英文摘要 Abstract
BACKGROUND: Long-term prospective data on periacetabular osteotomy (PAO) from Middle Eastern populations are limited. This study evaluated ≥ seven year clinical, functional, and radiographic outcomes following PAO and identified predictors of survivorship.
METHODS: Thirty-six consecutive patients (34.6 ± 7.2 years; 78% female) undergoing PAO (2014-2018) were prospectively followed. Inclusion required symptomatic dysplasia with Tönnis 0-2. Outcomes included HHS, WOMAC, HOS, SF-36, radiographic parameters (LCEA, AI), complications, and THA conversion. Reliability, multivariate regression, and Kaplan-Meier analyses were performed.
RESULTS: At 7.8 ± 1.2 years, HHS improved from 63.5 ± 11.2 to 89.6 ± 7.8 (p < 0.001). LCEA increased from 16.2 ± 4.3° to 31.8 ± 3.9° and AI decreased from 22.8 ± 5.1° to 7.2 ± 3.6°. ICC for measurements was 0.92. Complications occurred in 16.7% (mostly minor). THA conversion was 5.6%, both with preoperative Tönnis 2 and correction < 12°. Magnitude of LCEA correction independently predicted HHS improvement (β = 0.41, p < 0.01).
CONCLUSIONS: PAO achieved durable correction and sustained functional improvement with low THA conversion at mid- to long-term follow-up. Preoperative cartilage status and adequacy of correction are key determinants of outcome.
中文总结
这项来自中东地区的前瞻性研究对我们理解髋臼周围截骨术（PAO）的远期疗效具有重要参考价值。研究纳入了36名接受PAO手术的症状性髋关节发育不良患者，平均年龄34.6岁，随访时间达到7.8年。结果显示，Harris髋关节评分从术前的63.5分显著提升至89.6分，LCEA角从16.2度恢复至31.8度，髋臼指数也从22.8度下降至7.2度，这些影像学指标的改善说明髋臼覆盖得到了有效重建。值得注意的是THA转换率仅为5.6%，且均发生在术前Tönnis 2级和矫正不足12度的患者中。多因素分析表明，LCEA矫正幅度是功能预后的独立预测因素。这项研究告诉我们，PAO手术能够实现持久的矫形效果和功能改善，但术前软骨状态和矫正充分性是影响远期效果的关键因素。对于年轻患者而言，如果能够准确把握手术指征并做到充分矫正，PAO是一个能够有效延缓甚至避免关节置换的保髋选择。
英文摘要 Abstract
Prior to 2000, hip arthroscopy had been described by Burman but was not widely employed in clinical practice. After the early 2000s, however, hip arthroscopy became of interest to many surgeons, and its utilization has continued to increase over time. From the early days of hip arthroscopy, numerous studies have provided technical, anatomic, and clinical evidence in support of the use of arthroscopic hip surgery, including contributions from our group. This manuscript highlights key developments in the management of labral pathology, including the development of labral repair techniques, improved understanding of acetabular anatomy, and the development of labral reconstruction procedures, along with biomechanical studies to support their use. For the treatment of labral injuries from debridement to reconstruction, clinical outcome investigations and biomechanical studies have helped guide current surgical strategies. Finally, this review also discusses basic science research and ongoing translational clinical trials investigating novel orthobiologic approaches to support the next generation of evidence-based treatments for hip pathology. Research on patient-centered care management has increasingly focused on improving outcomes and avoiding the need for revision surgery, incorporating translational bench-to-bedside as well as bed-to-benchside approaches. This comprehensive research included in this paper spans over a 25-year period and combines four areas of research, including large clinical outcomes studies, biomechanics, biomotion/imaging, and finally novel therapies for regenerative and personalized medicine. The goal of this work is to continue improving outcomes for patients undergoing hip arthroscopy.
中文总结
这篇由Philippon团队发表的综述回顾了25年来髋关节镜技术的发展历程，从一个侧面展现了我们在认识和处理软骨唇盂病变方面的进步。早期髋关节镜主要用于诊断，真正进入临床应用是在2000年代之后。论文系统梳理了从唇裂清理、修复到重建的技术演进，详细讨论了我们对髋臼解剖认识的深化以及生物力学研究的贡献。作者指出，当前研究已经进入一个新时代——从单纯关注手术技术转向患者整体管理，包括如何避免翻修手术、如何实现个体化治疗。综述还介绍了正在进行的转化医学研究，涉及新型生物材料和再生医学策略。这篇文章的核心信息是：髋关节唇盂病变的治疗已经从简单的切除清理发展为精细的修复重建，未来向着组织工程和再生医学的方向迈进。对于从事髋关节运动医学的临床医生而言，理解这一发展脉络有助于为患者制定更合理的治疗方案。
英文摘要 Abstract
OBJECTIVE: To describe and compare arthroscopy-assisted (AA) with fluoroscopy-assisted (FA) minimally invasive plate osteosynthesis (MIPO) for simple transverse acetabular fractures.
STUDY DESIGN: Ex vivo cadaveric study.
SAMPLE POPULATION: A total of 10 canine cadavers (>20 kg) without coxofemoral joint disease.
METHODS: Pelvic computed tomography (CT) images were mirrored and three-dimensional (3D) printed to create models for precontouring 2.7-mm locking compression plates (LCP). Acetabula were randomly assigned to AA or FA MIPO groups and pelvis were prepared for stabilization by standardized osteotomies of the pubic, ischial and acetabular bones. In the AA group, fracture reduction was arthroscopically confirmed, and precontoured plates were applied via small approaches to the ilium and ischium. In the FA group, reduction was guided fluoroscopically. Surgical time, incision length, procedural complications, and feasibility were recorded. Postprocedural CT scans measured fracture gap, step formation, medio-lateral displacement and pelvic angulation. Necropsy assessed iatrogenic injuries.
RESULTS: MIPO was successful for all 20 acetabula. Mean procedure time and incision length were not significantly different between groups. Mean fracture gaps and step defects were <1 mm in both groups. Medio-lateral displacement exceeded 1 mm in the FA group (median 1.08 mm) compared to 0.74 mm in the AA group. Low coronal angles (<5°) were consistent across procedures. Sciatic nerve injury occurred in one case per group. Minor superficial cartilage damage was common.
CONCLUSION: Arthroscopy-assisted MIPO was feasible for simple acetabular fractures, resulting in anatomic (6/10) or near-anatomic (4/10) reductions.
CLINICAL SIGNIFICANCE: Further studies and clinical experience are necessary before recommending AA as an alternative for open approaches.
