hip joint

髋关节
  • 文章类型: Journal Article
    磁共振成像(MRI)越来越多地用于骨关节炎(OA)的分类和评估。许多研究都集中在膝关节OA上,研究MRI检测到的膝关节结构异常和膝关节疼痛之间的关联。髋关节OA在许多方面与膝关节OA不同,但对髋关节结构异常在髋部疼痛中的作用知之甚少。这项研究旨在系统评估MRI上髋关节异常的相关性,如软骨缺损,骨髓病变(BMLs),骨赘,二尖瓣旁囊肿,渗出性滑膜炎,和软骨下囊肿,髋部疼痛。我们搜索了从开始到2024年2月的电子数据库,以确定报告了髋关节MRI特征与髋关节疼痛之间关联的数据的出版物。使用纽卡斯尔-渥太华量表(NOS)对纳入研究的质量进行评分。根据CochraneBackReviewGroup方法指南评估了证据水平,并将其分为五个级别:强,中度,limited,冲突,也没有证据.共纳入9项研究,包括五项队列研究,三项横断面研究,和一项病例对照研究。中等水平的证据表明,BMLs的存在和变化与髋部疼痛的严重程度和进展呈正相关,其他MRI特征与髋部疼痛之间关联的证据有限,甚至存在冲突.只有少数样本量小到中等的研究评估了MRI上的髋关节结构变化与髋关节疼痛之间的关联。BMLs可能有助于髋部疼痛的严重程度和进展。需要进一步的研究来揭示髋关节MRI异常在髋关节疼痛中的作用。系统审查的协议已在PROSPERO注册(https://www。crd.约克。AC.英国/PROSPERO/,CRD42023401233)。
    Magnetic resonance imaging (MRI) is increasingly used in the classification and evaluation of osteoarthritis (OA). Many studies have focused on knee OA, investigating the association between MRI-detected knee structural abnormalities and knee pain. Hip OA differs from knee OA in many aspects, but little is known about the role of hip structural abnormalities in hip pain. This study aimed to systematically evaluate the association of hip abnormalities on MRI, such as cartilage defects, bone marrow lesions (BMLs), osteophytes, paralabral cysts, effusion-synovitis, and subchondral cysts, with hip pain. We searched electronic databases from inception to February 2024, to identify publications that reported data on the association between MRI features in the hip joint and hip pain. The quality of the included studies was scored using the Newcastle-Ottawa Scale (NOS). The levels of evidence were evaluated according to the Cochrane Back Review Group Method Guidelines and classified into five levels: strong, moderate, limited, conflicting, and no evidence. A total of nine studies were included, comprising five cohort studies, three cross-sectional studies, and one case-control study. Moderate level of evidence suggested a positive association of the presence and change of BMLs with the severity and progress of hip pain, and evidence for the associations between other MRI features and hip pain were limited or even conflicting. Only a few studies with small to modest sample sizes evaluated the association between hip structural changes on MRI and hip pain. BMLs may contribute to the severity and progression of hip pain. Further studies are warranted to uncover the role of hip MRI abnormalities in hip pain. The protocol for the systematic review was registered with PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ , CRD42023401233).
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  • 文章类型: Journal Article
    背景:尽管在股骨头坏死(ONFH)塌陷后阶段髋关节功能通常会恶化,一些患者仍然可以表现出长期良好的髋关节功能,一个被称为“崩溃生存”的状态。这项研究旨在确定在ONFH病例中适合“塌陷生存”的患者的特征。
    方法:这项横断面研究包括65例(87髋)患者,诊断为塌陷后ONFH≥3年(平均9.1年,范围3-23年)。使用Harris髋关节评分(HHS)评估髋关节功能。人口统计,临床,比较有利组(HHS>80)和较差组(HHS≤80)之间的影像学数据。通过多变量分析确定了髋关节功能的独立保护因素,并进一步应用受试者工作特征(ROC)曲线分析来评估这些因素的诊断效能。
    结果:优和劣组包括46和41臀部,分别。体重指数(BMI)存在显着差异,关联研究循环骨性(ARCO)阶段,塌陷程度,日本调查委员会(JIC)分类,坏死大小,两组髋关节半脱位(p<0.05)。多变量逻辑回归确定塌陷<3mm(OR:14.49,95CI:3.52-59.68,p<0.001),JIC类型B(OR:11.08,95%CI:1.07-115.12,p<0.05)和C1(OR:5.18,95%CI:1.47-18.20,p<0.05)为髋关节功能的独立保护因素,BMI(OR:0.76,95%CI:0.59~0.97,p=0.029)是独立危险因素。ROC曲线分析表明两者塌陷程度(AUC=0.798,灵敏度=91.3%,特异性=68.3%,p<0.0001)和JIC分类(AUC=0.787,灵敏度=80.4%,特异性=73.2%,p<0.0001)对髋关节功能具有令人满意的诊断价值。结合JIC分类和塌陷程度(AUC=0.868,灵敏度=76.1%,特异性=85.4%,p<0.0001)与单独使用任一者相比,诊断功效显着增强(p<0.05)。
    结论:在ONFH中,股骨头塌陷不一定决定预后不良.轻度塌陷(<3mm)和保留前外侧壁的患者更有可能保持满意的髋关节功能。使他们成为“崩溃生存”的候选人。\"
    BACKGROUND: Despite hip function typically deteriorating in the post-collapse stage of osteonecrosis of the femoral head (ONFH), some patients can still demonstrate long-term favorable hip function, a state termed \"survival with collapse\". This study aims to identify the characteristics of patients suitable for \"survival with collapse\" in cases of ONFH.
