切换至 "中华医学电子期刊资源库"
高级检索
中华关节外科杂志(电子版)

中华关节外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (05) : 521 -534. doi: 10.3877/cma.j.issn.1674-134X.2022.05.001

所属专题： 指南共识；

专家共识

临界型发育性髋关节发育不良的诊断与治疗专家共识(2022版)
中华医学会运动医疗分会青年学组, 中华医学会运动医疗分会髋关节运动创伤工作委员会, 中国康复医学会修复重建外科委员会保髋学组, 中国医师协会骨科医师分会保髋学组, 国家骨科与运动康复临床医学研究中心, 解放军总医院骨科医学部运动医学科   
  • 收稿日期:2022-06-14 出版日期:2022-10-01
  • 基金资助:
    基础加强计划重点基础研究项目(2020-JCJQ-ZD-264-1-8); 军队课题(211-CXGC-M113-02-05-01)

Expert consensus on diagnosis and treatment of borderline developmental dysplasia of hip (2022 edition)

The Chinese Medical Association Medical Branch of Sports Medicine the Youth Group, The Chinese Medical Association Medical Branch of Hip Sports Trauma Committee, The Chinese Rehabilitation Medicine Trauma Repair Reconstruction Surgery Committee Branch of Hip Preservation Group, The Chinese Medical Doctor Association Orthopedic Surgeon Branch of Hip Preservation Group, The National Clinical Medical Research Center for Orthopaedics and Sports Rehabilitation, The Department of Sports Medicine, Senior Department of Orthopedics, the PLA General Hospital   

  • Received:2022-06-14 Published:2022-10-01
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

中华医学会运动医疗分会青年学组, 中华医学会运动医疗分会髋关节运动创伤工作委员会, 中国康复医学会修复重建外科委员会保髋学组, 中国医师协会骨科医师分会保髋学组, 国家骨科与运动康复临床医学研究中心, 解放军总医院骨科医学部运动医学科. 临界型发育性髋关节发育不良的诊断与治疗专家共识(2022版)[J/OL]. 中华关节外科杂志(电子版), 2022, 16(05): 521-534.

The Chinese Medical Association Medical Branch of Sports Medicine the Youth Group, The Chinese Medical Association Medical Branch of Hip Sports Trauma Committee, The Chinese Rehabilitation Medicine Trauma Repair Reconstruction Surgery Committee Branch of Hip Preservation Group, The Chinese Medical Doctor Association Orthopedic Surgeon Branch of Hip Preservation Group, The National Clinical Medical Research Center for Orthopaedics and Sports Rehabilitation, The Department of Sports Medicine, Senior Department of Orthopedics, the PLA General Hospital. Expert consensus on diagnosis and treatment of borderline developmental dysplasia of hip (2022 edition)[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2022, 16(05): 521-534.

临界型发育性髋关节发育不良(BDDH)是介于成人发育性髋关节发育不良(DDH)和正常髋关节之间的一种特殊类型，其临床诊断和治疗一直存在争议，是运动医学和保髋外科的热点与难点。为进一步提高BDDH诊疗的规范性，由中华医学会运动医疗分会的青年学组和髋关节运动创伤工作委员会、中国康复医学会修复重建外科委员会保髋学组、中国医师协会骨科医师分会保髋学组、国家骨科与运动康复临床医学研究中心、解放军总医院骨科医学部运动医学科共同发起，采用推荐意见分级的评估、制订及评价(GRADE)体系和国际实践指南报告规范(RIGHT)遴选出临床最为关注的13个问题，最终形成38条循证医学推荐意见，旨在提高BDDH诊疗实践的科学性并最终提升以患者为中心的医疗服务质量。

关键词: 发育性髋关节发育不良, 诊断, 治疗, 多数赞同

Borderline developmental dysplasia of the hip (BDDH) is a special type in adult between developmental dysplasia of the hip (DDH) and normal hip. Its diagnosis and treatment is controversial and has always been a hot spot and difficulty in sports medicine and hip preservation. In order to further improve the standardization of diagnosis and treatment of the BDDH, this consensus was led by the Youth Group and the Sports Trauma of Hip joint Committee of Chinese Society of Sports Medicine of the Chinese Medical Association, the Hip Preservation Group of the Reparative and Reconstruction Surgery Committee of Chinese Association of Rehabilitation Medicine, the Hip Preservation Group of Chinese Association of Orthopaedic Surgeons, the National Clinical Medical Research Center for Orthopaedics and Sports Rehabilitation, and the Sports Medicin Department of Senior Department of Orthopedics, the PLA General Hospital. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and the Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist were adopted. Finally, 38 evidence-based recommendations were formulated based on 13 most concerned clinical problems. This consensus intended to improve the scientific nature of BDDH diagnosis and treatment and ultimately improve the quality of patient centered medical services.