中文总结
这项离体研究比较了关节镜辅助与透视辅助两种微创接骨板固定技术用于治疗犬简单横型髋臼骨折的效果。研究使用10具犬尸体骨盆，制作3D打印模型进行术前预塑形钢板，随后随机分配进行两种方式的微创操作。结果显示，两组在手术时间和切口长度方面没有显著差异，但关节镜辅助组在内外侧位移控制上表现更优（0.74mm vs 1.08mm），两组骨折间隙和台阶畸形均小于1mm。两种技术都存在坐骨神经损伤的风险，两组各发生一例。这项研究的临床意义在于验证了关节镜辅助微创手术的技术可行性，但同时也指出，在推荐作为开放手术的替代方案之前，还需要进一步的临床研究和经验积累。对于我们从事髋关节创伤的医生来说，这一技术进展提示，在条件允许的情况下，关节镜辅助可能提供更好的复位质量。
英文摘要 Abstract
OBJECTIVE: To establish an ultrasound protocol for identifying the muscular structures of the ventromedial hip region that contribute to coxofemoral joint stability, with comparative MRI and gross anatomic dissection confirmation of accurate structure identification.
METHODS: High-frequency B-mode ultrasonography and 3-Tesla MRI were utilized to bilaterally investigate the muscular anatomy of the ventromedial hip region in 5 normal adult canine pelvis cadaver specimens (n = 10) from September 1, 2024, through August 30, 2025. Ultrasonographic and MRI appearance and anatomic relationships of the evaluated structures were documented and assessed for consistency. Structure identification was confirmed through ultrasound-guided dye placement (using 2 separate specimens for each evaluated structure) followed by gross anatomical dissection.
RESULTS: High-quality ultrasound and MRI images of the pectineus, iliopsoas, adductor longus, adductor magnus et brevis, gracilis, and external obturator muscles were acquired in all specimens. The ultrasonographic approach for evaluating muscles of the ventromedial hip region was documented. Specimen dissection immediately following ultrasound-guided dye injections confirmed accurate identification of all 6 muscles on both attempts, performed separately by 2 clinicians. Structure identification and anatomical descriptions were consistent amongst MRI, ultrasound, and dissection.
CONCLUSIONS: This study provides foundational knowledge in ultrasound and MRI anatomy of the ventromedial hip region and demonstrates methods for effective ultrasonographic evaluation of this region.
CLINICAL RELEVANCE: These findings provide a foundation for diagnosing soft tissue injuries in the ventromedial hip region and guiding rehabilitation strategies in dogs with hip disease.
中文总结
这篇研究建立了一套完整的超声评估犬髋关节内侧区域肌肉结构的 protocol，具有重要的临床转化价值。研究团队使用高频超声和3T MRI对5具犬尸体骨盆进行了对照成像，并通过了超声引导染料注射和解剖分离的双重验证。结果成功识别了6块重要肌肉：耻骨肌、髂腰肌、长收肌、大收肌、股薄肌和闭孔外肌，超声、MRI和解剖三种方法的一致性达到了100%。这项工作的价值在于为临床兽医提供了髋关节内侧软组织损伤的诊断工具，也为后续康复方案的制定提供了影像学基础。从临床角度看，准确识别这些参与髋关节稳定性的肌肉结构，对于诊断软组织损伤和指导康复训练都具有重要意义。
英文摘要 Abstract
INTRODUCTION: This time-zero biomechanical study investigates femoral stem stability after extended trochanteric osteotomy (ETO) without fragment refixation, representing a worst-case scenario. ETO is used in complex femoral revisions to improve exposure while preserving soft tissue and neurovascular structures. In the setting of a short ETO, surgeons may choose between standard (STD) and intermediate revision (REV) stems, although their primary stability remains unclear. Clinically, STD are still used after short ETO with low rates of aseptic loosening, aiming for proximal bone loading to reduce stress shielding. We therefore hypothesized that STD would demonstrate non-inferior axial and torsional stability compared with REV in a short open ETO model.
MATERIALS AND METHODS: A biomechanical model using SYNBONE
RESULTS: REV showed higher axial stiffness (297.5 ± 39.7 N/mm) than STD (245.9 ± 33.2 N/mm, p = 0.035) and greater axial failure load (1228.1 ± 86.8 vs. 1002.5 ± 114.1 N, p = 0.003). Torsional stiffness and peak torque were comparable between groups. Axial failure with REV occurred at the distal stem tip, while STD fractured through the ETO. Torsional failure produced spiral fractures from the distal ETO in both groups.
CONCLUSIONS: Under time-zero worst-case conditions without ETO refixation, the REV demonstrated higher axial stability, while torsional stability was comparable. The STD provided sufficient primary stability after short open ETO, supporting its potential use when revision stem implantation is not required.
中文总结
这项生物力学研究探讨了扩展大转子截骨（ETO）后使用标准柄与中间柄的初期稳定性差异。研究使用合成骨模型模拟ETO场景，在不进行截骨块再固定的最坏情况下进行测试。结果显示，中间柄的轴向刚度（297.5 N/mm）显著高于标准柄（245.9 N/mm），轴向失败载荷也更高（1228.1 N vs 1002.5 N）。两组在扭转刚度和峰值扭矩方面没有差异。值得关注的是，标准柄组发生在ETO处的骨折，而中间柄组失败部位在远端柄尖。这项研究回答了一个实际问题：在短ETO情况下，如果不需要使用翻修柄，标准柄是否足够稳定？结论是标准柄在短开放ETO后提供了足够的主稳定性，支持在不需要加强固定的情况下使用标准柄。这对于临床决策具有指导意义。
英文摘要 Abstract
BACKGROUND: Osteonecrosis of the femoral head (ONFH) remains a challenging condition in orthopaedics
DESCRIPTION: This technique integrates the procurement of the fibula and its implantation into the femoral head via a direct anterior approach. The fibular pedicle is harvested, along with its nutrient peroneal vessels. The lateral circumflex femoral vessels are then exposed. Subsequently, an anterior capsulotomy and a cortical trough are created along the femoral neck. The necrotic region is extirpated and substituted with the fibular pedicle and cancellous bone from the femoral neck. Finally, an anastomosis is formed between the peroneal vessels of the transplanted fibula and the ascending branches of the lateral circumflex femoral vessels
ALTERNATIVES: Nonoperative alternatives for the treatment of ONFH include lifestyle changes like weight control, restriction of weight-bearing activities, and alcohol cessation, alongside pharmaceutical interventions that include antilipemic agents, anticoagulants, vasodilators, and bisphosphonates. Physical therapy methods such as electromagnetic stimulation, extracorporeal shock-wave therapy, and hyperbaric oxygen may also be employed. The surgical approaches to this condition cover a wide array of operations, including core decompression, precursor cell implantation, nonstructural bone grafting, nonvascularized bone grafting, vascularized iliac bone flap transfer, transtrochanteric rotational osteotomy, and porous metal implantation
RATIONALE: FVFG theoretically not only provides potential mechanical support for the necrotic femoral head, which may help prevent collapse, but also has the potential to improve the internal circulation of the femoral head and thus provide a favorable environment for osteoblast activity and contribute to bone induction and formation
EXPECTED OUTCOMES: On the basis of existing research
IMPORTANT TIPS: To safeguard the arcuate artery, it is advisable to sever the fibula with a muscle cuff measuring approximately 1 to 2 cm in length.The length of the fibula should be adjusted according to the surgical method utilized for the hip. Retain the fibula along with the peroneal arteriovenous vessels on the corresponding side, ensuring the preservation of the peroneal vessels to the greatest extent possible.To maintain ankle joint stability, it is necessary for the distal end of the fibula to be positioned at a minimum distance of 8 cm from the ankle joint following its removal.Prior to preparing the free fibula, it is important to carefully examine the side walls of the main vessels for any notable leakage. If leakage is detected, prompt repair should be performed.The period of weight-bearing should be established on the basis of postoperative radiographic follow-up in order to prevent weight-bearing too early, which can result in femoral head collapse and failure of the head preservation therapy.