    METHODS: This cross-sectional study included 65 patients (87 hips) diagnosed with post-collapse ONFH for ≥ 3 years (average 9.1 years, range 3-23 years). Hip function was assessed using the Harris Hip Score (HHS). Demographic, clinical, and radiographic data were compared between the favorable group (HHS > 80) and the poor group (HHS ≤ 80). Independent protective factors for hip function were identified by multivariate analysis and receiver operating characteristic (ROC) curve analysis was further applied to evaluate these factors\' diagnostic efficacy.
    RESULTS: The favorable and poor groups included 46 and 41 hips, respectively. Significant differences were found in body mass index (BMI), Association Research Circulation Osseous (ARCO) stage, collapse degree, Japanese Investigation Committee (JIC) classification, necrotic size, and hip subluxation between the two groups (p < 0.05). Multivariate logistic regression identified collapse < 3 mm(OR:14.49, 95%CI: 3.52-59.68, p < 0.001), JIC types B (OR: 11.08, 95% CI: 1.07-115.12, p < 0.05) and C1(OR: 5.18, 95% CI: 1.47-18.20, p < 0.05) as independent protective factors for hip function, while BMI (OR: 0.76, 95% CI: 0.59-0.97, p = 0.029) was an independent risk factor. ROC curve analysis demonstrated that both collapse degree (AUC = 0.798, sensitivity = 91.3%, specificity = 68.3%, p < 0.0001) and JIC classification (AUC = 0.787, sensitivity = 80.4%, specificity = 73.2%, p < 0.0001) had satisfactory diagnostic value for hip function. Combining JIC classification and collapse degree (AUC = 0.868, sensitivity = 76.1%, specificity = 85.4%, p < 0.0001) significantly enhanced diagnostic efficacy compared to using either alone (p < 0.05).
    CONCLUSIONS: In ONFH, femoral head collapse does not necessarily determine a poor prognosis. Patients with mild collapse (< 3 mm) and preserved anterolateral wall are more likely to retain satisfactory hip function, making them candidates for \"survival with collapse.\"
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  • 文章类型: Journal Article
    使用髋关节角度的步态监测为人员识别提供了一种有前途的方法,利用智能手机惯性测量单元(IMU)的功能。这项研究调查了使用智能手机IMU提取髋关节角度,以根据步态模式区分个体。数据来自10名健康受试者(8名男性,2只雌性)以4km/h的速度在跑步机上行走10分钟。一种传感器融合技术,结合了加速度计,陀螺仪,磁强计数据用于推导有意义的髋关节角度。我们在WEKA环境中采用了各种机器学习算法,根据髋关节模式对受试者进行分类,分类准确率达到88.9%。我们的研究结果表明,使用髋关节角度进行人员识别的可行性,为未来生物识别应用的步态分析研究提供基线。这项工作强调了基于智能手机的步态分析在个人识别系统中的潜力。
    Gait monitoring using hip joint angles offers a promising approach for person identification, leveraging the capabilities of smartphone inertial measurement units (IMUs). This study investigates the use of smartphone IMUs to extract hip joint angles for distinguishing individuals based on their gait patterns. The data were collected from 10 healthy subjects (8 males, 2 females) walking on a treadmill at 4 km/h for 10 min. A sensor fusion technique that combined accelerometer, gyroscope, and magnetometer data was used to derive meaningful hip joint angles. We employed various machine learning algorithms within the WEKA environment to classify subjects based on their hip joint pattern and achieved a classification accuracy of 88.9%. Our findings demonstrate the feasibility of using hip joint angles for person identification, providing a baseline for future research in gait analysis for biometric applications. This work underscores the potential of smartphone-based gait analysis in personal identification systems.
