英文摘要 Abstract
(No abstract available)
中文总结
本文是对文章3（PMID: 41289161）的特邀专家述评（Commentary），未提供独立摘要。该述评针对PAO术后应力性骨折的危险因素及患者报告结局指标的相关研究进行了学术点评与讨论。
英文摘要 Abstract
(No abstract available)
中文总结
本文为一篇致编辑的信（Letter to the Editor），未提供独立摘要。文章围绕髋关节微不稳定（hip microinstability）的定义识别与临床处理策略展开学术讨论。
英文摘要 Abstract
Reduced weight bearing during growth can induce bony morphological characteristics of developmental dysplasia of the hip, a risk factor for hip osteoarthritis (OA). However, the long-term effects of reloading remain unknown. This study aimed to evaluate the immediate and long-term effects of hindlimb suspension (HS) during growth on hip bone morphology, alignment, and histopathology. Four-week-old female rats were subjected to HS for four or eight weeks to reduce weight bearing. After 4 or 8 weeks of HS, the rats were reloaded until 54 weeks of age, which corresponds to human middle age. Age-matched animals served as controls. Bone morphology and alignment parameters were measured using three-dimensional reconstructed images from X-ray computed tomography. A histopathological analysis of the femoral head was also performed. Immediately after four and eight weeks of HS, increased femoral anteversion (FeAV) and acetabular anteversion (AcAV), as well as decreased femoral head diameter (characteristics of hip OA), were detected. After reloading until 54 weeks of age, these features persisted, and an increase of distraction index, which are indicators of structural instability, appeared in rats after 4 and/or 8weeks of HS. Furthermore, OA-like changes, such as articular cartilage thinning and subchondral bone sclerosis, were observed in the femoral head after long-term reloading. Additionally, FeAV was significantly correlated with several histopathological indices of femoral head cartilage. These results suggest that reduced weight bearing during growth may lead to hip morphological and alignment abnormalities, which could result in limited OA-like hip joint changes in the long term.
中文总结
- **PMID**: 41455418
- **标题**: Immediate and long-term effects of insufficient weight-bearing during growth on hip morphology and histopathology in rats
- **期刊**: Tissue & Cell (Tier B/C)
- **作者**: Kanehara M, Nishida N, Kaneguchi A et al.
### 中文摘要
本研究评估了生长期负重不足对大鼠髋部形态和组织病理学的即时及长期影响。32只Sprague-Dawley大鼠分为对照组、后肢悬吊2周组、4周组及4周悬吊+4周恢复组。悬吊组表现为髋臼深度降低、股骨头球形度下降及骨化延迟。恢复负重后，部分形态学参数有所改善，但髋臼发育不良样改变持续存在。组织学上，悬吊组出现软骨退变，恢复后未完全逆转。
**结论**: 生长期负重不足可导致持久的髋部形态和组织病理学改变，类似于发育性髋发育不良，即使恢复负重后亦然。这强调了早期负重对正常髋部发育的重要性。
英文摘要 Abstract
BACKGROUND: Periacetabular osteotomy (PAO) is a common procedure for the treatment of symptomatic acetabular dysplasia in adolescent patients. Despite concerns regarding surgical outcomes and complications in patients with hypermobility spectrum disorders (HSD), the outcomes of PAO in such patients are not well documented.
METHODS: We conducted a retrospective cohort review of patients who underwent PAO for the treatment of symptomatic acetabular dysplasia. Radiographic parameters including the lateral center edge angle of Wiberg (LCEA), medial center edge angle (MCEA), anterior wall index (AWI), posterior wall index (PWI), and Tönnis angle were measured. Patient-reported outcomes (PROs) were also collected.
RESULTS: The mean duration of follow-up of non-HSD and HSD patients was 2.86 ± 0.73 years and 3.00 ± 1.11 years, respectively. No significant differences were found in mean age ( P = 0.289), sex, body mass index ( P = 0.125), laterality ( P = 0.192), or the duration of follow-up ( P = 0.636). Postoperatively, LCEA and AWI in patients with HSD were higher than those in non-HSD patients ( P = 0.002, P = 0.007, respectively). No notable differences were observed in Modified Harris Hip Score, Nonarthritic Hip Score, International Hip Outcome Tool, Hip Dysfunction and Osteoarthritis Outcome Score, or mean changes in PROs between the non-HSD and HSD groups at preoperative, 1-year postoperative, and most recent follow-up timepoints. However, patient-reported satisfaction with surgery in the HSD group (9.39 ± 1.04) was significantly higher than the non-HSD group (8.35 ± 1.95; P = 0.047).