ACRONYMS AND ABBREVIATIONS: CD = core decompressionCT = computed tomographyARCO = Association Research Circulation OsseousMRI = magnetic resonance imaging.
中文总结
这篇技术介绍文章详细阐述了吻合血管的腓骨移植治疗股骨头坏死（ONFH）的手术方法。股骨头坏死是骨科领域最具挑战性的疾病之一，患者往往年轻且活动需求高。手术首先切取带血供的腓骨及其营养血管，然后通过直接前方入路植入股骨头，清除坏死骨后填入腓骨瓣和来自股骨颈的松质骨，最后进行血管吻合。作者解释了这种技术选择的理论依据：腓骨瓣不仅提供机械支撑防止股骨头塌陷，还能改善股骨头内部血供，为骨形成创造有利环境。文章还总结了已发表文献中的预期结果和重要手术技巧。虽然这是一篇技术描述性文章，但对于考虑采用保头手术的年轻ONFH患者而言，FVFG是一个值得了解的治疗选项，尤其适用于坏死范围较大但尚未塌陷的病例。
英文摘要 Abstract
PURPOSE: Pediatric femoral neck fractures (PFNFs) are rare (≈1% of pediatric fractures), and avascular necrosis (AVN) is a devastating complication without a universally accepted management. High-degree posterior rotational osteotomy (HDPRO) with three-dimensional (3D) navigation is a novel joint-preserving technique with the potential to improve outcomes.
METHODS: A retrospective case series was conducted with three pediatric patients (2 boys, 1 girl; aged 9-15 years at injury) diagnosed with AVN secondary to PFNF. All underwent HDPRO using Stryker OrthoMap 3D navigation to reposition the viable anteromedial femoral head. Preoperative and postoperative outcomes were assessed using radiographic analysis, functional scoring (Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ)), and sports participation. Follow-up ranged from 24 to 36 months.
RESULTS: All patients showed pain relief, functional improvement, stable femoral head morphology, and revascularization. JHEQ improved to 79-84 points; hip motion normalized without impingement. All patients returned to sports (track, volleyball, cycling).
CONCLUSIONS: HDPRO with 3D navigation is a promising joint-preserving option for AVN following PFNF. Preliminary results are favorable; however, the small cohort and limited follow-up warrant larger studies.
SIGNIFICANCE OF STUDY: To the best of our knowledge, this is the first report demonstrating that navigation-guided HDPRO reliably relocates the viable anteromedial head to the load-bearing zone.
LEVEL OF EVIDENCE: Level IV.
中文总结
这篇病例系列报道了3D导航辅助下高角度后旋转截骨术治疗儿童股骨颈骨折后股骨头坏死的新方法。儿童股骨颈骨折是一种罕见损伤（约占儿童骨折的1%），一旦发生坏死往往后果严重。3例患儿（9-15岁）在股骨头坏死发生后接受了这一定制化手术，利用Stryker 3D导航系统将存活的前内侧股骨头重新定位到负重区。随访24-36个月的结果令人鼓舞：所有患儿疼痛缓解，功能改善，股骨头形态稳定并实现了血供重建，JHEQ评分达到79-84分，运动功能恢复正常。这项技术的创新点在于利用3D导航精确定位活骨组织到正常负重位置，最大限度保留自身关节。作者也诚实地指出，由于病例数少、随访时间短，需要更大规模研究验证。这对于从事儿童髋关节的临床医生来说，是一个有前景的保髋方向。
英文摘要 Abstract
OBJECTIVES: (1) To radiographically examine morphologies consistent with femoroacetabular impingement (FAI) syndrome in youth ice hockey and ringette athletes aged 14 to 24 years; (2) to examine FAI syndrome diagnosis because it relates to positive findings on special tests.
DESIGN: Cross-sectional.
SETTING: University, Sport Medicine Center.
PARTICIPANTS: Male and female ice hockey/ringette athletes at 14 to 24 years with no history of traumatic hip/pelvic injuries/surgeries.
INTERVENTIONS: Examination of a novel screening protocol, using a cluster of tests, for FAI syndrome.
MAIN OUTCOME MEASURES: Clinical hip findings (hip passive range of motion [p-ROM]; hip muscle strength testing; hip impingement special tests [ST]), radiographic evidence of FAI syndrome (α angle; lateral center edge angle [LCEA]; crossover sign).
RESULTS: A convenience sample of 28 males and 30 females consented from a larger cohort to undergo radiographs. FAI syndrome was present in 61% of males and 67% of females. Males demonstrated higher odds of cam morphologies unilaterally relative to females (OR = 4.29, 95% CI, 1.52-12.23), and based on point estimates, females displayed higher odds of pincer morphologies, both unilaterally (OR = 2.68, 95% CI, 0.95-7.73) and bilaterally (OR = 2.41, 95% CI, 0.73-8.12). Males displayed higher α angle than females (b 2 = 6.05, 95% CI, -9.75 to -2.34). No other covariates were associated with α angle/LCEA. With each additional positive ST, the odds of having evidence of FAI syndrome increased 3-fold (OR = 3.34, 95% CI, 1.91-5.83).
CONCLUSIONS: Youth male and female ice hockey and ringette athletes display similar prevalence of FAI syndrome; however, specific morphologies differ by sex. This study provides evidence that a cluster of tests may increase the certainty with which suspected FAI syndrome can be assessed through screening.