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  • 文章类型: Journal Article
    背景:甲状腺功能减退综合征(HMS),或有限的髋关节运动范围(ROM),经常在接受大量训练的青少年中报道。本研究旨在调查传统静态拉伸(STR)和自我肌筋膜释放(MFR)对HMS髋关节青少年的影响。
    方法:本研究为随机对照试验。髋关节HMS的青少年运动员分为23STR和23MFR。采用泡沫滚动作为MFR的训练方法。两种干预措施均在6周内每天进行两次,持续20分钟。培训是通过移动视频拍摄和分发的。自我评估的哥本哈根髋关节和腹股沟结果评分,ROM,力量,和跳跃测试在干预前后进行测量。无限制的健康侧被指定为非HMS(nHMS)并作为参考值。
    结果:研究参与者在屈曲(FLX)方面存在局限性,绑架(ABD),内部旋转(IR),和外部旋转(ER)。STR组的ROM恢复至nHMS水平。MFR组的FLX和ABD也恢复,然而,与nHMS相比,IR和ER的角度较低。MFRFLX,ABD,ER强度,单跳测试像nHMS一样恢复,然而,尽管改善,STR组显著低于nHMS.两组均描述了较低的干预前哥本哈根髋关节和腹股沟结果评分子量表日常生活活动,运动,和体力活动相比nHMS。干预后日常生活活动和体力活动均提高到健康水平,然而,运动低于nHMS。
    结论:STR和MFR对髋关节活动度和髋关节自评评分均有影响。此外,MFR在FLX中的强度有所改善,ABD,和ER。然而,MFR组关于三元组的改进,交叉跳跃,和自我评估的运动是有限的。因此,STR和MFR不仅可有效改善ROM,还可有效改善HMS髋关节的肌肉功能不对称。
    BACKGROUND: Hypomobility syndrome (HMS), or limited hip range of motion (ROM), is often reported in adolescents who train heavily. This study was aimed to investigate the impact of traditional static stretching (STR) and self-myofascial release (MFR) in adolescents with HMS hip.
    METHODS: This study was a randomized controlled trial. Adolescent athletes with HMS hip were grouped as 23 STR and 23 MFR. Foam rolling was employed as the training method for MFR. Both interventions were performed twice a day for 20 minutes in 6 weeks. The training was filmed and distributed via the mobile video. Self-assessed Copenhagen Hip & Groin Outcome Score, ROM, strength, and hop tests were measured before and after the interventions. The healthy side without limitations was designated as non-HMS (nHMS) and taken as reference value.
    RESULTS: The study participants had limitations in flexion (FLX), abduction (ABD), internal rotation (IR), and external rotation (ER). The ROM of STR group was recovered to nHMS level. The FLX and ABD of MFR group was also recovered, however the IR and ER had lower angles compared to nHMS. MFR FLX, ABD, ER strength, and single hop test were restored like that of nHMS, however STR group was substantially lower than nHMS despite the improvements. Both groups depicted lower pre-intervention Copenhagen Hip & Groin Outcome Score subscale activities daily living, sport, and physical activity compared to nHMS. Activities daily living and physical activity were improved to healthy levels after the intervention, however sport was lower than that of nHMS.
    CONCLUSIONS: Both STR and MFR had impact on hip mobility and hip self-assessment score. Furthermore, MFR had strength improvements in FLX, ABD, and ER. However, the improvements in MFR group regarding triples, crossover hops, and self-assessed sports were limited. Therefore, STR and MFR are effective in improving not only ROM but also muscle function asymmetry in HMS hip.