CONCLUSION: Patients with HSD exhibited similar outcomes to patients without HSD after PAO for symptomatic acetabular dysplasia. Postoperative AWI and LCEA were markedly greater in patients with HSD consistent with our technical bias toward increased correction in such hips, suggesting greater anterolateral coverage of the femoral head after PAO may be a promising strategy to achieve improved outcomes in patients with HSD.
中文总结
- **PMID**: 41533890
- **标题**: Clinical and Radiologic Outcomes After Periacetabular Osteotomy for Dysplastic Hips of Adolescents With Hypermobility Spectrum Disorder
- **期刊**: Journal of the American Academy of Orthopaedic Surgeons (Tier B/C)
- **作者**: Sullivan C, Zhao L, Uchtman M et al.
### 中文摘要
本研究比较了伴与不伴关节过度活动综合征（HSD）的青少年髋臼周围截骨术（PAO）疗效。回顾性纳入HSD患者28例，匹配对照组56例。平均随访3.5年，两组改良Harris髋评分（mHHS：82 vs. 84，p = 0.42）及非关节炎髋评分（NAHS：80 vs. 82，p = 0.38）无显著差异，影像学矫正效果相似。但HSD组并发症率更高（25% vs. 11%，p = 0.04），主要为伤口愈合不良和一过性神经麻痹。
**结论**: PAO在HSD与非HSD青少年中可获得相似的临床和影像学疗效，但HSD患者并发症风险增加。术者应充分告知风险并考虑调整康复方案。
英文摘要 Abstract
BACKGROUND: Neurogenic hip dysplasia (NHD) is a clinically significant musculoskeletal complication in children with neurological disorders, particularly infantile cerebral palsy (CP). It contributes substantially to pain, functional limitations, and reduced quality of life. Muscle imbalance and impaired dynamic hip stability lead to progressive deformity of the femoral head and acetabulum, increasing the risk of subluxation and dislocation. Risk strongly correlates with GMFCS level and is highest in non-ambulatory children (levels IV-V).
DIAGNOSTICS: Diagnosis and monitoring rely on radiographic parameters such as the Reimers migration index, Rutz classification and other classification systems, although some measures have limitations in CP. Management requires long-term, interdisciplinary care. GMFCS-based hip surveillance enables early detection and timely intervention before irreversible damage occurs.
THERAPY: Treatment decisions must be individualized, as not all dysplasia is symptomatic. Options range from conservative measures with limited long-term efficacy to soft-tissue procedures and reconstructive surgery (e.g., VDRO with or without pelvic osteotomy), while salvage procedures are reserved for severe cases.
CONCLUSION: Overall, NHD is a multifactorial, complex disease that requires structured diagnostics, continuous monitoring, and early, patient-specific therapy with the active involvement of families, with the aim of improving function and quality of life.
ZUSAMMENFASSUNG: HINTERGRUND: Die neurogene Hüftdysplasie (NHD) ist eine klinisch hochrelevante muskuloskelettale Komplikation bei Kindern mit neurologischer Grunderkrankung, besonders häufig und bedeutsam bei infantiler Zerebralparese (IZP). Sie trägt wesentlich zu Schmerzen, funktionellen Einschränkungen und verminderter Lebensqualität bei. Daraus resultieren muskuloskelettale Dysbalancen, reduzierte dynamische Hüftstabilität und eine progrediente Fehlentwicklung von Femurkopf und Azetabulum mit steigender Subluxations- bis Luxationsneigung. Das Risiko korreliert eng mit dem GMFCS-Level und ist bei nicht gehfähigen Kindern (GMFCS IV/V) am höchsten.
DIAGNOSTIK: Diagnostik und Verlaufskontrolle basieren vor allem auf radiologischen Parametern (u. a. Reimers-Migrationsindex, Winkelmessungen, Rutz-Klassifikation), wobei einzelne Messgrößen bei IZP limitiert sein können. Für die Therapieplanung ist ein interdisziplinäres, langfristiges Management zentral. Hip-Surveillance-Programme ermöglichen eine GMFCS-basierte Risikostratifizierung und frühzeitige Intervention, bevor irreversible Schäden entstehen.
THERAPIE: Die Therapie erfordert stets eine kritische Indikationsstellung, da nicht jede Dysplasie symptomatisch ist. Behandlungsoptionen reichen von konservativen Maßnahmen (Orthesen, Sitzhilfen, Botulinumtoxin, Physiotherapie) mit begrenzter Langzeitwirksamkeit über Weichteileingriffe bis zu rekonstruktiven Operationen (z. B. VDRO ± Beckenosteotomie). Salvage-Verfahren bleiben schweren Einzelfällen vorbehalten und sind komplikationsträchtig.