Key words: Developmental dysplasia of the hip, Diagnosis, Therapeutics, Consensus
表1 证据质量GRADE分级
证据质量 定义 含义
高 指南制定小组对真实效应值接近效应估计值很有信心 进一步研究基本不可能改变对效应估计值的信心
中 指南制定小组对效应估计值有中等程度的信心；真实值可能接近估计值，但仍存在二者截然不同的可能性 进一步研究有可能对效应估计值的信心产生重要影响，且可能改变该估计值
低 指南制定小组对效应估计值的确信度有限；真实值可能与估计值大不相同 进一步研究很有可能对效应估计值的信心产生重要影响，且很有可能改变该估计值
极低 指南制定小组对效应估计值几乎没有信心；真实值可能与估计值大不相同 任何效应估计值都非常不确定
表2 升高或降低证据质量
升级 降级
剂量－效应关系 研究局限性
  +1剂量－效应关系证据   －1严重局限性
可能的混杂因素   －2非常严重局限性
  +1所有可能的混杂可降低效应 不一致性
  －1重大的不一致性
效应量大 间接性
  +1强，无可能的混杂因素   －1部分不确定性
  +2非常强，无重要的内部真实性和直接证据缺陷   －2重要不确定性
    不精准性
      －1不精准数据
    报告偏倚
      －1极可能存在报告偏倚
表3 共识中涉及的推荐强度分级与定义
推荐强度等级 定义
强推荐 明确显示干预措施利大于弊
弱推荐 利弊不确定或干预措施可能利大于弊
专家建议(good practice statement，GPS) 基于非直接证据或专家意见、经验形成的推荐
表4 BDDH的诊断与治疗专家共识证据推荐分级汇总表
  条目 推荐意见 推荐分级
BDDH的定义 推荐1 基于影像学检查，以站立(负重)骨盆正位(前后位)X线片测量髋臼LCEA定义BDDH 1B
推荐2 LCEA是指股骨头中心平行于身体纵轴的线与从股骨头中心到髋臼外缘连线之间的夹角，其髋臼外缘的标定点参照Wiberg法，即髋臼顶部骨性外缘 1C
推荐3 LCEA范围值为20°~25° 1C
推荐4 LCEA在20°~25°之间，且存在髋关节疼痛、关节活动受限等称为症状性BDDH 1B
症状性BDDH的诊断 推荐5 使用"关节不稳定"这一术语表述症状性BDDH的关节不稳定 1A
推荐6 临床病史采集应明确有无外伤，是否为运动员、舞蹈演员或运动业余爱好者，既往诊治经过等 1C
推荐7 症状主要表现为髋关节的疼痛、活动受限、跛行等，多由机械性损伤和/或关节不稳定引起 1B
推荐8 体格检查包括骨科髋关节一般性检查和髋关节不稳定、股骨髋臼撞击综合征、髂前下棘撞击征及多发韧带松弛等专项检查 2C
推荐9 影像学检查一般包括X线片、MRI、CT平扫和三维重建及肌肉骨骼超声，主要用于评估关节稳定性、骨性结构异常、软组织损伤、关节软骨损伤和骨关节炎程度等 1B
症状性BDDH的非手术治疗 推荐10 初次诊断症状性BDDH，未见明显关节不稳定，未行规范化保守治疗可行系统的保守治疗 1C
推荐11 症状性BDDH合并关节外疾病，症状复杂可先行保守治疗 1B
推荐12 治疗方法包括改变生活和运动习惯，应用NSAIDs和营养保护软骨补充剂，加强髋周肌群训练及物理治疗等，治疗时间以3~6个月为宜。 专家建议GPS
治疗方案的选择 推荐13 症状性BDDH的常用外科手术治疗方法包括髋关节镜和PAO，手术方案的选择取决于不同手术方式的适应证、禁忌证及患者的意愿 1B
髋关节镜手术治疗的危险因素 推荐14 性别差异不作为关节镜手术的危险因素 1C
推荐15 年龄≥42岁或BMI≥30 kg/m2是关节镜手术的危险因素 2C
推荐16 站立和直行时严重疼痛、外展肌疲劳或关节不稳定专项体格检查试验阳性是关节镜手术的危险因素 专家建议GPS
推荐17 圆韧带撕裂≥50%、关节囊及周围组织损伤或多发韧带松弛Beighton评分≥4分是关节镜手术的危险因素 1B
推荐18 髋臼Tönnis角>15°是关节镜手术的危险因素 1B
推荐19 骨关节炎Tönnis分级1级或局部轻度软骨损伤是关节镜手术的危险因素 1B
推荐20 严重的焦虑、抑郁或期望值过高是关节镜手术的危险因素 1C
