目的:影响髋关节发育不良性骨关节炎(DHOA)骨盆倾斜方向(PO)的因素尚不清楚。这项回顾性队列研究评估了形态学特征,脊柱对齐,单侧DHOA患者的髋关节功能。
方法:在2018年至2022年之间,纳入了104例单侧DHA患者。患者分为平坦PO组(F-PO组;PO<2°),患侧PO(A-PO组;PO向下≥2°),和不受影响的侧PO(U-PO组;PO向上≥2°)。人口统计,影像学髋关节和下肢参数,脊柱参数,组间比较功能评分。
结果:F-PO患者分别有39、44和21例,A-PO,和U-PO组,分别。Crowe分类的半脱位百分比在三组之间显示出显着差异。U-PO组的股骨头偏侧距离明显大于F-PO和A-PO组。此外,A-PO组的髋关节内收角度明显低于F-PO和U-PO组。腰椎侧凸角度组间差异显著。在多变量分析中,髋关节内收角度被提取为与A-PO相关的独立因素。年龄,半脱位百分比,髋关节内收角度被确定为与U-PO相关的独立因素。U-PO组Harris髋关节评分明显低于F-PO组。
结论:髋关节内收角度影响A-PO,而年龄,半脱位百分比,髋关节内收角度影响U-PO;腰椎侧凸角度与PO方向相关。U-PO患者的功能评分较差,表明DHOA中髋关节挛缩和半脱位对PO方向的影响。
OBJECTIVE: Factors affecting direction of pelvic obliquity (PO) in dysplastic hip osteoarthritis (DHOA) remains unclear. This retrospective cohort study evaluates morphological characteristics, spinal alignment, and hip function in patients with unilateral DHOA.
METHODS: Between 2018 and 2022, 104 patients with unilateral DHA were enrolled. Patients were categorized into flat PO (F-PO group; PO < 2°), affected side PO (A-PO group; PO downward by ≥ 2°), and unaffected side PO (U-PO group; PO upward by ≥ 2°). Demographics, radiographic hip and lower limb parameters, spinal parameters, and functional scores were compared between the groups.
RESULTS: There were 39, 44, and 21 patients in the F-PO, A-PO, and U-PO group, respectively. The subluxation percentage of Crowe classification showed a significant difference among the three groups. The femoral head lateralization distance was significantly greater in the U-PO group than in the F-PO and A-PO groups. Furthermore, the hip adduction angle was significantly lower in the A-PO group than in the F-PO and U-PO groups. The lumbar scoliosis angle was significantly different between the groups. In multivariate analysis, hip adduction angle was extracted as an independent factor associated with the A-PO. Age, subluxation percentage, and hip adduction angle were identified as independent factors associated with the U-PO. Harris hip score was significantly poorer in U-PO group than in F-PO group.
CONCLUSIONS: Hip adduction angle influenced A-PO, while age, subluxation percentage, and hip adduction angle influenced U-PO; lumbar scoliosis angle was associated with PO direction. U-PO patients had poorer functional scores, indicating the impact of hip contracture and subluxation on PO direction in DHOA.