中文总结
这项横断面研究聚焦于青年冰球和Ringette运动员的股骨髋臼撞击综合征（FAIS）。研究对58名14-24岁运动员进行了临床检查和影像学评估，包括特检阳性率和α角、LCEA等放射学指标。结果显示FAIS在男性运动员中占61%，女性占67%，差异不大。但具体分型有显著差异：男性更常见cam畸形（单侧cam形态OR=4.29），而女性更倾向于pincer形态。每增加一项特检阳性，FAIS诊断 odds增加3倍（OR=3.34）。这项研究的临床意义在于：青年运动员FAIS患病率很高，但男女分型特点不同，提示我们在筛查和诊断时需要区别对待。重要的是，研究证实组合特检能够提高FAIS诊断的准确性，这为临床筛查提供了实用工具。对于从事运动医学的医生来说，在评估年轻运动员髋关节疼痛时应当考虑到FAIS的可能。
英文摘要 Abstract
INTRODUCTION: We aimed to establish age-related characteristics of posture-dependent pelvic tilt and standing spinopelvic alignment in patients with symptomatic hip dysplasia (HD) from adolescence to middle age.
MATERIALS AND METHODS: A total of 101 patients with HD indicated for eccentric rotational acetabular osteotomy (ERAO) between 2016 and 2024 were included. Pelvic tilt in supine and standing positions was quantified using the anterior pelvic plane (APP) angle estimated from computed tomography-based 3D pelvic models matched to supine and standing anteroposterior hip radiographs. The change from supine to standing was calculated as standing minus supine; negative values indicated a posterior change. Three-dimensional acetabular coverage during postural transition was compared across age groups. Standing radiographic hip and spinopelvic parameters were also examined using multivariable regression analysis to identify factors associated with age.
RESULTS: Age was correlated with the supine-to-standing change in the APP angle (r = 0.47, p < 0.001). The change shifted closer to zero with increasing age, with younger patients showing a larger posterior change compared with older patients. Patients in their teens showed a more pronounced decrease in anterosuperior acetabular coverage at the 2 o'clock position compared with those in their 40 s (p = 0.017) and 50 s (p = 0.040). Furthermore, anterior wall index in standing (β = 0.26, p = 0.007), sagittal vertical axis (β = 0.24, p = 0.015), and sacral slope (β = 0.24, p = 0.014) were identified as independent factors associated with age.
CONCLUSIONS: Younger patients with HD showed a larger posterior change in pelvic tilt during postural transition compared with middle-aged patients. These findings support preoperative assessment of functional acetabular coverage in the standing position, particularly in the anterosuperior region in younger patients, when planning ERAO. Longitudinal studies are needed to determine whether maintaining anterior pelvic tilt during standing contributes to preservation of joint integrity into middle adulthood.
中文总结
这项研究探讨了髋关节发育不良患者骨盆倾斜和脊柱对线随年龄变化的特征。研究纳入了101名接受离心旋转髋臼截骨术（ERAO）的患者，从青少年到中年不等，利用3D CT模型匹配X线片评估不同体位下的骨盆参数变化。研究发现，年龄与卧位到立位的骨盆倾斜变化呈中度相关（r=0.47），年轻患者从卧位到立位时骨盆后倾程度更大，而中年患者这种变化趋于减小。进一步分析显示，年轻患者在2点钟位置的前上髋臼覆盖减少更为明显。这项研究的临床指导意义在于：术前评估时应当关注功能性立位髋臼覆盖情况，尤其对于年轻患者不能仅依赖卧位影像。这提示我们在制定手术计划时需要考虑患者的年龄因素和姿势变化对髋臼覆盖的影响，从而实现更精准的矫形。
英文摘要 Abstract
OBJECTIVES: This study aimed to investigate the prevalence of hip-related groin pain (HRGP), and femoroacetabular impingement (FAI) syndrome-related signs and symptoms, in ice hockey and ringette athletes, considering important covariables (eg, age, sex).
DESIGN: Intra and interrater reliability and cross-sectional.
SETTING: University, Sport Medicine Centre.
PARTICIPANTS: Male and female ice hockey/ringette athletes at 14 to 24 without a history of traumatic hip/pelvic injuries/surgeries.
INTERVENTIONS: Novel screening for the assessment of HRGP and signs and symptoms associated with FAI syndrome.
MAIN OUTCOME MEASURES: HGRP-focused hip history questionnaire, International Hip Outcome tool, clinical hip screen (hip passive range of motion (ROM), p-ROM; hip muscle strength testing; hip impingement special tests).
RESULTS: HRGP was reported by 61% of participants [105/166 (63%) male, 60/104 (57%) female]. Men with HRGP had reduced ROM in flexion (with = 124 degrees, 95% CI, 122-125 degrees; without = 126 degrees, 95% CI, 124-127 degrees, t = 1.81, P = 0.04), adduction (with = 26 degrees, 95% CI, 25-27 degrees; without = 28 degrees, 95% CI, 27-29 degrees; t = 0.21, P = 0.01), and internal rotation (with = 31 degrees, 95% CI, 30-33 degrees; without = 34 degrees, 95% CI, 33-35 degrees; t = 2.86, P = 0.002) compared with male without HRGP. Both male and female with HRGP reported up to 5-fold increased odds of positive findings on impingement tests compared with those without HRGP [flexion-adduction-internal rotation (FADIR): male, odds ratio (OR = 2.84, 95% CI, 1.73-4.69; female OR = 5.37, 95% CI, 2.21-14.87)]. When modelled and fit with other covariates, FADIR (OR = 0.76, 95% CI, 0.51-1.12) and maximal squat distance (OR = 1.69, 95% CI, 1.30-3.60) increased odds of having HRGP. International Hip Outcome scores (OR = 0.96, 95% CI, 0.95-0.98) displayed an inverse relationship with HRGP.
CONCLUSION: Findings from this study provide evidence to support the use of hip screening in athletes at risk of FAI syndrome. Challenges to the assessment of the hip joint continue to limit the reliability of screening tools.
中文总结
这项研究针对青年冰球和轮滑运动员进行了髋部相关腹股沟疼痛的流行病学调查，共纳入270名14至24岁无创伤史的运动员。数据显示61%的参与者报告存在髋部相关腹股沟疼痛，其中男性占63%，女性占57%，这个比例相当高。研究者进一步分析了体格检查的差异，发现有症状的男性运动员在屈髋、外展和内旋活动度上均显著低于无症状组，尤其以内旋受限最为明显，平均值从34度降至31度。在特殊检查方面，有症状组FADIR试验阳性率明显升高，女性甚至达到5倍以上的优势比，提示盂唇损伤和髋关节撞击综合征的可能性较高。值得注意的是，国际髋关节结局评分与疼痛程度呈负相关，评分越低症状越重。这一研究为高强度冰上运动中的髋部筛查提供了循证依据，建议对从事这类运动的年轻人群进行常规髋关节评估，以早期识别和处理潜在的髋关节问题。
英文摘要 Abstract
BACKGROUND: Femoroacetabular impingement (FAI) morphology may contribute to abnormal loading of the adductor-rectus abdominis (RA) aponeurosis and development of core muscle injury (CMI) in cutting-pivoting athletes. It is unclear whether CMI with combined RA and adductor longus (RA-AL) symptoms has a higher prevalence of FAI morphology than CMI with AL symptoms alone.