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  • 文章类型: Journal Article
    背景:髋臼发育不良患者常报告髋关节不稳定,疼痛,髋关节相关功能较差。髋臼周围截骨术(PAO)是一种旨在重新定位髋臼以改善关节一致性并改善疼痛和功能的外科手术。我们旨在研究术前临床措施对PAO后功能恢复的影响以及PAO后临床结果之间的关联。
    方法:我们筛选了49名潜在参与者,28人报名参加,23人完成了两次研究访问(PAO前和PAO后6个月)。我们评估了测力计测量的臀部和大腿力量,下蹲和反移动跳跃(CMJ)期间的加载模式,疼痛强度,和设备测量的身体活动(PA)水平(光,中度至剧烈的PA[MVPA],和每日步骤)。我们使用线性回归模型来检查PAO前肌肉力量(峰值扭矩;肢体对称指数[LSI])和负荷模式对PAO后6个月个体疼痛强度和PA水平的影响。此外,我们使用Pearson相关系数检验了PAO后6个月所有变量之间的横断面相关性.
    结果:PAO前的下蹲和CMJ期间的下肢肌肉力量和负荷模式不能预测PAO后6个月个体的疼痛强度或设备测量的PA水平(p>0.05)。在PAO之后六个月,较高的膝关节伸肌LSI与在MVPA中花费的较高时间相关(r=0.56;p=0.016),在下蹲任务期间,较高的髋关节外展肌LSI与较低的疼痛(r=0.50;p=0.036)和较高的肢体负荷(r=0.59;p=0.010)相关。最后,较高的髋屈肌LSI与较高的CMJ起飞相关的肢体负荷相关(r=0.52;p=0.021),较高的髋关节伸肌强度与较高的CMJ着陆相关的肢体负荷相关(r=0.56;p=0.012).
    结论:PAO后六个月,较高的臀部和大腿肌肉力量和力量对称性与较低的疼痛有关,PA水平较高,以及在动态运动任务期间更大的归一化肢体负载。
    BACKGROUND: Individuals with acetabular dysplasia often report hip joint instability, pain, and poor hip-related function. Periacetabular osteotomy (PAO) is a surgical procedure that aims to reposition the acetabulum to improve joint congruency and improve pain and function. We aimed to examine the influence of presurgery clinical measures on functional recovery following PAO and the associations among clinical outcomes after PAO.
    METHODS: We screened 49 potential participants, 28 were enrolled, and 23 completed both study visits (pre-PAO and 6 months post-PAO). We evaluated dynamometer-measured hip and thigh strength, loading patterns during a squat and countermovement jump (CMJ), pain intensity, and device-measured physical activity (PA) levels (light, moderate-to-vigorous PA [MVPA], and daily steps). We used linear regression models to examine the influence of muscle strength (peak torque; limb symmetry index [LSI]) and loading patterns before PAO on pain intensity and PA levels in individuals 6 months following PAO. Additionally, we used Pearson correlation coefficient to examine cross-sectional associations among all variables 6 months following PAO.
    RESULTS: Lower extremity muscle strength and loading patterns during the squat and CMJ before PAO did not predict pain intensity or device-measured PA levels in individuals 6 months following PAO (p > 0.05). Six months following PAO, higher knee extensor LSI was associated with higher time spent in MVPA (r = 0.56; p = 0.016), higher hip abductor LSI was associated with both lower pain (r = 0.50; p = 0.036) and higher involved limb loading during the squat task (r = 0.59; p = 0.010). Lastly, higher hip flexor LSI was associated with higher CMJ takeoff involved limb loading (r = 0.52; p = 0.021) and higher involved hip extensor strength was associated with higher CMJ landing involved limb loading (r = 0.56; p = 0.012).
    CONCLUSIONS: Six months after PAO, higher hip and thigh muscle strength and strength symmetry were associated with lower pain, higher PA levels, and greater normalized limb loading during dynamic movement tasks.