髋关节镜手术适应证 推荐21 临床症状和体征主要来源于髋臼盂唇损伤、股骨髋臼撞击综合征或髂前下棘撞击等，经保守治疗无明显改善的症状性BDDH是关节镜手术治疗的适应证 1B
髋关节镜手术禁忌证 推荐22 ACEA角<20°是关节镜手术治疗的禁忌证 2C
推荐23 Shenton线不连续或髂股线IFL百分比>22%是关节镜手术治疗的禁忌证 1B
推荐24 股骨颈前倾角>35°或颈干角>140°是关节镜手术治疗的禁忌证 专家建议GPS
推荐25 骨关节炎Tönnis分级≥ 2级、关节间隙≤ 2 mm或MRI显示广泛软骨下水肿或软骨剥脱是关节镜手术治疗的禁忌证 1B
髋关节镜术中注意事项 推荐26 髋臼缘骨性结构应有限磨除，股骨头颈交界区凸轮(Cam)畸形、髋臼侧异常髂前下棘应充分成型，损伤盂唇尽可能缝合修复固定 1B
推荐27 关节囊切开后应通过缝合实现关节囊组织的闭合 1B
推荐28 谨慎行髂腰肌肌腱松解 1C
PAO手术适应证 推荐29 临床症状和体征主要来源于关节不稳定(包括关节镜术后出现持续性症状性关节不稳定)是PAO手术治疗的适应证 1B
推荐30 符合本专家共识临床问题7关节镜手术禁忌证中的第1条或第2条(髋臼前方骨性覆盖不足或股骨近端骨性结构异常)是PAO手术治疗的适应证 1B
PAO手术禁忌证 推荐31 外展内旋－功能位X线片股骨头和髋臼对合关系不良是PAO手术的禁忌证 2B
推荐32 Tönnis分级≥2级是PAO手术的禁忌证 1C
推荐33 髋关节活动明显受限是PAO手术的禁忌证 1B
PAO术中注意事项 推荐34 术中应保护坐骨神经和股神经，准确行坐骨、耻骨和髂骨关节外截骨，精准调整改善髋臼覆盖和有效固定 1B
术后康复目标和策略 推荐35 总体目标是消除疼痛和肿胀、恢复神经肌肉控制，稳定腰－骨盆－髋关节复合体，提升髋关节、躯干和下肢运动链功能，早日恢复正常生活、重返工作岗位或体育运动 1C
推荐36 基本策略是强调术后快速康复FTS理念和着重个体化、阶段性康复 1C
康复注意事项 推荐37 评估BDDH术后是否伴有医源性关节不稳定 1C
推荐38 阶段性康复应在上一阶段的基础上充分考虑患者恢复状况 1C
[1]
张洪，罗殿中，程徽．成人髋关节发育不良保髋工作进展[J]．中国修复重建外科杂志，2018，32(07):854-859.
[2]
黄洪杰，王斯遥，王健全．关节镜治疗髋关节发育不良的进展[J]．临床外科杂志，2021，29(04):305-309.
[3]
张建平，张佳，吴毅东，等．髋关节镜治疗股骨髋臼撞击合并临界髋发育不良[J]．中国矫形外科杂志，2022，30(5):416-420.
[4]
Maldonado DR, Chen SL, Walker-Santiago R, et al. An intact ligamentum teres predicts a superior prognosis in patients with borderline dysplasia: a matched-pair controlled study with minimum 5-year outcomes after hip arthroscopic surgery[J]. Am J Sports Med, 2020, 48(3): 673-681.
[5]
Nawabi DH, Degen RM, Fields KG, et al. Outcomes after arthroscopic treatment of femoroacetabular impingement for patients with borderline hip dysplasia[J]. Am J Sports Med, 2016, 44(4): 1017-1023.
[6]
Beck EC, Nwachukwu B, Chahla J, et al. Patients with borderline hip dysplasia achieve clinically significant outcome after arthroscopic femoroacetabular impingement surgery: a Case-Control study with minimum 2-year follow-up[J]. Am J Sports Med, 2019, 47(11): 2636-2645.