PURPOSE/HYPOTHESIS: The purpose was to determine (1) whether athletes with CMI with RA-AL or isolated AL symptoms differ in prevalence of FAI syndrome (FAIS) and (2) whether prevalence or severity of FAI morphology differs between these groups. It was hypothesized that athletes with RA-AL symptoms will have a higher prevalence of FAIS and more severe FAI morphology than those with AL symptoms alone.
STUDY DESIGN: Case series; Level of evidence, 4.
METHODS: Athletes who underwent surgical treatment of a CMI between 2021 and 2025 at a single center were identified. Patients were categorized as RA-AL or AL based on symptoms and physical examination findings. FAIS status was determined by symptomatic impingement morphology and treated with hip arthroscopy and core muscle surgery. Impingement anatomy was assessed on radiographs via lateral center-edge angle, crossover ratio, ischial spine sign, head-neck offset ratio, anterior center-edge angle, and α angle.
RESULTS: A total of 65 athletes with CMI were included (median age 21 years; IQR 18-43; 97% male); 42 (65%) had RA-AL and 23 (35%) had AL symptoms. No baseline demographic differences were identified between groups. The prevalence of symptomatic FAIS was 38% (25/65) overall and was lower (29%; 12/42) in the RA-AL group than the AL group (57%; 13/23) (
CONCLUSION: There is a very high prevalence of FAI morphology, particularly femoral cam morphology, in both RA-AL and AL symptomatic athletes with CMI, suggesting a likely role of FAI morphology in CMI development. Symptomatic FAI is more common in athletes with isolated AL symptoms versus RA-AL symptoms. Type and degree of radiographic FAI morphology were not associated with specific CMI symptom patterns.
中文总结
这项研究探讨了核心肌肉损伤（CMI）症状模式与股骨髋臼撞击综合征的关联。CMI在剪切和变向运动项目中常见，可能与FAI形态导致的异常负荷有关。研究纳入了65名接受手术治疗的CMI运动员，按症状分为腹直肌-内收肌（RA-AL）组和单纯内收肌（AL）组。核心发现是：两组中都存在很高的FAI形态患病率（整体38%），但有趣的是，单纯AL组FAI患病率反而更高（57% vs 29%）。两组在人口学特征上没有差异，均以男性为主（97%）。这一发现挑战了我们的常识——腹直肌和内收肌同时受累的患者并不比单纯内收肌受累者有更高的FAI患病率，反而是后者更需要警惕FAI的存在。这提示我们在评估CMI运动员时，对于存在单纯内收肌症状的患者应当更积极地排查FAI形态。
英文摘要 Abstract
INTRODUCTION: A periacetabular osteotomy (PAO) is a joint-preserving surgical option for treatment of acetabular dysplasia. The procedure aims to prevent, or at least delay, the development of osteoarthritis, and subsequent need for total hip arthroplasty (THA). The conversion rate to THA differs widely in the literature, but most of the studies have few patients, and the follow-up time is often short for THA as an endpoint. The aim of this study was to evaluate the long-term outcome after PAO surgery with the rate of conversion to THA as the primary outcome.
MATERIALS AND METHODS: Patients ≥18 years that underwent a PAO operation at the Karolinska University Hospital in Stockholm, Sweden from 2006 to 2022 were included. Radiological signs of hip osteoarthritis, and the lateral center-edge angle (LCEA) was calculated on pre- and postoperative radiographs or CT-scans. The national Swedish Arthroplasty Register was used to find cases who had a secondary operation with THA.
RESULTS: The number of cases included was 96. Median age was 30 (18–46) years, and 84% (
CONCLUSIONS: The PAO procedure is a suitable option in young patients with symptomatic dysplasia of the hip in order to avoid, or at least delay, hip arthroplasty.
中文总结
这项来自瑞典卡罗林斯卡大学医院的8年随访研究评估了PAO手术的长期疗效。研究纳入了96例连续病例，中位年龄30岁，主要终点是THA转换率。结果显示THA转换率在8年时为19%，在15年时上升至32%——这意味着约三分之一的患者在15年内最终需要关节置换。从统计学角度这是一个令人警醒的数据，但同时也说明PAO确实为相当比例的患者争取了更长时间的自身关节保留。研究还发现LCEA和盂唇状况与预后相关。这项研究的重要价值在于提供了长期随访数据，让我们能够更准确地回答患者关于"PAO能让我推迟多久换关节"的问题。对于保髋手术的适应症选择和患者期望管理，这些数据具有重要的临床参考价值。
英文摘要 Abstract
INTRODUCTION: Periacetabular osteotomy, commonly performed for prearthritic hip dysplasia, was identified as a procedure that could benefit from an enhanced recovery after surgery pathway due to wide variation in multimodal pain management and regional anesthesia practices at our institution. The global aim of this project was to implement an enhanced recovery after surgery pathway for patients undergoing periacetabular osteotomy. Our SMART aim was to achieve greater than 70% compliance for the intraoperative medication bundle elements during the first PDSA cycle.
METHODS: A multidisciplinary pathway was designed and implemented with key stakeholders from the Departments of Evidence Based Practice, Anesthesiology, Orthopedic Surgery, and Perioperative Nursing. Patient data from all patients undergoing periacetabular osteotomy from 2018 to the present were analyzed, which included the baseline cohort as well as outcomes from two Plan-Do-Study-Act cycles.
RESULTS: After ERAS implementation and two subsequent Plan-Do-Study-Act cycles, we observed a decrease in hospital length of stay from 3.34 days (95% CI [2.95, 3.72]) to 2.37 days (95% CI [2.00, 2.74]) and an intraoperative medication bundle compliance of 90%. These gains occurred with minimal change in average postoperative pain scores and no hospital readmissions within 30 days of surgery.
CONCLUSIONS: Multidisciplinary enhanced recovery after surgery pathways continue to play a critical role in standardizing perioperative care, reducing unwarranted variation, and promoting faster recovery across paediatric populations.
