sacralpelvic incidence（ SPI）,sacral femoralangle（ SFA）,pelvic femoral angle（ PFA）;（ 2） the spinal sagittal parameters：spinal tilt（ ST）,lumbar lordosis（ LL）;（ 3） the sagittal parameters： femur inclination（ FI）. Inter-observer reliabilities of these patients were carried out and then comparisons among three groups were carried out by one way ANOVA. [Results]There was no statistically significant difference between the groups in age and gender distribution. The reliability of PI in DDH group（ a = 0. 008） was lower than that of the normal control（ a = 0. 350） and HOA group（ a = 0. 276）. Patients with DDH showed significantly higher SS（ 45. 6 ± 12. 09）,PT（ 16. 7 ± 8. 81）,PI（ 55. 3 ± 16. 63）,PFA（ 12. 7 ± 15. 15）,SPI（ 76. 4 ± 10. 87） and FI（ 14. 3 ± 7. 12） than HOA group（ P〈0. 05）. In addition,the LL（ 37. 3 ± 15. 87） and ST（ 87. 8 ±5. 43） of patients with DDH were comparable as those of HOA patients but significantly different from the normal control group（ P〈0. 05）. [Conclusion] DDH patientshave more forward tilted pelvis when compared to patients with HOA,which might lead to more forward inclination of spine and flexion of hip and kneejoint. The spinal-pelvic sagittal alignment of DDH patients shouldbe considered when planning for total hip arthroplasty.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2015年第7期644-648,共5页
Orthopedic Journal of China
基金
江苏省"六大人才高峰"第十批高层次人才项目(编号:WSW-002)
南京市医学发展项目杰出青年基金(项目编号:JQX13008)
南京市医学发展项目一般性课题(项目编号:YKK12081)
