■脊柱骨盆参数,包括骨盆倾斜(PT),骶骨斜坡(SS),和骨盆发病率,已经被开发来表征腰椎和髋关节运动之间的关系,但是缺乏文献可以描述股骨髋臼撞击综合征(FAIS)患者与无FAIS患者之间脊柱骨盆参数的差异,以及这些参数对关节镜治疗FAIS结果的影响。
■目的:(1)确定FAIS患者与无FAIS的对照组之间的脊柱骨盆参数差异;(2)确定脊柱骨盆参数与术前患者报告结果(PROs)之间的关联;(3)确定脊柱僵硬(站立-坐ΔSS≤10°)患者与无脊柱患者之间的PROs差异。
■队列研究;证据水平,2.
■该研究招募了年龄≥18岁的患者,这些患者接受了初次髋关节镜检查以使用凸轮治疗FAIS,钳子,或混合(凸轮和钳)形态。参与者使用低剂量3维X线摄影系统进行术前站立式成像,并在年龄和体重指数(BMI)上与没有FAIS的对照组相匹配,后者也进行了EOS成像。比较了FAIS组和对照组在EOS膜上测量的脊柱骨盆参数。FAIS患者在手术前和随访1年时完成了改良的Harris髋关节评分(mHHS)和非关节炎髋关节评分(NAHS)。比较脊柱僵硬患者与无脊柱僵硬患者的预后评分。使用Pearson相关性评估了脊柱骨盆参数与基线结果评分之间的关联。连续变量用学生t检验和/或Mann-WhitneyU检验进行比较,和分类变量用Fisher精确检验进行比较。
■共有50例FAIS患者(男性26例;女性24例;平均年龄,36.1±10.7岁;平均BMI,25.6±4.2)与没有FAIS的30名对照匹配(13名男性;17名女性;平均年龄,36.6±9.5岁;平均BMI,26.7±3.6)。年龄,性别,和BMI在FAIS组和对照组之间没有显着差异(P>.05)。站立PT在僵硬和非僵硬队列之间没有显着差异(P=0.73),但FAIS组的坐姿PT是对照组的两倍多(36.5°vs15.0°;P<.001)。在FAIS组中,僵硬脊柱的发生率明显较高(62.0%vs3.3%;P<.001)。在FAIS患者中,那些有硬刺的人有明显更高的凸轮冲击的患病率,而非僵硬棘刺的混合撞击发生率较高(P=.04).脊柱僵硬的FAIS患者与无脊柱僵硬的患者相比,术前mHHS或NAHS评分或术后改善评分无显著差异(P>.05)。但发现较高的坐姿SS与较高的基线mHHS呈正相关(r=0.36;P=.02)。
■与没有FAIS的对照参与者相比,患有FAIS的患者更有可能出现僵硬的脊柱(站立式ΔSS≤10°)。脊柱僵硬的FAIS患者比没有脊柱僵硬的患者更可能具有孤立的凸轮形态。尽管坐姿SS与基线mHHS呈正相关,脊柱僵硬与无脊柱僵硬的FAIS患者术后1年结局无显著差异.
UNASSIGNED: Spinopelvic parameters, including pelvic tilt (PT), sacral slope (SS), and pelvic incidence, have been developed to characterize the relationship between lumbar spine and hip motion, but a paucity of literature is available characterizing differences in spinopelvic parameters among patients with femoroacetabular impingement syndrome (FAIS) versus patients without FAIS, as well as the effect of these parameters on outcomes of arthroscopic treatment of FAIS.
UNASSIGNED: To (1) identify differences in spinopelvic parameters between patients with FAIS versus controls without FAIS; (2) identify associations between spinopelvic parameters and preoperative patient-reported outcomes (PROs); and (3) identify differences in PROs between patients with stiff spines (standing-sitting ΔSS ≤10°) versus those without.
UNASSIGNED: Cohort study; Level of evidence, 2.
UNASSIGNED: The study enrolled patients ≥18 years of age who underwent primary hip arthroscopy for treatment of FAIS with cam, pincer, or mixed (cam and pincer) morphology. Participants underwent preoperative standing-sitting imaging with a low-dose 3-dimensional radiography system and were matched on age and body mass index (BMI) to controls without FAIS who also underwent
EOS imaging. Spinopelvic parameters measured on
EOS films were compared between the FAIS and control groups. Patients with FAIS completed the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS) before surgery and at 1-year follow-up. Outcome scores were compared between patients with stiff spines versus those without. Associations between spinopelvic parameters and baseline outcome scores were assessed with Pearson correlations. Continuous variables were compared with Student t test and/or Mann-Whitney U test, and categorical variables were compared with Fisher exact test.
UNASSIGNED: A total of 50 patients with FAIS (26 men; 24 women; mean age, 36.1 ± 10.7 years; mean BMI, 25.6 ± 4.2) were matched to 30 controls without FAIS (13 men; 17 women; mean age, 36.6 ± 9.5 years; mean BMI, 26.7 ± 3.6). Age, sex, and BMI were not significantly different between the FAIS and control groups (P > .05). Standing PT was not significantly different between stiff and non-stiff cohorts (P = .73), but sitting PT in the FAIS group was more than double that of the control group (36.5° vs 15.0°; P < .001). Incidence of stiff spine was significantly higher in the FAIS group (62.0% vs 3.3%; P < .001). Among FAIS patients, those with stiff spines had a significantly higher prevalence of cam impingement, whereas those with non-stiff spines had a higher prevalence of mixed impingement (P = .04). No significant differences were seen in preoperative mHHS or NAHS scores or pre- to postoperative improvement in scores between FAIS patients with stiff spines versus those without (P > .05), but a greater sitting SS was found to be positively correlated with a higher baseline mHHS (r = 0.36; P = .02).
UNASSIGNED: Patients with FAIS were more likely to have a stiff spine (standing-sitting ΔSS ≤10°) compared with control participants without FAIS. FAIS patients with stiff spines were more likely to have isolated cam morphology than patient without stiff spines. Although sitting SS was positively correlated with baseline mHHS, no significant differences were seen in 1-year postoperative outcomes between FAIS patients with versus without stiff spine.