中文总结
这项研究展示了如何通过实施增强术后恢复（ERAS）方案来优化青少年PAO手术的围术期管理。研究开始前该中心在多模式镇痛和区域麻醉方面存在很大差异，研究团队设计了一个多学科参与的ERAS路径并通过PDSA循环进行持续改进。实施ERAS后，住院时间从3.34天缩短至2.37天，术中药物束管理依从性达到90%，而术后疼痛评分和30天再入院率均无显著变化。这项研究的价值不仅在于证实了ERAS在青少年PAO中的可行性和有效性，更在于展示了一个标准化的质量改进方法。对于正在开展保髋手术的中心，建立类似的ERAS路径有望改善患者体验、缩短住院时间并减少不必要的变异。
英文摘要 Abstract
BACKGROUND: Postoperative instability remains a significant concern following total hip arthroplasty (THA), particularly in patients with small acetabular dimensions or in situations requiring limited surgical exposure (e.g., elderly fracture cases). Dual mobility cups incorporating peripheral fins and apical fixation spikes may enhance primary stability; however, these fixation features may complicate insertion through limited posterior exposure. This technical note describes a custom guiding sleeve designed to facilitate acetabular reaming and insertion of dual mobility cups with peripheral fins and apical fixation spikes while preserving surrounding soft tissues.
METHODS: A cadaveric feasibility study was conducted using three fresh-frozen hips with small acetabular dimensions. A custom-designed cylindrical guiding sleeve was used during acetabular reaming and cup insertion through a limited posterior approach.
RESULTS: The guiding sleeve created a protected cylindrical corridor that displaced surrounding soft tissues and facilitated acetabular preparation and cup insertion without soft-tissue impingement in this cadaveric feasibility study.
CONCLUSIONS: The guiding sleeve demonstrated technical feasibility in this cadaveric feasibility study and may represent a useful adjunct for acetabular preparation and implantation of dual mobility cups with peripheral fins and apical spikes through limited posterior exposure. Further clinical studies are warranted to evaluate its effectiveness in vivo.
中文总结
这篇技术说明介绍了一种用于小髋臼和有限显露的全髋关节置换术的专用导向套筒。研究背景是双动髋臼杯因其周边fin和尖端固定 spikes设计而具有更好的初期稳定性，但这些特征在有限后路显露时可能增加植入难度。研究使用3具小髋臼尸体骨盆进行离体实验，自定义的圆柱形导向套筒在髋臼准备和杯植入过程中有效保护了周围软组织，创建了一个清晰的工作通道。这是一项概念验证研究，证明了技术可行性但尚未进行临床验证。对于处理小髋臼病例（如老年骨折患者）的外科医生来说，如果术中显露受限，这款导向套筒可能是一个有价值的新工具，但前提是需要进一步的临床研究来验证其有效性和安全性。
英文摘要 Abstract
AIMS: Patients with spastic cerebral palsy (CP) are at a high risk of neurogenic hip dysplasia/subluxation depending on the severity of the neuromuscular disorder. Untreated, approximately one third of all patients develop hip dislocation. Reconstruction with femoral varus derotational osteotomy (VDRO) combined with Dega acetabuloplasty (PO) represents the gold standard. The goal of this study was the radiographic assessment after reconstructive treatment of spastic hip dysplasia/(sub)luxation and to derive specific thresholds and target values of neck shaft angle NSA) and femoro-epiphyseal acetabular roof (FEAR)-index that could be beneficial in predicting long-term outcome.
METHODS: In this retrospective evaluation, 121 patients (224 hips) with CP who underwent VDRO/acetabuloplasty were grouped according to their age at surgery and postoperative radiographic parameters (NSA and FEAR-index) and compared with each other over time (5-year follow-up). The preoperative, postoperative and follow-up X-rays were analyzed. For this purpose, the FEAR, lateral center-edge angle (LCE) and migration percentage (MP) were analyzed as outcome measures at hip-level using linear mixed models (LMM).
RESULTS: Patients older than 8 years and with a postoperative FEAR > -20° or a postoperative NSA > 130° showed a significantly worse postoperative result (FEAR, LCE and MP). A deterioration of the outcome parameters was found in all subgroups to approximately the same extent up to 2 years postoperatively. After 5 years, the findings remained stable. Failure rates and relative risks of inferior subgroups (FEAR-index ≥-20°, NSA ≥ 130°, age ≥ 8 years) were approximately twice as high (n
CONCLUSION: A sufficient postoperative head coverage/reduction of MP and thus joint stability is crucial for long-term outcomes after VDRO and PO. Particularly the FEAR-index seems to be a useful parameters for the surgeon for preoperative planning and postoperative aftercare. If postoperative risk factors are present, an individualized aftercare program and hip monitoring plan that establishes more frequent postoperative assessment and possible prolonged abduction therapy should be considered.
中文总结
这项研究回顾了121例脑瘫儿童髋关节重建手术的影像学预后因素。研究对象均接受了股骨近端内翻去旋转截骨（VDRO）联合Dega髋臼截骨术，研究目标是找出能够预测长期结果的影像学阈值。分析显示，术后FEAR指数>-20°或颈干角>130°且年龄超过8岁的患儿，预后显著更差。5年随访时这些亚组的失败率约为其他亚组的两倍。混合模型分析表明，术后头覆盖和复位质量（以 Migration Percentage 衡量）对于长期稳定性至关重要。FEAR指数在术前规划和术后评估中都表现出作为预后指标的价值。这项研究的临床意义在于：它为脑瘫儿童髋关节重建手术提供了具体的影像学参考阈值，可以帮助外科医生在术前识别高危患者，在术后监测中重点关注这些参数，以期及早干预改善预后。
英文摘要 Abstract
BACKGROUND: Femoroacetabular impingement syndrome (FAIS) is a major cause of chronic hip pain and early osteoarthritis. Surgical correction, traditionally via open surgical dislocation and increasingly via hip arthroscopy, aims to restore hip function by correcting bony morphology. While both techniques address cam and pincer lesions, the long-term implications of the surgical approach and specific impingement morphology on five-year structural outcomes, including hip instability, osteoarthritis (OA) progression, and conversion to total hip arthroplasty (THA), remain poorly defined.
METHODS: We conducted a retrospective cohort study using the TriNetX US Collaborative Network, analyzing de-identified electronic medical records from 2,725 patients (2,321 arthroscopic, 404 open) who underwent FAIS correction between 2003 and 2023 with a minimum five-year follow-up. Patients were grouped by surgical approach (Arthroscopic vs. Open) and morphology (Cam-only vs. Pincer-only vs. Mixed). Primary outcomes were five-year cumulative incidence and time-to-event incidence (Hazard Ratio, HR) of hip instability/dislocation, hip OA, and THA conversion.
