凸轮型髋臼撞击综合征凸轮畸形与髋臼软骨下硬化骨的相关性

Relationship between Cam Deformity and Subchondral Sclerosis of Acetabulum in Cam-type Femoroacetabular Impingement Syndrome

目的通过测量凸轮型髋臼撞击综合征患者髋臼软骨下硬化骨厚度及α角度,分析凸轮畸形与髋臼软骨下骨增厚程度之间的相关性及与髋关节骨关节炎组织学特征相关性。方法对我院2014年3月至2019年5月109例患者髋关节MRI作回顾性分析,其中男65例,女44例;年龄20~40岁,平均(29.4±1.2)岁。对髋臼软骨下骨厚度进行量化,分析存在凸轮畸形与软骨下髋臼硬化程度之间的相关性。结果α角≥50°诊断为凸轮型髋关节撞击综合征(femoroacetabular impingement,FAI)23例,α角<50°无凸轮畸形86例,发病率为21.1%。凸轮型畸形软骨下骨比无凸轮型畸形者厚0.71 mm(P<0.05)。凸轮畸形髋臼软骨下骨增厚形态各异,主要见于髋臼前上方,共有7种畸形。分别为回旋镖形、薄层形、透镜状、钩形、弧形、云雾状、水滴状。结论凸轮畸形与髋臼软骨下骨增厚程度之间存在相关性。伴有凸轮型畸形的髋臼在前上方软骨下骨较正常髋臼软骨下硬化骨厚度增加,与髋关节骨关节炎早期组织学特征相符合。

Objective To analyze the correlation between cam deformity and subchondral bone thickness of acetabulum and histological characteristics of hip osteoarthritis by measuring the thickness andαangle ofacetabulum in patients with cam-type femoroacetabular impingement syndrome.Methods 109 patients with hip joint MRI in our hospital were retrospectively analyzed,including 65 male and 44 female,with an average age of(29.4±1.2).The thickness of the subchondral bone of the acetabulum was quantified,and the correlation between cam deformity and the degree of sclerosis of the subchondral acetabulum was analyzed.Results 23 patients had cam-type femoroacetabular impingement syndrome with angle ofα≥50°and 86 patients had no cam deformity with angle of alpha<50°.The incidence was 21.1%.The thickness of subchondral bone in cam-shaped deformity was 0.71 mm thicker than that in non-cam-shaped deformity(P<0.05).The subchondral bone thickening of the cam deformity of the acetabulum was different,mainly in the anterior and upper part of the acetabulum.There were 7 deformities in the cam deformity.They were circular darts,thin layers,lenses,hooks,arcs,clouds and droplets.Conclusion There is a correlation between cam deformity and subchondral bone thickness of acetabulum.The thickness of subchondral sclerosis of acetabulum with cam deformity is higher than that of normal acetabulum,which was consistent with the early histological characteristics of hip osteoarthritis.