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  • 文章类型: Journal Article
    靴子被许多人广泛用于各种目的,但它们对步态生物力学和损伤风险的影响尚不清楚。这项研究调查了靴子对步行生物力学的影响,与休闲鞋相比。比较了20名年龄在20至30岁之间的健康男性参与者在穿着靴子和鞋子进行自我步行时的下肢关节运动学和动力学。结果表明,在早期站立时,穿靴子行走与较大的髋关节伸肌(P=0.009)和踝关节背屈肌(P<0.001)有关,髋部功率产生(P<0.001)和膝关节功率吸收(P<0.001)在早期摆动阶段,髋关节外展肌(P<0.001)和膝关节内收(P<0.001)的时刻,矢状髋关节的净同心工作(13.9%,P=0.001)和额叶(21.7%,P=0.002)平面。相比之下,整个姿势的距下旋肌力矩(P<0.001),站立后期踝关节角速度(P<0.001),和净同心(-42.7%,P<0.001)和偏心(-44.6%,P=0.004)在靴状态下,距下关节的功明显较低。髋关节和膝关节的补偿性调整可能是由于踝关节的限制。虽然靴子可以帮助那些患有脚踝疾病的人,下肢负荷和肌肉骨骼损伤和骨关节炎的风险可能会增加。这项研究为靴子对步态的生物力学影响提供了新的观点,相关伤害的潜在预防和治疗策略,和推进鞋类设计。
    Boots are widely used by many people for various purposes, but their impact on gait biomechanics and injury risk is not well understood. This study investigated the effects of boots on walking biomechanics, compared to casual footwear. The lower limb joint kinematics and kinetics of 20 healthy male participants aged 20 to 30 years old were compared during self-paced walking with boots and shoes. The results showed that walking with boots is associated with greater hip extensor (P = 0.009) and ankle dorsiflexor (P < 0.001) moments in early stance, hip power generation (P < 0.001) and knee power absorption (P < 0.001) in early swing phase, hip abductor (P < 0.001) and knee adduction (P < 0.001) moments in the entire stance, net concentric work for the hip joint in sagittal (13.9%, P = 0.001) and frontal (21.7%, P = 0.002) planes. In contrast, the subtalar supinator moment in the entire stance (P < 0.001), ankle angular velocity in late stance (P < 0.001), and net concentric (- 42.7%, P < 0.001) and eccentric (- 44.6%, P = 0.004) works of subtalar joint were significantly lower in the boot condition. The compensatory adjustments in the hip and knee joints may result from ankle restrictions. While boots may aid those with ankle disorders, lower limb loading and the risk of musculoskeletal injuries and osteoarthritis could be increased. This study offers new perspectives on the biomechanical impact of boots on gait, potential prevention and treatment strategies of related injuries, and advancing footwear design.
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  • 文章类型: Journal Article
    目的:探讨基于Roy适应模式(RAM)的协同护理对术后功能重建的影响。股骨粗隆间骨折患者的软组织疼痛和生活质量。
    方法:本研究采用回顾性配对对照方法。选择2018年7月至2021年9月我院收治的96例股骨粗隆间骨折患者。根据不同的护理方法,将患者分为协作组和常规组,每组48例。两组患者均采用髓内钉手术治疗。常规组给予常规围手术期护理干预,协作组在此基础上给予协同护理干预。比较两组干预前后髋关节功能恢复情况及生活质量。术前、术后疼痛程度,记录两组围手术期并发症。采用Logistic多因素回归分析影响股骨粗隆间骨折患者术后髋关节功能恢复的危险因素,从而构建风险预测模型。采用ROC曲线分析影响因素预测股骨粗隆间骨折患者术后髋关节功能恢复的临床价值。
    结果:合作组干预后Harris各维度评分明显高于干预前及常规组(P<0.05)。干预后,协作组髋关节功能优良率为83.33%,显著高于常规组的60.42%(P<0.05)。术后各时间点协同组VAS评分明显低于常规组(P<0.05)。干预后,生理功能的分数,生理作用,协作组的身体疼痛和一般健康状况明显高于常规组(P<0.05)。协作组并发症发生率为6.25%,显著低于常规组的22.92%(P<0.05)。年龄差异有统计学意义,术前ASA分级,内固定方法,髋关节恢复优组与髋关节恢复差组的骨质疏松分级及围手术期护理方法差异有统计学意义(P<0.05)。Logistic多因素回归分析显示,年龄,术前ASA分级,内固定方式和骨质疏松分级是影响术后髋关节功能恢复的危险因素,围手术期护理方法是保护因素(P<0.05)。影响因素中,内固定方式及骨质疏松程度对预测股骨粗隆间骨折患者术后髋关节功能恢复有一定的临床价值。
    结论:基于RAM模式的协同护理方法可有效恢复股骨粗隆间骨折患者术后髋关节功能。减轻患者围手术期疼痛程度,提高患者的生活质量,降低并发症的发生率,可在临床上推广应用。此外,影响股骨粗隆间骨折患者术后髋关节功能恢复的因素很多,根据影响因素采取有针对性的措施提高髓内钉治疗效果。
    OBJECTIVE: To explore the effect of collaborative nursing based on Roy Adaptive Mode (RAM) on postoperative functional reconstruction, soft tissue pain and quality of life in patients with femoral intertrochanteric fracture.