[7]
Hevesi M, Hartigan D, Wu IT, et al. Are results of arthroscopic labral repair durable in dysplasia at midterm follow-up? A 2-center matched cohort analysis[J]. Am J Sports Med, 2018, 46(7): 1674-1684.
[8]
Freiman SM, Schwabe MT, Fowler L, et al. Prevalence of borderline acetabular dysplasia in symptomatic and asymptomatic populations: a systematic review and meta-analysis[J/OL]. Orthop J Sports Med, 2022, 10(2): 23259671211040455.DOI：10.1177/23259671211040455.
[9]
Ding Z, Sun Y, Liu S, et al. Hip arthroscopic surgery in borderline developmental dysplastic hips: a systematic review[J]. Am J Sports Med, 2019, 47(10): 2494-2500.
[10]
Kuroda Y, Saito M, Sunil KK, et al. Hip arthroscopy and borderline developmental dysplasia of the hip: a systematic review[J]. Arthroscopy, 2020, 36(9): 2550-2567.e1.
[11]
Kamath AF. Bernese periacetabular osteotomy for hip dysplasia: Surgical technique and indications[J]. World J Orthop, 2016, 7(5): 280-286.
[12]
孙明宏，罗殿中，程徽，等．髋臼周围截骨术中与术后早期并发症分析[J/CD]．中华关节外科杂志(电子版)，2017，11(03):293-297.
[13]
陈勇，罗殿中，程徽，等．伯尔尼髋臼周围截骨术后并发耻骨下支应力性骨折[J]．中国骨与关节杂志，2016，5(02):87-90.
[14]
Shah A, Kay J, Memon M, et al. Clinical and radiographic predictors of failed hip arthroscopy in the management of dysplasia: a systematic review and proposal for classification[J]. Knee Surg Sports Traumatol Arthrosc, 2020, 28(4): 1296-1310.
[15]
Hanson JA, Kapron AL, Swenson KM, et al. Discrepancies in measuring acetabular coverage: revisiting the anterior and lateral center edge angles[J]. J Hip Preserv Surg, 2015, 2(3): 280-286.
[16]
Siebenrock KA, Kistler L, Schwab JM, et al. The acetabular wall index for assessing anteroposterior femoral head coverage in symptomatic patients[J]. Clin Orthop Relat Res, 2012, 470(12): 3355-3360.
[17]
Blackman AJ. Editorial commentary: revision arthroscopy for borderline dysplastic hips: a borderline surgical indication[J]. Arthroscopy, 2019, 35(12): 3248-3249.
[18]
Murata Y, Fukase N, Dornan G, et al. Arthroscopic treatment of femoroacetabular impingement in patients with and without borderline developmental dysplasia of the hip: a systematic review and meta-analysis[J/OL]. Orthop J Sports Med, 2021, 9(8): 23259671211015973. DOI：10.1177/23259671211015973.
[19]
Murata Y, Fukase N, Martin M, et al. Comparison between hip arthroscopic surgery and periacetabular osteotomy for the treatment of patients with borderline developmental dysplasia of the hip: a systematic review[J/OL]. Orthop J Sports Med, 2021, 9(5): 23259671211007401. DOI：10.1177/23259671211007401.
[20]
Henebry A, Gaskill T. The effect of pelvic tilt on radiographic markers of acetabular coverage[J]. Am J Sports Med, 2013, 41(11): 2599-2603.
[21]
杨国跃，李雅玥，罗殿中，等．拍摄体位对发育性髋关节发育不良X线评估指标的影响[J]．中华骨科杂志，2019，39(15):954-960.
[22]
Wiberg G. The anatomy and roentgenographic appearance of a normal hip joint [J]. Acta Chir Scand, 1939, 83(suppl 58): 7-38.
[23]
Fredensborg N. The CE angle of normal hips[J]. Acta Orthop Scand, 1976, 47(4): 403-405.
[24]
Ogata S, Moriya H, Tsuchiya K, et al. Acetabular cover in congenital dislocation of the hip[J]. J Bone Joint Surg Br, 1990, 72(2): 190-196.
[25]
Omeroglu H, Biçimoglu A, Agu şH, et al. Measurement of center-edge angle in developmental dysplasia of the hip: a comparison of two methods in patients under 20 years of age[J]. Skeletal Radiol, 2002, 31(1): 25-29.