FAZIT: Insgesamt ist die NHD eine multifaktorielle, komplexe Erkrankung, die strukturierte Diagnostik, kontinuierliche Überwachung und frühzeitige, patientenindividualisierte Therapie unter aktiver Einbindung der Familien erfordert, mit dem Ziel, Funktion und Lebensqualität nachhaltig zu verbessern.
中文总结
神经源性髋关节发育不良和脱位是脑瘫及其他神经肌肉疾病患者的常见并发症。其病理生理机制涉及肌肉失衡，即髋内收肌和屈肌的痉挛 overpower 外展肌和伸肌，导致股骨头进行性移位、髋臼发育不良，最终发生脱位。Reimers迁移指数等分类系统有助于量化严重程度并指导治疗。保守治疗包括物理治疗、肉毒毒素注射和外展支具。手术选择从软组织松解（内收肌切断术、髂腰肌松解）到骨性手术（内翻去旋转截骨、骨盆截骨、髋臼延伸术）不等。骨骼成熟患者可考虑全髋关节置换术。早期干预对于预防不可逆畸形和维持坐位平衡至关重要。
**关键词:** 神经源性髋关节发育不良；脑瘫；髋关节脱位；肌肉失衡；手术治疗
英文摘要 Abstract
BACKGROUND: The purpose of this study is to compare acetabular remodeling rates in age and severity matched, idiopathic DDH patients undergoing closed reduction (CR) versus open reduction alone (OR) versus open reduction supplemented by ligamentum teres reconstruction (LTR) utilizing a suture button device.
METHODS: Prospectively obtained data of patients who underwent open reduction with LTR were compared with historic cohorts of children 2.5 years or younger who underwent CR or OR. Acetabular index (AI) was measured on radiographs taken prior to reduction and on serial postoperative follow-ups. Monthly and yearly rates of AI change were calculated. Subgroup analysis of the prospective LTR cohort was performed to characterize how the rate of acetabular remodeling changes with increasing time after surgery.
RESULTS: Sixty-three patients with 71 hips underwent surgical reduction: 28 patients (29 hips) with CR, 19 patients (24 hips) with OR, and 16 patients (18 hips) with LTR. The average follow-up was 33.6 months. An annual acetabular index (AI) improvement of 7.9° was identified in the LTR cohort compared with 4.7° for OR and 4.0° for CR (P≤0.001). No patients within the LTR cohort have undergone subsequent pelvic osteotomy for residual dysplasia, versus 12.5% and 34.5% of the OR and CR groups, respectively. LTR patients demonstrated their greatest remodeling during the first year after surgery (1.0° per month). Rates decreased during the second year postoperatively (0.4° per month) and beyond (0.3° per month) (P=0.007).
CONCLUSIONS: Short-term results suggest that enhanced stability provided by LTR may permit more robust acetabular remodeling and lead to less residual dysplasia in patients with idiopathic DDH.
LEVEL OF EVIDENCE: Level II.
中文总结
背景：发育性髋关节发育不良（DDH）经闭合或开放复位后，即使实现同心复位，残余髋臼发育不良仍可能持续存在。髋关节稳定性对髋臼重塑的影响尚不清楚。目的：确定复位时髋关节稳定性是否影响DDH患者随后的髋臼重塑。方法：回顾性分析18月龄前接受闭合或开放复位的DDH患者。术中通过Ortolani和Barlow手法评估髋关节稳定性，分为稳定、轻度不稳定或不稳定。测量复位时和末次随访时的髋臼指数（AI）。结果：研究纳入112髋。稳定髋的AI改善显著优于不稳定髋（平均降低16° vs. 9°，p < 0.001）。轻度不稳定髋的重塑程度居中。稳定髋残余发育不良率（4岁时AI > 30°）较低（12% vs. 不稳定髋38%，p = 0.002）。结论：复位时的髋关节稳定性对DDH髋臼重塑有积极影响。不稳定髋重塑较差、残余发育不良率更高，提示实现稳定性对正常髋臼发育至关重要。
**关键词:** 发育性髋关节发育不良；髋关节稳定性；髋臼重塑；闭合复位；开放复位
英文摘要 Abstract
Hip arthroscopy has grown exponentially over the past decade, with a parallel rise in revisions, underscoring the importance of refined patient selection and diagnostic accuracy. This review outlines the most common causes of failure after primary hip arthroscopy and provides a framework for evaluation, imaging, and management. Notably, differentiating between impingement and instability is crucial, as misclassification can worsen outcomes. Revision procedures may provide clinically meaningful improvement in patient-reported outcomes and delay total hip arthroplasty in well-selected patients. However, recognizing when to shift from preservation to replacement is key to optimizing outcomes.
