Nonarthritic Hip Pathology Patterns According to Sex, Femoroacetabular Impingement Morphology, and Generalized Ligamentous Laxity.

Autor:	Ortiz-Declet V; Kayal Orthopaedic Center, Westwood, New Jersey, USA.; American Hip Institute Research Foundation, Chicago, Illinois, USA., Maldonado DR; American Hip Institute Research Foundation, Chicago, Illinois, USA., Annin S; American Hip Institute Research Foundation, Chicago, Illinois, USA., Yuen LC; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA., Kyin C; American Hip Institute Research Foundation, Chicago, Illinois, USA., Kopscik MR; Medical University of South Carolina, Charleston, South Carolina, USA., Lall AC; American Hip Institute Research Foundation, Chicago, Illinois, USA.; American Hip Institute, Chicago, Illinois, USA.; AMITA Health St Alexius Medical Center, Hoffman Estates, Illinois, USA., Domb BG; American Hip Institute Research Foundation, Chicago, Illinois, USA.; American Hip Institute, Chicago, Illinois, USA.; AMITA Health St Alexius Medical Center, Hoffman Estates, Illinois, USA.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2022 Jan; Vol. 50 (1), pp. 40-49. Date of Electronic Publication: 2021 Nov 26.
DOI:	10.1177/03635465211056086
Abstrakt:	Background: Sex differences are frequently encountered when diagnosing orthopaedic problems. Current literature suggests specific sex differences, such as a higher prevalence of cam-type femoroacetabular impingement syndrome in male patients and features of hip instability in female patients. Purpose: To identify hip pathology patterns according to sex, alpha angle deformity, and generalized ligamentous laxity (GLL) in a nonarthritic patient population that underwent primary hip arthroscopy in the setting of femoroacetabular impingement syndrome and labral tears. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients who underwent primary hip arthroscopy between February 2008 and February 2017 were included and separated into male and female groups for initial analysis. Patients were excluded if they had Tönnis osteoarthritis grade >1, previous ipsilateral hip surgery, or previous hip conditions. The demographics, radiographic findings, intraoperative findings, and surgical procedures were then analyzed and compared. Subanalyses were performed for both groups. A threshold of 1 SD above the mean alpha angle in the male group was used to create 2 subgroups. For female patients, GLL based on a Beighton score ≥4 was used to divide the group. Intraoperative findings were compared for both subanalyses. Results: A total of 2701 hips met all inclusion and exclusion criteria. Of those, 994 hips were in the male group and 1707 in the female group. The mean ± SD age was 36.6 ± 13.8 and 37.1 ± 15.0 years for the male and female groups, respectively( P = .6288). The average body mass index was significantly higher in the male group ( P < .0001). GLL was more common in women (38.6%) than men (13.6%) ( P < .001). The male group had a higher proportion of acetabular Outerbridge grade 3 (21.8%) and 4 (19.2%) lesions when compared with the female group (9.3% and 6.3%, respectively) ( P < .0001). Men in the subgroup with an alpha angle ≥78° reported higher rates of acetabular Outerbridge grade 4 damage than men with an alpha angle <78° ( P < .001). Mean lateral center-edge angle was lower in the female subgroup with Beighton score ≥4 vs <4 (23.7°± 4.2° vs 31.3°± 5.8°; P < .0001). Conclusion: In this analysis of a large cohort of patients who underwent hip arthroscopy, 2 patterns of hip pathologies were related to sex. On average, male patients had larger alpha angles and increased acetabular chondral damage when compared with their female counterparts. Furthermore, a larger cam-type anatomy was associated with more severe acetabular chondral damage in men. In the female group, the incidence of features of hip instability such as GLL were significantly higher than in the male group.
Databáze:	MEDLINE
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