[26]
Wylie JD, Kapron AL, Peters CL, et al. Relationship between the lateral center-edge angle and 3-dimensional acetabular coverage[J/OL]. Orthop J Sports Med, 2017, 5(4): 2325967117700589. DOI: 10.1177/2325967117700589.
[27]
Safran MR, Murray IR, Andrade AJ, et al. Criteria for the operating room confirmation of the diagnosis of hip instability: the results of an international expert consensus conference[J]. Arthroscopy, 2022, 1(22): 2837-2849.e2
[28]
Boykin RE, Anz AW, Bushnell BD, et al. Hip instability[J]. J Am Acad Orthop Surg, 2011, 19(6): 340-349.
[29]
Curtis DM, Murray IR, Money AJ, et al. Hip microinstability: understanding a newly defined hip pathology in young athletes[J]. Arthroscopy, 2022, 38(2): 211-213.
[30]
Kapron AL, Peters CL, Aoki SK, et al. The prevalence of radiographic findings of structural hip deformities in female collegiate athletes[J]. Am J Sports Med, 2015, 43(6): 1324-1330.
[31]
Ellsworth BK, Sink EL, Doyle SM. Adolescent hip dysplasia：what are the symptoms and how to diagnose it[J]. Curr Opin Pediatr, 2021, 33(1): 65-73.
[32]
Lorenzon P, Scalvi A, Scalco E. The painful hip in young adults between impingement and mild dysplasia: clinical and instrumental diagnostical criteria[J]. Acta Biomed, 2020, 91(4/S): 11-20.
[33]
Griffin DR, Dickenson EJ, O'donnell J, et al. The warwick agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement[J]. Br J Sports Med, 2016, 50(19): 1169-1176.
[34]
Poultsides LA, Bedi A, Kelly BT. An algorithmic approach to mechanical hip pain[J]. HSS J, 2012, 8(3): 213-224.
[35]
Safran MR. Microinstability of the hip-gaining acceptance[J]. J Am Acad Orthop Surg, 2019, 27(1): 12-22.
[36]
Hoppe DJ, Truntzer JN, Shapiro LM, et al. Diagnostic accuracy of 3 physical examination tests in the assessment of hip microinstability[J/OL]. Orthop J Sports Med, 2017, 5(11): 2325967117740121. DOI：10.1177/2325967117740121.
[37]
Wyatt M, Weidner J, Pfluger D, et al. The femoro-epiphyseal acetabular roof (FEAR) index: a new measurement associated with instability in borderline hip dysplasia？[J]. Clin Orthop Relat Res, 2017, 475(3): 861-869.
[38]
Haefeli PC, Steppacher SD, Babst D, et al. An increased iliocapsularis-to-rectus-femoris ratio is suggestive for instability in borderline hips[J]. Clin Orthop Relat Res, 2015, 473(12): 3725-3734.
[39]
Kraeutler MJ, Garabekyan T, Goodrich JA, et al. Standardizing the prearthritic hip joint space width: an analysis of 994 Hips[J]. Arthroscopy, 2018, 34(7): 2114-2120.
[40]
Nwachukwu B, Gaudiani M, Marsh NA, et al. Labral hypertrophy correlates with borderline hip dysplasia and microinstability in femoroacetabular impingement: a matched case-control analysis[J]. Hip Int, 2019, 29(2): 198-203.
[41]
D'ambrosi R, Hantes ME, Mariani I, et al. Successful return to sport in patients with symptomatic borderline dysplasia following hip arthroscopy and T-shaped capsular plication[J]. Knee Surg Sports Traumatol Arthrosc, 2021, 29(5): 1370-1377.
[42]
Bali K, Poitras S, Carsen S. Non-surgical management of pre-arthritic dysplastic hip pain.//Beaulé P. Hip dysplasia[M/OL]. Cham, Switzerland, Springer, 2020: 111-128. https://doi.org/10.1007/978-3-030-33358-4_8.
[43]
Lewis CL, Sahrmann SA. Effect of posture on hip angles and moments during gait[J]. Man Ther, 2015, 20(1): 176-182.
[44]
Barratt PA, Brookes N, Newson A. Conservative treatments for greater trochanteric pain syndrome: a systematic review[J]. Br J Sports Med, 2017, 51(2): 97-104.
[45]
Adler KL, Giordano BD. The utility of hip arthroscopy in the setting of acetabular dysplasia: a systematic review[J]. Arthroscopy, 2019, 35(1): 237-248.