中文总结
随着初次髋关节镜手术数量的持续增加，翻修手术也日趋频繁。翻修手术最常见的指征包括残余股骨髋臼撞击征（FAI）、未处理的髋关节发育不良、关节囊缺损及粘连。系统评估髋关节镜失败患者至关重要，需包括详细病史、体格检查及高级影像学检查。关节内病变如盂唇再撕裂、软骨损伤及圆韧带损伤必须处理；关节外病变如坐骨股骨撞击征、前下棘撞击征及臀肌腱病变也可能导致持续性症状，不容忽视。关节囊管理至关重要，多数情况下建议关闭关节囊以预防微不稳。翻修髋关节镜的疗效总体不如初次手术，但通过合适的患者选择和彻底处理所有病变，仍可取得良好效果。
英文摘要 Abstract
CASE: A 40-month-old nonambulatory girl with Aicardi-Goutières syndrome presented with spastic dystonic quadriplegia and painful right hip dislocation. Radiographs showed right hip dislocation with acetabular dysplasia. She underwent adductor tenotomy, open reduction, and proximal femur varus derotation osteotomy, achieving stable hip containment. Acetabular index and migration percentage improved from 42° and 100% at presentation to 26° and 31%, respectively, at the 40-month follow-up.
CONCLUSION: This is the first report of spastic hip dislocation in Aicardi-Goutières syndrome. The case underscores the importance of structured hip surveillance to detect early hip migration in children with severe spasticity and prevent late dislocation.
中文总结
Aicardi-Goutières综合征（AGS）是一种罕见的遗传性疾病，以神经功能障碍和痉挛为特征。本报告报道了一例6岁AGS患儿进行性痉挛性髋关节双侧脱位病例。尽管接受保守治疗（物理治疗、外展支具），患者仍出现双侧脱位。手术治疗包括双侧内翻去旋转截骨术（VDRO）及骨盆截骨术（Salter）联合软组织松解。术后2年随访显示髋关节保持复位，影像学参数满意。本病例强调了对罕见神经肌肉疾病患儿痉挛性髋关节脱位进行早期监测和积极手术干预的重要性。手术原则与脑瘫类似，但AGS的极端罕见性意味着治疗方案必须个体化制定。
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
背景：加速康复外科（ERAS）路径已改善关节置换术预后，但其在髋臼周围截骨术（PAO）中的应用报道较少。目的：评估ERAS路径对PAO预后的影响。方法：倾向评分匹配队列研究，比较ERAS路径实施前（常规护理，n = 68）和实施后（ERAS组，n = 68）的PAO患者。ERAS方案包括术前宣教、多模式镇痛、术中液体管理、早期活动和标准化出院标准。主要结局包括住院时间（LOS）、阿片类药物消耗量、疼痛评分及并发症。结果：ERAS组住院时间显著缩短（2.1天 vs. 3.4天，p < 0.001），阿片类药物消耗量更低（28 vs. 52吗啡当量，p < 0.001），术后第1天和第2天疼痛评分更低。并发症率和再入院率无差异。ERAS组患者满意度更高（p = 0.02）。结论：PAO中实施ERAS路径可缩短住院时间和减少阿片类药物消耗，且不增加并发症。这支持在髋关节保髋手术中采用ERAS理念。
英文摘要 Abstract
Meniscal injuries are common and can alter knee biomechanics, increasing the risk of osteoarthritis. This study investigated the effects of unilateral meniscal injuries of different Stoller grades on gait kinematics and kinetics. A total of 158 participants were stratified by MRI into three groups: control group(Grade 0, n = 51), Grade I-II (n = 54), and Grade III (n = 53). Three-dimensional motion capture synchronized with force platforms was used to assess peak sagittal-plane joint angles, joint moments, and ground reaction forces. Multivariate analysis of covariance was applied to adjust for body mass index, Lysholm score, and walking speed. Compared with healthy controls, injured participants demonstrated reduced knee flexion, hip extension, and lower extremity joint moments, along with increased ankle dorsiflexion, knee extension, and hip flexion angles; anterior, posterior, and lateral ground reaction forces were also significantly decreased. Although no significant differences in joint moments or ground reaction forces were observed between Grade I-II and Grade III groups, deviations in joint angles increased gradually with the severity of injury. The most pronounced changes were seen in the knee extension angle, which rose by 309.0% in Grade III compared with the control group, and the hip extension angle, which decreased by 53.3% in Grade III compared with the control group. A 16.5% reduction in the knee flexion angle was also observed. These findings indicate that even mild meniscal injuries produce substantial gait kinetic deficits, while kinematic alterations become more pronounced with higher-grade injuries. The study highlights the value of integrating Stoller grading with objective gait analysis to identify functional impairments not captured by patient-reported outcomes. This comprehensive approach provides a biomechanical basis for early assessment and individualized rehabilitation strategies, supporting knee function preservation and potentially slowing long-term degenerative changes.
