非创伤性股骨头坏死髋关节积液与坏死分期及髋关节功能的相关性分析

Analysis on the correlation between joint effusion and stage of necrosis and joint function in nontraumatic osteonecrosis of femoral head

目的探讨非创伤性股骨头坏死(NONFH)患者髋关节积液与坏死分期、关节功能之间的相关性,了解股骨头坏死对关节积液的影响。方法对46例NONFH患者74髋资料进行回顾性分析。根据MRI影像将关节积液分为0~Ⅲ级;依据ARCO分期将NONFH分为Ⅰ~Ⅳ期;髋关节功能按照Harris评分标准评分并分为4个等级。分析关节积液与坏死分期、Harris评分之间的相关性。结果 74髋中65髋发生关节积液。ARCO分期与关节积液分级相关(r=0.50,P<0.001),不同ARCO分期的关节积液分级差异有统计学意义(χ2=24.81,P<0.001),关节积液分级随着坏死分期(Ⅰ~Ⅲ期)增加而增加,以Ⅲ期患者的关节积液最常见。Harris评分等级与关节积液分级有相关性(r=0.52,P<0.001),不同功能评分等级的关节积液分级差异有统计学意义(χ2=21.97,P<0.001),关节积液分级随Harris评分等级降低而增加。结论 NONFH关节积液的发生情况与坏死分期及关节功能评分明显相关,关节积液在一定程度上可以作为预测疾病发生和进展的辅助指标。

Objective To explore the correlation between the joint effusion and stage of necrosis and joint function in nontraumatic osteonecrosis of femoral head（ NONFH）,so as to further understand the effect of joint effusion in NONFH. Methods The data of 46 cases（ 74 hips） with NONFH were analyzed retrospectively. According to the MRI,the joint effusion of hip were divided into 0 - Ⅲ grades. According to the ARCO staging system,NONFH was divided intoⅠ - Ⅳ stages. Harris score criteria was used to judge the hip joint function and these patients were divided into4 grades. The correlation between joint effusion and ARCO stage and Harris score was analysed respectively. Results There were 65 hips joint effusion occurred among 74 hips of femoral head necrosis. ARCO stage correlated with joint effusion grading（ r = 0. 50,P〈0. 001）,the results showed significant difference in joint effusion grading among these necrosis stagings（ χ-2= 24. 81,P〈0. 001）. With the advance of necrosis from stageⅠto stage Ⅲ,the joint effusion grading increased gradually. Joint effusion was most commonly seen in stage Ⅲ of NONFH. Harris score grading correlated with joint effusion grading（ r = 0. 52,P〈0. 001）,the results showed significant difference in joint effusion grading among these Harris gradings（ χ-2= 21. 97,P〈0. 001）. With the decrease of Harris score,the joint effusion grading increased gradually. Conclusions The incidence of joint effusion is correlated significantly with stage of necrosis and Harris score in NONFH. To a certain extent,joint effusion can be used as an auxiliary indicator to predict the occurrence and progression of disease.