[46]
Hetsroni I, Dela TK, Duke G, et al. Sex differences of hip morphology in young adults with hip pain and labral tears[J]. Arthroscopy, 2013, 29(1): 54-63.
[47]
Cvetanovich GL, Levy DM, Weber AE, et al. Do patients with borderline dysplasia have inferior outcomes after hip arthroscopic surgery for femoroacetabular impingement compared with patients with normal acetabular coverage？[J]. Am J Sports Med, 2017, 45(9): 2116-2124.
[48]
Beck EC, Drager J, Nwachukwu B, et al. Patients with borderline hip dysplasia achieve clinically significant improvement after arthroscopic femoroacetabular impingement surgery: a case-control study with a minimum 5-year follow-up[J]. Am J Sports Med, 2020, 48(7): 1616-1624.
[49]
Saks BR, Fox JD, Owens JS, et al. One bony morphology, two pathologic entities: sex-based differences in patients with borderline hip dysplasia undergoing hip arthroscopy[J]. Am J Sports Med, 2021, 49(14): 3906-3914.
[50]
Beals TR, Soares RW, Briggs KK, et al. Ten-year outcomes after hip arthroscopy in patients with femoroacetabular impingement and borderline dysplasia[J]. Am J Sports Med, 2022, 50(3): 739-745.
[51]
Maldonado DR, Perets I, Mu BH, et al. Arthroscopic capsular plication in patients with labral tears and borderline dysplasia of the hip: analysis of risk factors for failure[J]. Am J Sports Med, 2018, 46(14): 3446-3453.
[52]
Hatakeyama A, Utsunomiya H, Nishikino S, et al. Predictors of poor clinical outcome after arthroscopic labral preservation, capsular plication, and cam osteoplasty in the setting of borderline hip dysplasia[J]. Am J Sports Med, 2018, 46(1): 135-143.
[53]
Kester BS, Capogna B, Sa MR, et al. Independent risk factors for revision surgery or conversion to total hip arthroplasty after hip arthroscopy: a review of a large statewide database from 2011 to 2012[J]. Arthroscopy, 2018, 34(2): 464-470.
[54]
Della Rocca F, Di Francia V, Schiavi P, et al. Hip arthroscopy and T-shaped capsular plication for the treatment of borderline dysplasia: a minimum 2-year follow-up[J]. Eur J Orthop Surg Traumatol, 2022, 32(3): 449-458.
[55]
Wang L, Zhou B, Zhao Z, et al. Body-mass index and obesity in urban and rural China：findings from consecutive nationally representative surveys during 2004－18[J]. Lancet, 2021, 398(10294): 53-63.
[56]
Yoon SJ, Lee SH, Jang SW, et al. Hip arthroscopy of a painful hip with borderline dysplasia[J]. Hip Pelvis, 2019, 31(2): 102-109.
[57]
Mcclincy MP, Wylie JD, Yen YM, et al. Mild or borderline hip dysplasia：are we characterizing hips with a lateral center-edge angle between 18 ° and 25 ° appropriately？[J]. Am J Sports Med, 2019, 47(1): 112-122.
[58]
Domb BG, Martin DE, Botser IB. Risk factors for ligamentum teres tears[J]. Arthroscopy, 2013, 29(1): 64-73.
[59]
Chaharbakhshi EO, Perets I, Ashberg L, et al. Do ligamentum teres tears portend inferior outcomes in patients with borderline dysplasia undergoing hip arthroscopic surgery? A match-controlled study with a minimum 2-year follow-up[J]. Am J Sports Med, 2017, 45(11): 2507-2516.
[60]
Saadat A, Lall AC, Battaglia MR, et al. Prevalence of generalized ligamentous laxity in patients undergoing hip arthroscopy: a prospective study of patients' clinical presentation, physical examination, intraoperative findings, and surgical procedures[J]. Am J Sports Med, 2019, 47(4): 885-893.
[61]
Harris JD. Capsular management in hip arthroscopy[J]. Clin Sports Med, 2016, 35(3): 373-389.
[62]
Kizaki K, Hatakeyama A, Utsunomiya H, et al. Arthroscopic double shoelace capsular plication technique for the treatment of borderline hip dysplasia associated with capsular laxity[J]. Arthrosc Tech, 2019, 8(8): e923-e927.
[63]
Kobayashi N, Inaba Y, Kubota S, et al. The distribution of impingement region in cam-type femoroacetabular impingement and borderline dysplasia of the hip with or without cam deformity: a computer simulation study[J]. Arthroscopy, 2017, 33(2): 329-334.
