■髋部微不稳定是年轻人疼痛和残疾的一个日益公认的原因。尚不清楚有髋关节微不稳定的患者与没有髋关节微不稳定的患者之间是否存在被动髋关节运动范围(ROM)的差异。
■潜在的韧带和囊膜松弛将导致股骨髋臼撞击(FAI)患者之间临床可检测的被动ROM的差异,微不稳定性患者,和无症状控制。
■横断面研究;证据水平,3.
■对2012年至2018年期间接受髋关节镜检查的所有患者进行了回顾性审查。根据术中发现诊断为孤立的微不稳定性的患者被识别并分类为孤立的FAI。不稳定性,或FAI+不稳定性。没有髋关节损伤史的患者作为对照。记录仰卧位屈曲时的运动范围,内部旋转,和外部旋转。单变量和多变量分析在每个单独的测量以及运动的组合,包括总旋转弧,屈曲+旋转弧,然后创建并测试屈曲+2×旋转弧模型以预测不稳定状态。
■总共,包括263个臀部:69个孤立的不稳定,50与FAI,50与FAI+不稳定,和94控制臀部。与FAI和对照组相比,不稳定和FAI+不稳定组中女性患者比例更高(P<0.001)。在单变量分析中,所有组的所有运动平面均存在差异(P<.001).多变量分析表明,所有组的屈曲和屈曲旋转弧存在差异。在有症状的患者中,髋关节微不稳定的最佳预测模型是屈曲+旋转弧≥200°(Akaike信息标准,132.3;P<.001)灵敏度为68.9%,特异性为80.0%,阳性预测值为89.1%,阴性预测值为51.9%。
■髋关节微不稳定患者的ROM明显高于有症状和无症状的无髋关节微不稳定患者。髋关节屈曲+旋转弧≥200°的有症状的患者极有可能出现髋关节微不稳定的术中发现阳性,而屈曲+旋转弧<200°的患者的不稳定状态很难预测。
UNASSIGNED: Hip microinstability is an increasingly recognized cause of pain and disability in young adults. It is unknown whether differences in passive hip range of motion (ROM) exist between patients with versus without hip microinstability.
UNASSIGNED: Underlying ligamentous and capsular laxity will result in differences in clinically detectable passive ROM between patients with femoroacetabular impingement (FAI), patients with microinstability, and asymptomatic controls.
UNASSIGNED: Cross-sectional study; Level of evidence, 3.
UNASSIGNED: A retrospective review of all patients undergoing hip arthroscopy between 2012 and 2018 was conducted. Patients with a diagnosis of isolated microinstability based on intraoperative findings were identified and classified as having isolated FAI, instability, or FAI + instability. Patients without a history of hip injury were included as controls. Range of motion was recorded in the supine position for flexion, internal rotation, and external rotation. Univariate and multivariate analysis was performed on each measurement in isolation as well as combinations of motion to include total rotation arc, flexion + rotation arc, and flexion + 2× rotation arc Models were then created and tested to predict instability status.
UNASSIGNED: In total, 263 hips were included: 69 with isolated instability, 50 with FAI, 50 with FAI + instability, and 94 control hips. A higher proportion of patients in the instability and FAI + instability groups were female compared with the FAI and control groups (P < .001). On univariate analysis, differences were found in all groups in all planes of motion (P < .001). Multivariable analysis demonstrated differences in all groups in flexion and flexion + rotation arc. In symptomatic patients, the best performing predictive model for hip microinstability was flexion + rotation arc ≥200° (Akaike information criterion, 132.3; P < .001) with a sensitivity of 68.9%, specificity of 80.0%, positive predictive value of 89.1%, and negative predictive value of 51.9%.
UNASSIGNED: Patients with hip microinstability had significantly greater ROM than symptomatic and asymptomatic cohorts without hip microinstability. Symptomatic patients with hip flexion + rotation arc ≥200° were highly likely to have positive intraoperative findings for hip microinstability, whereas instability status was difficult to predict in patients with a flexion + rotation arc of <200°.