成人髋臼发育不良的程度与髋关节脱位的关系

目的：探讨成人髋臼发育不良的程度与髋关节脱位的关系.方法：回顾性分析66例成人髋臼发育不良患者的影像学资料,男25例,女41例.年龄23 ～ 66岁,中位数44岁.髋关节无异常表现14例,髋部酸胀不适6例,髋部疼痛41例,跛行5例.对66例患者的双侧髋关节正位X线片图像进行测量.按有无并发髋关节脱位分为脱位组和无脱位组,对2组患者的CE角、Sharp角、髋臼顶切线角、髋臼指数、股骨头覆盖率、髋关节内侧间隙、髋关节上间隙进行比较分析.结果：①一般结果.单侧髋臼发育不良24例,双侧髋臼发育不良42例.CE角＜20°者45例,Sharp角＞45°者36例,髋臼指数＜41.6％者30例,股骨头覆盖率＜75％者55例,髋顶切线角≤0°者61例.Shenton线不连续53例,Calve线不连续61例.髓关节内侧间隙增宽51例,髋关节上间隙变窄18例.49例出现髋关节脱位,包括半脱位和脱位,其中29例为双侧脱位,20例为单侧脱位;向外脱位18例,向外上脱位31例.②影像学参数测量结果.脱位组的CE角、髋臼顶切线角、股骨头覆盖率、髋关节上间隙均小于无脱位组[（9.86°±3.73°）,（20.07°±3.16°）,t=10.086,P =0.001;（-9.48°±1.68°）,（-2.50°±1.67°）,t=19.547,P=0.001; （45.00±8.33）％,（70.25±4.50）％,t=11.87,P=0.001;（2.80±0.79） turm,（4.43±0.74）mm,t=7.445,P=0.001];脱位组的Sharp角和髋关节内侧间隙均大于无脱位组[（49.19°±2.58°）,（45.25°±4.20°）,t=4.564,P=0.001;（12.26±2.74）mm,（5.43±1.44） mm,t=9.758,P=0.001];2组患者髋臼指数比较,差异无统计学意义[（40.40±6.65）％,（41.75±2.64）％,t=0.811,P=0.200].结论：成人髋臼发育不良易并发髋关节脱位,髋关节脱位与髋臼结构发育不良的程度有关.

Study on the relationship between acetabular dysplasia degree and hip dislocation

Objective：To explore the relationship between aeetabular dysplasia（AD） degree and hip dislocation. Methods：The imaging data of 66 patients with AD were analyzed retrospectively. The patients consisted of 25 males and 41 females ,and ranged in age from 23 to 66 years（ Mean = 44 yrs）. Fourteen patients presented with no abnormal clinical manifestation in hips, 6 presented with hip ache, 41 hip pain and 5 limping. The anteroposterior X-ray fihn image of bilateral hip joints were measured in the 66 patients. The patients were divided into dislocation group and none dislocation group according to whether they had hip dislocation or not, and the two groups were compared with each other in CE angle, Sharp angle, acetabulum top tangent angle, acetabulum index, femoral head coverage rate, hip medial space and hip upper space. Results：The AD located in unilateral hip in 24 patients and in bilateral hip in 42 patients. The CE angle of 〈 20° was found in 45 patients,the Sharp angle of 〉 5° was found in 36 patients,the acetabulum index of 〈 41.6% was found in 30 patients,the femoral head coverage rate of 〈 75% was found in 55 patients and the acetabulum top tangent angle of 〈0° was found in 61 patients. The Shenton line was discontinuous in 53 patients and the calve line was also discontinuous in 61 patients. The hip medial space widened in 51 patients, while the hip upper space narrowed in 18 patients. Forty-nine patients presented with hip dislocation, including subluxation and luxation, Bilateral dislocation was found in 29 patients and unilateral dislocation was found in 20 patients. Outward dislocation was found in 18 patients and outward upper dislocation was found in 31 patients. The CE angle, acetabulum top tangent angle, femoral head coverage rate and hip upper space were lower in the dislocation group compared with the none dislocation group（9.86 ＋/-3.73 vs 20.07 ＋/-3.16 de- grees,t=10.086,P=0.001; -9.48 ＋/-1.68 vs -2.50 ＋/- 1.67 degrees,t =19.547,P=0.001;45.00 ＋//- 8.33 vs 70.