    METHODS: A retrospective matched control method was used in this study. A total of 96 patients with femoral intertrochanteric fracture admitted to our hospital from July 2018 to September 2021 were selected. According to different nursing methods, the patients were divided into a collaborative group and a routine group, with 48 cases in each group. Patients in both groups were treated with intramedullary nail surgery. The routine group was given routine perioperative nursing intervention, and the collaborative group was given collaborative nursing intervention on this basis. The hip function recovery and quality of life before and after the intervention were compared between the two groups. The preoperative and postoperative pain degree, and the perioperative complications of the two groups were recorded. Logistic multivariate regression analysis was used to analyze the risk factors affecting the recovery of hip joint function in patients with femoral intertrochanteric fracture after operation, thereby constructing a risk prediction model. ROC curve was used to analyze the clinical value of influencing factors in predicting postoperative hip function recovery in patients with femoral intertrochanteric fracture.
    RESULTS: Harris score each dimension after intervention in the collaborative group was obviously higher than that of before intervention and the conventional group (P < 0.05). After intervention, the excellent and good rate of hip joint function the collaborative group was 83.33%, which was significantly higher than 60.42% in the routine group (P < 0.05). Postoperative VAS scores each time point in the collaborative group was obviously lower than that in the routine group (P < 0.05). After intervention, the scores of physiological function, physiological role, body pain and general health in the collaborative group were significantly higher than those in the routine group (P < 0.05). The incidence of complications in the collaborative group was 6.25%, which was significantly lower than 22.92% in the routine group (P < 0.05). There were statistically significant differences in age, preoperative ASA grade, internal fixation method, osteoporosis grade and perioperative nursing methods between the excellent hip recovery group and the poor hip recovery group (P < 0.05). Logistic multivariate regression analysis showed that age, preoperative ASA grade, internal fixation method and osteoporosis grade were the risk factors affecting the recovery of hip joint function after operation, and perioperative nursing method was the protective factor (P < 0.05). Among the influencing factors, the internal fixation method and the grade of osteoporosis had certain clinical value in predicting the recovery of hip joint function in patients with femoral intertrochanteric fracture after operation.
    CONCLUSIONS: The RAM model-based collaborative nursing method may effectively restore the hip joint function of patients with femoral intertrochanteric fracture after operation, and may reduce the perioperative pain degree of patients, improve the quality of life of patients and reduce the incidence of complications, which can be popularized and applied in clinical practice. In addition, there are many factors influencing the recovery of hip joint function in patients with femoral intertrochanteric fracture after operation, and targeted measures should be taken according to the influencing factors to improve the effect of intramedullary nail treatment.
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  • 文章类型: Journal Article
    这项研究旨在回答这个问题:哪个是传统的或短的股骨茎?Optymis茎被用作短股茎,AccoladeII茎被用作常规的股骨茎。短股骨干组(第1组)95例,常规骨干组(第2组)90例。SF-36生活质量评分,大腿疼痛,和Harris髋关节评分用于评估患者的临床结局。术前,术后立即,最后的随访X射线用于放射学评估。茎内翻/外翻对齐,改变臀部偏移,髋臼前倾/倾角改变,股骨迁移,髋臼迁移,关节周围骨化,并对两组进行骨整合评价。第1组的平均随访时间为5.5年,第2组的平均随访时间为5.2年。两组临床评分无显著差异(Harris髋关节评分,SF-36)。第2组的大腿疼痛明显更高(p=0.0001)。至于放射学参数,第1组表现出更多的内翻位置相关结果。在角度稳定性方面,发现组1比组2更不稳定(p=0.0001)。第1组重建股骨偏移的能力更好。第2组关节周围骨化更常见。第1组的股骨骨整合在近端较紧密,第2组的股骨骨整合在远端较紧密。当评估两个股骨干的中期放射学和临床结果时,他们彼此之间没有优势。
    This study aims to answer the question: Which are superior-conventional or short femoral stems?. An Optymis stem was used as a short-femoral stem, and an Accolade II stem was used as a conventional-femoral stem. There were 95 patients in the short femoral stem group (Group 1) and 90 in the conventional stem group (Group 2). The SF-36 Life Quality Score, thigh pain, and the Harris Hip Score were used to evaluate the patients\' clinical outcomes. Pre-operative, immediate post-operative, and final follow-up x-rays were used for radiological evaluation. Stem varus/valgus alignment, hip offset changing, acetabular anteversion/inclination changing, femoral migration, acetabular migration, periarticular ossification, and osteointegration evaluation were assessed for both groups. The mean follow-up time was 5.5 years for Group 1 and 5.2 years for Group 2. No significant difference existed between the two groups in terms of clinical scores (Harris Hip Score, SF-36). Thigh pain was significantly higher in Group 2 (p = 0.0001). As for radiological parameters, Group 1 exhibited more varus position-related results. In terms of angular stability, Group 1 was found to be more unstable than Group 2 (p = 0.0001). The power to reconstruct femoral offset was superior in Group 1. Periarticular ossification was more frequent in Group 2. Femoral osteointegration was denser proximally in Group 1 and distally in Group 2. When mid-term radiological and clinical results of both femoral stems are evaluated, they have no superiority over each other.