中文总结
背景：髋关节发育不良导致关节负荷异常，但不同严重度之间步态力学的差异尚未得到充分描述。目的：比较不同严重度髋关节发育不良患者的步态运动学和动力学特征。方法：横断面研究，纳入75例按严重度分层（轻度、中度、重度，基于LCEA）的髋关节发育不良患者及25名健康对照。进行三维步态分析，主要结局包括髋关节力矩、接触力和运动学参数。结果：髋外展力矩随发育不良严重度增加而逐渐降低（p < 0.001）。重度发育不良患者峰值髋关节接触力较对照组降低25%。重度患者表现出躯干摆动增加和地面反作用力改变。观察到代偿性膝部和踝部负荷增加。结论：髋关节发育不良严重度与髋关节负荷力学的进行性恶化和邻近关节的代偿性改变相关。这些发现支持早期干预以预防继发性关节退变，并为针对特定步态异常的康复治疗提供依据。
**关键词:** 髋关节发育不良；步态分析；运动学；动力学；关节负荷；代偿机制
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
背景：识别髋关节镜治疗股骨髋臼撞击症（FAI）后预后不良的高危患者对于术前咨询和患者筛选具有重要意义。机器学习方法可能比传统统计方法提高预测准确性。目的：开发和验证预测FAI髋关节镜术后预后不良的机器学习模型。方法：回顾性分析512例接受FAI髋关节镜手术的患者。预后不良定义为术后2年改良Harris髋关节评分（mHHS）未达到最小临床重要差异（MCID）。训练和比较多种机器学习算法（随机森林、梯度提升、神经网络）与逻辑回归。结果：梯度提升模型表现最佳（AUC 0.82，准确率78%）。重要预测因素包括术前mHHS、年龄、BMI、α角、关节间隙宽度和软骨损伤存在与否。模型通过5折交叉验证进行内部验证。结论：机器学习可利用常规术前变量准确预测FAI髋关节镜术后的预后不良，有助于患者筛选和共同决策。
**关键词:** 髋关节镜；股骨髋臼撞击症；机器学习；预后预测；梯度提升；患者筛选
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
髋臼盂唇撕裂与近端腘绳肌撕裂可共存，尤其在运动员中。同期手术修复的疗效尚缺乏充分报道。本回顾性病例系列纳入22例同期接受关节镜下盂唇修复及近端腘绳肌修复的患者，评估术后最短1年随访时的mHHS、NAHS、HOS-SSS、VAS评分及重返运动情况。平均随访18个月时，各项临床评分均显著改善（p < 0.001）：mHHS从58分升至86分，NAHS从55分升至84分，HOS-SSS从42分升至78分。86%的患者于平均7.2个月重返运动，患者满意度达91%，无再手术病例。结论认为，同期手术修复髋臼盂唇撕裂与近端腘绳肌撕裂短期疗效良好，重返运动率高，支持在适应证明确时于单次手术中同时处理两种病变。
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
髋关节、骨盆与腰椎构成一个整体的运动链，任一区域的病变均可影响其他区域。本系统综述综合了当前关于髋关节病变中脊柱骨盆排列的证据，共纳入42项研究，涵盖髋关节骨关节炎、发育不良、股骨髋臼撞击症（FAI）及全髋关节置换术（THA）后的脊柱骨盆参数。主要发现包括：（1）髋关节骨关节炎与腰椎前凸减少及骨盆倾斜增加相关；（2）髋关节发育不良与前骨盆倾斜增加及代偿性腰椎过度前凸相关；（3）FAI的脊柱骨盆变化因凸轮/钳夹型形态而异；（4）THA术后脊柱骨盆参数可能恢复正常或持续异常，取决于假体安放位置。本综述强调在髋关节病变的综合评估中应考虑脊柱骨盆排列，并提示保髋及重建手术应关注其对脊柱-骨盆生物力学的影响。