[64]
Domb BG, Chaharbakhshi EO, Perets I, et al. Hip arthroscopic surgery with labral preservation and capsular plication in patients with borderline hip dysplasia: minimum 5-year patient-reported outcomes[J]. Am J Sports Med, 2018, 46(2): 305-313.
[65]
Murphy NJ, Eyles JP, Hunter DJ. Hip osteoarthritis: etiopathogenesis and implications for management[J]. Adv Ther, 2016, 33(11): 1921-1946.
[66]
Dwyer MK, Lee JA, Mccarthy JC. Cartilage status at time of arthroscopy predicts failure in patients with hip dysplasia[J]. J Arthroplasty, 2015, 30(9 Suppl): 121-124.
[67]
Gudmundsson P, Nakonezny PA, Lin J, et al. Functional improvement in hip pathology is related to improvement in anxiety, depression, and pain catastrophizing: an intricate Link between physical and mental well-being[J/OL]. BMC Musculoskelet Disord, 2021, 22(1): 133. DOI：10.1186/s12891-021-04001-5.
[68]
Sochacki KR, Brown L, Cenkus K, et al. Preoperative depression is negatively associated with function and predicts poorer outcomes after hip arthroscopy for femoroacetabular impingement[J]. Arthroscopy, 2018, 34(8): 2368-2374.
[69]
Feghhi D, Shearin J, Bharam S. Arthroscopic management of subspinous impingement in borderline hip dysplasia and outcomes compared with a matched cohort with nondysplastic femoroacetabular impingement[J]. Am J Sports Med, 2020, 48(12): 2919-2926.
[70]
Curtis DM, Pullen WM, Murray IR, et al. Female gender, decreased lateral center edge angle and a positive hyperextension-external rotation test are associated with ease of hip distractability at time of hip arthroscopy[J]. Knee Surg Sports TraumatolArthrosc, 2022, 30(6): 2188-2194.
[71]
Lequesne M, S èze de. False profile of the pelvis: a new radiographic incidence for the study of the hip. Its use in dysplasias and different coxopathies[J]. Rev Rhum Mal Osteoartic, 1961, 28: 643-652
[72]
Kirsch JM, Khan M, Bedi A. Does hip arthroscopy have a role in the treatment of developmental hip dysplasia？[J]. J Arthroplasty, 2017, 32(9S): S28-S31.
[73]
Ross JR, Larson CM, Bedi A. Indications for hip arthroscopy[J]. Sports Health, 2017, 9(5): 402-413.
[74]
Mozingo JD, Schuring LL, Mortensen AJ, et al. Effect of patient positioning on measurement of the anterior center-edge angle on false-profile radiographs and its 3-dimensional mapping to the acetabular rim[J/OL]. Orthop J Sports Med, 2022, 10(2): 23259671211073834. DOI：10.1177/23259671211073834.
[75]
Kraeutler MJ, Ashwell ZR, Garabekyan T, et al. The iliofemoral line：a radiographic sign of acetabular dysplasia in the adult hip[J]. Am J Sports Med, 2017, 45(11): 2493-2500.
[76]
Chaharbakhshi EO, Hartigan D, Perets I, et al. Is hip arthroscopy effective in patients with combined excessive femoral anteversion and borderline dysplasia? A match-controlled study[J]. Am J Sports Med, 2019, 47(1): 123-130.
[77]
张利强，张洪，罗殿中，等．髋臼周围截骨术治疗临界发育性髋关节发育不良的疗效[J]．中华骨科杂志，2021，41(14):966-976.
[78]
Bolia IK, Briggs KK, Locks R, et al. Prevalence of high-grade cartilage defects in patients with borderline dysplasia with femoroacetabular impingement: a comparative cohort study[J]. Arthroscopy, 2018, 34(8): 2347-2352.
[79]
Uchida S, Utsunomiya H, Mori T, et al. Clinical and radiographic predictors for worsened clinical outcomes after hip arthroscopic labral preservation and capsular closure in developmental dysplasia of the hip[J]. Am J Sports Med, 2016, 44(1): 28-38.
[80]
Utsunomiya H, Briggs KK, Gj D, et al. Predicting severe cartilage damage in the hip: a model using patient-specific data from 2，396 hip arthroscopies[J]. Arthroscopy, 2019，35(7): 2051-2060.e13.
[81]
Kuroda Y, Saito M, Çlnar EN, et al. Patient-related risk factors associated with less favourable outcomes following hip arthroscopy[J]. Bone Joint J, 2020, 102-B(7): 822-831.