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  • 文章类型: Journal Article
    髋关节滑膜软骨瘤病推荐关节镜治疗。然而,有关长期临床结局的证据有限.
    为了评估患者报告的长期结局(PRO)和生存率,并确定残余松散体的潜在影响,通过术后即刻计算机断层扫描(CT)评估,关于临床结果。
    案例系列;证据级别,4.
    在2010年3月至2015年5月期间接受关节镜治疗并被诊断为滑膜软骨瘤病的连续队列患者被纳入研究。术前射线照相,CT,并进行磁共振成像。术前,中期(至少4年),并收集长期(至少8年)的PRO用于疼痛的视觉模拟量表,改良哈里斯髋关节评分(mHHS),非关节炎髋关节评分(NAHS),和12项国际髋关节结果工具(iHOT-12)。计算实现最小临床重要差异(MCID)的百分比。在术后立即进行CT扫描时,比较了有和没有残留松散身体的患者的PROs和生存率。
    共有28名患者(20%的患者失去了随访)被纳入研究,平均随访期为104.9个月(范围,96-139个月)。PROs包括疼痛的视觉模拟量表(术前,3.8±1.2;中期,0.9±1.7;长期,0.8±1.4),mHHS(术前,66.4±14.4;中期,92.8±12.3;长期,93.5±10.5),NAHS(术前,45.2±16.2;中期,81.8±15.3;长期,83.1±12.9),和iHOT-12(术前,48.4±15.6;中期,69.3±11.7;长期,72.7±11.4)在中期和长期随访中均有所改善(均P<.001)。总的来说,27(96.4%),28(100%),26例(92.9%)患者获得mHHS的MCID,NAHS和iHOT-12,分别在长期随访中。在中期和长期随访之间,任何PRO和实现MCID的比率均无显著差异(均P>0.05)。1例患者(3.6%)接受了翻修手术。在23例在术前CT或X线片上有松散身体的患者中,14例患者(60.9%)在术后即刻CT上显示出明显的残余松散体,其NAHS(P=.045)和iHOT-12(P=.037)评分较低,但长期生存率(P>.05)与没有松散体的患者相比。
    关节镜治疗髋关节滑膜软骨瘤病取得了满意的长期临床疗效和较强的生存率。大多数患者在中期和长期随访之间维持或改善了他们的整体功能状态。此外,残留有松散身体的患者临床结局较差,尽管生存率相当。
    UNASSIGNED: Arthroscopic treatment is recommended for hip synovial chondromatosis. However, evidence regarding long-term clinical outcomes is limited.
    UNASSIGNED: To evaluate long-term patient-reported outcomes (PROs) and survival, and to determine the potential effect of residual loose bodies, as evaluated by immediate postoperative computed tomography (CT), on clinical outcomes.
    UNASSIGNED: Case series; Level of evidence, 4.
    UNASSIGNED: A consecutive cohort of patients undergoing arthroscopic treatment and diagnosed with synovial chondromatosis between March 2010 and May 2015 were included in the study. Preoperative radiography, CT, and magnetic resonance imaging were performed. Preoperative, midterm (minimum of 4 years), and long-term (minimum of 8 years) PROs were collected for visual analog scale for pain, modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and 12-item international Hip Outcome Tool (iHOT-12). The percentages achieving minimal clinically important difference (MCID) were calculated. PROs and survival were compared between patients with and without residual loose bodies evident on immediate postoperative CT scan.