RESULTS: In patients with mixed FAIS morphology, the arthroscopic approach was associated with a significantly lower risk of instability/dislocation (3.7% vs. 11.6%; HR 0.393, p<0.001) compared to the open approach. Conversely, the open approach demonstrated a lower incidence of hip OA (4.6% vs. 7.8%; HR 2.320, p=0.001 favoring open). Although the overall five-year THA incidence was equal (2.4%), arthroscopy had a significantly higher hazard of conversion (HR 6.112, p=0.004). Subgroup analysis found no statistically significant difference in instability, OA, or THA rates between cam and pincer morphologies within either the arthroscopic or open cohort.
CONCLUSION: Surgical approach significantly impacts five-year structural outcomes in FAIS correction. Arthroscopy offers superior early joint stability, but the open approach may be associated with a more protective effect against long-term OA progression. Impingement morphology (cam vs. pincer) did not independently influence these five-year outcomes. These findings support a trade-off between approaches and highlight the need for tailored surgical selection to optimize joint preservation.
中文总结
这项大型回顾性研究利用美国电子病历数据，比较了关节镜与开放手术治疗股骨髋臼撞击综合征5年结构预后的差异。研究纳入了2725名患者（2321例关节镜，404例开放），分析了三项主要结局：关节不稳/脱位、髋关节骨关节炎进展和THA转换。对于混合型撞击患者，关节镜组的不稳/脱位发生率显著低于开放组（3.7% vs 11.6%），但骨关节炎进展率反而更高（7.8% vs 4.6%）。虽然总体THA转换率相当（均为2.4%），但关节镜组的转换风险时间比更高（HR 6.112）。亚组分析未发现cam和pincer形态在两种入路间存在显著差异。这项研究的临床启示是：手术入路选择会影响5年预后，关节镜提供更好的早期稳定性，但开放手术在骨关节炎控制方面可能更有优势。在与患者讨论手术方案时，应当将这些长期数据纳入考量。
英文摘要 Abstract
INTRODUCTION: Hip instability is an important complication of spinal muscular atrophy (SMA), which leads to various functional impairments, including mobility challenges and difficulties with daily care. The primary objective of this study is to determine the prevalence and severity of hip instability in a cohort of SMA patients managed at a tertiary care center. The prevalence of scoliosis and its association with hip instability in children with SMA were also assessed.
METHODS: This is a retrospective cross-sectional study including children with a genetic diagnosis of SMA and available hip x-rays, conducted between 2018 and 2023. Patients were grouped based on SMA type and motor status (non-sitters, sitters, or walkers). Relevant parameters were collected including hip subluxation/dislocation, presence of scoliosis, number of
RESULTS: Fifty-four children with types 1-3 SMA were included in this study. Hip dislocation/subluxation in both hips was most prevalent in type 1 SMA patients [Fisher's Exact Test (FET):
DISCUSSION: To the best of our knowledge, this is the first study in the Middle East on hip instability and scoliosis in a cohort of children with SMA. Hip dislocation and/or subluxation is most common and most severe in type 1 SMA. The study's findings can aid the development of hip instability screening programs in SMA patients, enabling early intervention.
中文总结
这是首篇关于中东地区脊髓性肌萎缩症（SMA）儿童髋关节不稳和脊柱侧弯相关性的研究。54名1-3型SMA儿童被纳入分析，按运动功能状态分组（卧床型、坐位型、行走型）。研究发现在两种髋关节均出现脱位/半脱位的患病率在1型SMA中最高，且随病型加重而降低。1型患儿通常在2岁前即出现髋关节问题，而3型则多在4-6岁才出现。研究还发现脊柱侧弯与髋关节不稳存在统计学关联。这项研究的重要价值在于为SMA儿童建立了髋关节不稳的患病率基线数据，提示我们应当对1型SMA进行更早期的髋关节筛查，以便在不可逆改变发生前进行干预。对于这类神经肌肉性疾病患儿，早期筛查和定期监测是改善长期预后的关键。
英文摘要 Abstract
Developmental dysplasia of the hip represents a spectrum of disorders ranging from mild acetabular dysplasia to complete hip dislocation. Early diagnosis and treatment are essential to prevent long-term complications. The Pavlik harness remains the first-line treatment for infants with reducible hip dysplasia or dislocation diagnosed within the first months of life and has demonstrated high success rates. However, complications related to its use may occasionally occur. One of the rare but significant complications is obturator (inferior) dislocation of the hip during treatment. We present the case of a two-month-old female infant diagnosed with Graf type IV developmental dysplasia of the right hip. Following reduction and treatment with a Pavlik harness, follow-up imaging revealed an obturator dislocation of the hip. The harness was discontinued, and closed reduction with subsequent casting was performed. Despite an initially successful reduction, the patient later developed persistent dysplasia, subluxation, and femoral head fragmentation. Long-term follow-up demonstrated improvement in hip stability, but residual acetabular dysplasia and deformity of the ossific nucleus were present, consistent with coxa plana. The patient is currently scheduled for a corrective pelvic osteotomy. This case highlights the importance of careful monitoring during Pavlik harness treatment and early recognition of atypical displacement patterns. Prompt diagnosis and appropriate management are essential to prevent further complications and optimize long-term hip development.
中文总结
这篇病例报告描述了一例Pavlik吊带治疗发育性髋关节发育不良期间发生的罕见并发症——闭孔（下）脱位。2月龄女婴诊断为右侧Graf IV型髋关节发育不良，在Pavlik吊带治疗后随访影像发现发生了闭孔脱位。团队立即停止吊带并改为闭合复位加石膏固定。尽管初期复位成功，患儿后来仍出现了持续性发育不良、半脱位和股骨头骨化核碎裂，最终需要接受骨盆截骨手术。这例病例提醒我们，即使使用成功率很高的Pavlik吊带，也需要密切监测以早期发现不寻常的移位模式。闭孔脱位是吊带治疗的一种罕见但严重的并发症，及时识别和调整治疗方案对优化长期预后至关重要。临床上应当教育家长了解异常症状的识别，并确保有规律的随访 Imaging。
英文摘要 Abstract
BACKGROUND: Acetabular labral tears and hip rotator cuff injuries frequently coexist and present with overlapping symptoms, posing diagnostic and therapeutic challenges. However, outcomes of simultaneous arthroscopic repair for these combined pathologies remain unclear. This study evaluated short-term outcomes after arthroscopic hip rotator cuff repair performed concurrently with acetabular labral repair vs. labral repair, while describing surgical considerations and characterizing the demographic and clinical features of concomitant injuries.
