FAI合并盂唇损伤手术前后MSCT解剖参数的变化

doi:10.7517/issn.1674-0475.220802

摘要/Abstract

摘要： 本研究探讨股骨髋臼撞击症(FAI)合并盂唇损伤手术前后多层螺旋CT(MSCT)解剖参数变化及其与临床症状改善、关节功能相关性。选取266例FAI合并盂唇损伤患者进行本次研究,均行髋关节镜下骨赘切除联合盂唇修补,根据术后3个月疗效分为优良组(n=228)和非优良组(n=38)。比较两组一般资料、术前和术后3个月中心边缘角(LCE)、偏心距(Offset)、股骨头突出指数(FEI)、髋臼前后缘夹角(EE)、α角及各MSCT参数差值。应用Pearson分析术前和术后3个月LCE、Offset、FEI、EE、α角差值与改良Harris髋关节评分(mHHS)、疼痛视觉模拟评分法(VAS)关系,采用多元线性回归方程分析手术效果的相关影响因素。结果显示,优良组、非优良组术后3个月LCE、α角均低于术前,Offset、FEI、EE均高于术前(P＜0.05);优良组术后3个月LCE、α角低于非优良组,Offset、FEI、EE高于非优良组(P＜0.05);优良组术后3个月与术前LCE、Offset、FEI、EE、α角差值绝对值大于非优良组(P＜0.05);术后3个月与术前LCE、Offset、FEI、EE、α角差值绝对值均与mHHS评分呈正相关,与VAS评分呈负相关(P＜0.05);术后3个月LCE、Offset、FEI、EE、α角均与mHHS评分显著相关(P＜0.05)。FAI合并盂唇损伤手术前后MSCT解剖参数变化可反映临床症状改善程度,且与关节功能有关,在临床治疗、评估患者预后方面具有应用价值。

关键词: 股骨髋臼撞击症, 盂唇损伤, 多层螺旋CT, 关节功能

Abstract: This study investigated the changes of anatomical parameters of multi-slice spiral CT (MSCT) before and after surgery for femoroacetabular impingement (FAI) complicated with labral injury and its correlation with clinical symptom improvement and joint function. All 266 patients with FAI combined with glenoid labrum injury were selected for this study and underwent hip arthroscopic osteotomy combined with glenoid labrum repair, and were divided into excellent (n=228) and non-excellent (n=38) groups according to the outcome at 3 months after surgery. The general data, preoperative and 3-month postoperative central marginal angle (LCE), eccentric distance (Offset), femoral head prominence index (FEI), acetabular anterior-posterior margin angle (EE), α-angle and the difference of each MSCT parameter were compared between the two groups. Pearson’s analysis was applied to analyze the relationship between preoperative and 3-month postoperative LCE, Offset, FEI, EE, α-angle difference and modified Harris Hip Score (mHHS) and pain visual analog scoring method (VAS), and multiple linear regression equation was used to analyze the influencing factors related to surgical outcomes. The results showed that the LCE and α-angle were lower than those before surgery, and Offset, FEI and EE were higher than those before surgery in the excellent and non-excellent groups at 3 months after surgery (P<0.05). LCE and α-angle at 3 months after surgery were lower in the superior group than in the non-excellent group, and Offset, FEI, and EE were higher than in the non-excellent group (P<0.05). The absolute values of LCE, Offset, FEI, EE, and α-angle differences at 3 months postoperatively versus preoperatively were greater in the superior group than in the non-excellent group (P<0.05). The absolute values of LCE, Offset, FEI, EE, and alpha angle difference were positively correlated with mHHS scores and negatively correlated with VAS scores at 3 months postoperatively versus preoperatively (P<0.05). LCE, Offset, FEI, EE, and α-angle were significantly correlated with mHHS score at 3 months postoperatively (P<0.05). The changes in MSCT anatomical parameters before and after surgery for FAI combined with glenoid labral injury can reflect the degree of clinical symptom improvement and are related to joint function, and have application value in clinical treatment and assessment of patient prognosis.

Key words: femoral acetabular impingement, glenoid labral injury, multilayer spiral CT, joint function

陈洪, 张伟, 彭超, 尚瑞松. FAI合并盂唇损伤手术前后MSCT解剖参数的变化[J]. 影像科学与光化学, 2022, 40(6): 1497-1501.

CHEN Hong, ZHANG Wei, PENG Chao, SHANG Ruisong. Changes of MSCT Anatomical Parameters before and after FAI Combined Labral Injury Surgery[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(6): 1497-1501.

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