    UNASSIGNED: A total of 28 patients (20% of patients were lost to follow-up) were included in the study with a mean follow-up period of 104.9 months (range, 96-139 months). PROs including visual analog scale for pain (preoperative, 3.8 ± 1.2; midterm, 0.9 ± 1.7; long-term, 0.8 ± 1.4), mHHS (preoperative, 66.4 ± 14.4; midterm, 92.8 ± 12.3; long-term, 93.5 ± 10.5), NAHS (preoperative, 45.2 ± 16.2; midterm, 81.8 ± 15.3; long-term, 83.1 ± 12.9), and iHOT-12 (preoperative, 48.4 ± 15.6; midterm, 69.3 ± 11.7; long-term, 72.7 ± 11.4) were improved at both midterm and long-term follow-up (all with P < .001). In total, 27 (96.4%), 28 (100%), and 26 (92.9%) patients achieved MCID for mHHS, NAHS and iHOT-12, respectively, at the long-term follow-up. No significant difference was found in any of the PROs and the rate of achieving MCID between midterm and long-term follow-up (all with P > .05). One patient (3.6%) underwent revision surgery. Among the 23 patients who had loose bodies on preoperative CT or radiographs, 14 patients (60.9%) with residual loose bodies evident on immediate postoperative CT demonstrated lower NAHS (P = .045) and iHOT-12 (P = .037) scores but a comparable survival (P > .05) at long-term follow-up compared with those who did not have loose bodies.
    UNASSIGNED: Arthroscopic treatment for hip synovial chondromatosis achieved satisfactory long-term clinical outcomes with strong survival. Most patients maintained or improved their overall functional status between midterm and long-term follow-up. Furthermore, patients with residual loose bodies had less favorable clinical outcomes, although the survival rate was comparable.
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  • 文章类型: Journal Article
    1)描述精英男性澳大利亚橄榄球联盟(AFL)选秀者的关节内特征(患病率和严重程度)和骨髋关节形态(患病率和大小);2)检查骨髋关节形态(凸轮和钳形形态)与关节内特征(软骨缺损和唇撕裂)之间的关系;3)检查关节内特征之间的关系,骨髋关节形态,和哥本哈根髋部和腹股沟结果评分(HAGOS)。横断面研究。58名男性AFL选秀者接受了3特斯拉髋关节MRI检查。α角确定了凸轮形态,髋臼深度确定了钳形形态。对于每个臀部,对关节内特征进行半定量评分.所有球员都完成了HAGOS以确定臀部/腹股沟症状和运动功能。Logistic回归确定骨性髋关节形态是否与唇撕裂和软骨缺损有关。Mann-WhitneyU测试评估了有和没有关节内特征和骨髋关节形态的足球运动员之间HAGOS子量表得分的差异。在20%和19%的臀部中,凸轮和钳形形态明显,分别。近一半的臀部(41%)有唇缘撕裂,只有14%有软骨缺损.较大的α角与唇撕裂的存在相关(OR1.14,95CI1.07至1.21,p<0.001),但与软骨缺损无关。髋关节成像结果与较低(较差)的HAGOS评分无关。髋关节影像学发现常见于精英男性AFL选秀者,但与更严重的疼痛无关。症状,或运动功能。凸轮形态可能有助于男性AFL受选者唇撕裂的发展。
    1) describe intra-articular features (prevalence and severity) and bony hip morphology (prevalence and size) in elite male Australia Football League (AFL) draftees; 2) examine the relationship between bony hip morphology (cam and pincer morphology) and intra-articular features (cartilage defects and labral tears); and 3) examine the relationship between intra-articular features, bony hip morphology, and the Copenhagen Hip and Groin Outcome Score (HAGOS). Cross-sectional study. 58 male AFL draftees underwent 3-tesla hip MRI. Alpha angle determined cam morphology and acetabular depth defined pincer morphology. For each hip, intra-articular features were scored semi-quantitatively. All players completed the HAGOS to determine hip/groin symptoms and sports function. Logistic regression determined whether bony hip morphology was associated with labral tears and cartilage defects. Mann-Whitney U tests evaluated the difference in HAGOS subscale scores between football players with and without intra-articular features and bony hip morphology. Cam and pincer morphology were evident in 20% and 19% of hips, respectively. Nearly half of hips (41%) had a labral tear, with only 14% having a cartilage defect. Greater alpha angle was associated with the presence of labral tears (OR 1.14, 95%CI 1.07 to 1.21, p < 0.001) but not cartilage defects. Hip imaging findings were not associated with lower (worse) HAGOS scores. Hip joint imaging findings were common in elite male AFL draftees but not associated with worse pain, symptoms, or sport function. Cam morphology may contribute to the development of labral tears in male AFL draftees.
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