METHODS: In this retrospective matched-cohort study, patients who underwent primary arthroscopic concomitant repair of acetabular labral tears and hip rotator cuff injuries between September 2019 and September 2023 were identified. These patients were matched in a 1:2 ratio based on sex, age (±2 years), and body mass index (BMI, ±5 kg/m
RESULTS: Thirty-one patients underwent arthroscopic repair of hip rotator cuff injuries with concomitant labral repair (83.87% female; mean age, 52.13 ± 7.47 years; mean BMI, 28.33 ± 5.42), and were matched to 62 patients who underwent labral repair alone (83.87% female; mean age, 51.97 ± 7.21 years; mean BMI, 28.50 ± 5.35). Baseline characteristics, including age, sex, BMI, preoperative imaging findings, and preoperative PROs, were comparable between the groups (all
CONCLUSION: In patients undergoing arthroscopic hip rotator cuff repair with concomitant labral repair, no significant differences in short-term clinical outcomes were observed compared to those undergoing arthroscopic labral repair alone, indicating that simultaneous arthroscopic repair yields favorable short-term results.
中文总结
这项配对队列研究探讨了同时存在唇裂和髋关节旋转袖损伤患者的关节镜同期修复效果。研究纳入了31名接受同期修复的患者（平均年龄52岁），与62名仅接受唇裂修复的患者进行1:2配对比较。2年随访结果显示，两组在疼痛评分、功能评分和影像学结局上均无显著差异，表明同期修复没有增加并发症风险且临床效果满意。这是一个重要的临床发现，因为髋关节旋转袖损伤与唇裂经常共存，但关于同期手术的研究很少。这项研究为临床医生提供了循证依据：对于同时存在这两种病理改变的患者，同期关节镜修复是一个可行的选择，可以避免二次手术、减少总体创伤并降低医疗成本。年龄分布（平均52岁）也提示我们在中老年髋关节疼痛患者中应当考虑到旋转袖损伤合并唇裂的可能。
英文摘要 Abstract
Quantitative computed tomography (QCT) plays a crucial role in assessing bone strength and fracture risk by enabling volumetric analysis of bone density distribution in the proximal femur. However, deploying automated segmentation models in practice remains difficult because deep networks trained on one dataset often fail when applied to another. This failure stems from domain shift, where scanners, reconstruction settings, and patient demographics vary across institutions, leading to unstable predictions and unreliable quantitative metrics. Overcoming this barrier is essential for multi-center osteoporosis research and for ensuring that radiomics and structural finite element analysis results remain reproducible across sites. In this work, we developed a domain-adaptive transformer segmentation framework tailored for multi-institutional QCT. Our model is trained and validated on one of the largest hip fracture related research cohorts to date, comprising 1,024 QCT images scans from Tulane University and 398 scans from Mayo Clinic, Rochester, Minnesota for proximal femur segmentation. Importantly, Mayo Clinic, Rochester labels were not used during training; only its unlabeled images were incorporated for domain-invariant feature learning To address domain shift, we integrate two complementary strategies within a 3D TransUNet backbone: adversarial alignment via Gradient Reversal Layer (GRL), which discourages the network from encoding site-specific cues, and statistical alignment via Maximum Mean Discrepancy (MMD), which explicitly reduces distributional mismatches between institutions. This dual mechanism balances invariance and fine-grained alignment, enabling scanner-agnostic feature learning while preserving anatomical detail. Experimental results demonstrate that the combined strategy for domain adaptation using GRL and MMD yields the most consistent performance, achieving a Dice similarity coefficient of 99.53 %, and a Precision of 99.64 %, and a 95
中文总结
这篇文章报道了人工智能在定量CT髋关节影像分析领域的重要进展。研究团队开发了一种基于域自适应Transformer的近端股骨分割框架，旨在解决多中心数据训练中的域偏移问题。模型训练数据来自两个大型髋关节骨折研究队列，包括Tulane大学的1024例和Mayo诊所的398例QCT扫描，其中Mayo诊所的数据仅用作无标签的域适应训练。为克服不同机构间扫描仪参数和患者群体的差异，团队在3D TransUNet架构中引入了两种互补策略：基于梯度反转层的对抗性对齐和基于最大均值差异的统计对齐，前者帮助网络学习域不变特征，后者减少机构间的分布偏差。实验结果表明，联合使用这两种策略取得了最优性能，Dice相似系数达99.53%，精确率达99.64%，实现了跨扫描仪的稳定分割。这一技术突破对骨质疏松多中心研究、放射组学分析和有限元力学分析具有重要价值，为推动髋关节定量CT影像的标准化和可重复性奠定了基础。
英文摘要 Abstract
INTRODUCTION: While the hip, pelvis, and lumbar spine are known to move synchronously, their exact relationship has yet to be determined. The aim of this study was to define the biomechanical relationship between the hip, pelvis, and lumbar spine.
METHODS: A cohort of fifty healthy subjects between 18- and 35-years-old were recruited to participate, including 25 males and 25 females. Exclusion criteria included presence of back or hip pain, inability to stand upright or sit with hips flexed to 90°, history of ankylosing spondylitis, femoroacetabular impingement, or prior hip or spine surgery. Three lateral radiographs were obtained for each patient, including standing, relaxed seated, and the flexed-forward seated views. Radiographic variables measured included sacral slope (SS), pelvic-femoral angle (PFA), and lumbar lordosis (LL). Calculations included the change in SS (ΔSS), the change in PFA (ΔPFA), the change in LL (ΔLL). Pearson correlations were used to determine the relationship between ΔSS, ΔPFA, and ΔLL with significance set to p<.05.
RESULTS: The average age of participants was 25.70±2.34 years with a body mass index (BMI) of 24.10±3.02 kg/m
CONCLUSIONS: Motion between the hip, pelvis, and lumbar spine is highly correlated. For every degree increase of hip flexion, the pelvis tilts posteriorly 0.71, causing the lumbar spine to flex 1.58 degrees to maintain upright posture. For every degree increase of hip flexion, the lumbar spine decreases flexion 0.86 degrees. Given the increased interest and clinical applicability of spinopelvic biomechanics in the spine community, these definitions are essential to moving forward with research in this topic.
中文总结
这项基础生物力学研究定义了髋关节、骨盆和腰椎之间的运动学关系。研究纳入50名年轻健康志愿者（18-35岁），拍摄三种体位的侧位X线片：站立位放松坐位和屈髋坐位，测量指标包括骶骨倾斜角（SS）、骨盆-股骨角（PFA）和腰椎前凸（LL）。核心发现是三者在运动学上高度相关：髋关节每屈曲1度，骨盆后倾0.71度，腰椎为维持直立姿势需额外屈曲1.58度；反之髋关节伸展时腰椎前凸减少0.86度。这项研究的价值在于提供了量化的脊柱-骨盆-髋联动数据，对于脊柱外科医生在考虑spinopelvic生物力学参数时具有重要参考意义，同时也为髋关节疾病患者的下腰痛评估提供了鉴别诊断思路。这种跨学科的理解有助于避免在临床决策中孤立地看待髋或腰的问题。