[82]
吴毅东，于康康，李春宝，等. 髋关节镜手术适应证的选择与禁忌证[J]．中国矫形外科杂志，2022，30(5):431-435.
[83]
Kalore NV, Jiranek WA. Save the torn labrum in hips with borderline acetabular coverage[J]. Clin Orthop Relat Res, 2012, 470(12): 3406-3413.
[84]
Mas MJ, Sanz-Reig J, Verdu RC, et al. Arthroscopic management with labral preservation, femoral osteoplasty, and capsular plication in patients with borderline hip dysplasia. Results of a matched-cohort study at minimum two year follow-up[J]. Int Orthop, 2020, 44(12): 2567-2575.
[85]
Maldonado DR, Diulus SC, Annin S, et al. Borderline dysplastic female patients with painful internal snapping improve clinical outcomes at minimum two-year follow-up following hip arthroscopy with femoroplasty, labral repair, iliopsoas fractional lengthening, and capsular plication: a propensity-matched controlled comparison[J]. Arthroscopy, 2021, 37(8): 2473-2484.
[86]
Matsuda DK, Wolff AB, NhoSJ, et al. Multicenter arthroscopic study of the hip (MASH) study group.hip dysplasia: prevalence, associated findings, and procedures from large multicenter arthroscopy study group[J]. Arthroscopy, 2018, 34(2): 444-453.
[87]
Zhang SX, An MY, Li ZL, et al. Arthroscopic treatment for femoroacetabular impingement syndrome with external snapping hip: a comparison study of matched case series[J]. Orthop Surg, 2021, 13(6): 1730-1738.
[88]
Ekhtiari S, De Sa D, Haldane CE, et al. Hip arthroscopic capsulotomy techniques and capsular management strategies: a systematic review[J]. Knee Surg Sports Traumatol Arthrosc, 2017, 25(1): 9-23.
[89]
Freeman KL, Nho SJ, Suppauksorn S, et al. Capsular management techniques and hip arthroscopy[J]. Sports Med Arthrosc Rev, 2021, 29(1): 22-27.
[90]
Millis MB, Mcclincy M. Periacetabular osteotomy to treat residual dysplasia in adolescents and young adults：indications，complications，results[J]. J Child Orthop, 2018, 12(4): 349-357.
[91]
Swarup I, Zaltz I, Robustelli S, et al. Outcomes of periacetabular osteotomy for borderline hip dysplasia in adolescent patients[J]. J Hip Preserv Surg, 2020, 7(2): 249-255.
[92]
吴尽言，陈晓东．青少年及成人发育性髋关节发育不良保髋治疗最新研究进展[J]．中国修复重建外科杂志，2021，35(12):1513-1518.
[93]
Wyles CC, Vargas JS, Heidenreich MJ, et al. Natural history of the dysplastic hip following modern periacetabular osteotomy[J]. J Bone Joint Surg Am, 2019, 101(10): 932-938.
[94]
罗殿中，张洪，张伟佳．髋臼周围截骨三种手术入路比较[J]．实用骨科杂志，2013，19(6):481-484.
[95]
高仁智，祝兆琛，谢宗平．经改良髂腹股沟入路行髋臼周围截骨术治疗成人髋臼发育不良的中期疗效[J]．中国修复重建外科杂志，2021，35(9):1100-1104.
[96]
鞠盛涛，贾堂宏，宁斌. 髋臼周围截骨术治疗成人髋关节发育不良的疗效[J]．山东大学学报(医学版)，2014，52(10):100-102.
[97]
马佩燕，张育娜，陈桂香．以快速康复外科理念为基础的个体化康复护理对髋关节置换术后患者的影响[J]．齐鲁护理杂志，2022，28(06):45-49.
[98]
Malloy P, Malloy M, Draovitch P. Guidelines and pitfalls for the rehabilitation following hip arthroscopy[J]. Curr Rev Musculoskelet Med, 2013, 6(3): 235-241.
[99]
Spencer-Gardner L, Eischen JJ, Levy BA, et al. A comprehensive five-phase rehabilitation programme after hip arthroscopy for femoroacetabular impingement[J]. Knee Surg Sports Traumatol Arthrosc, 2014, 22(4): 848-859.
[100]
Chen Y, Yang K, Marušic A, et al. A reporting tool for practice guidelines in health care: the RIGHT statement[J]. Ann Intern Med, 2017, 166(2): 128-132.
[1] 王亚红, 蔡胜, 葛志通, 杨筱, 李建初. 颅骨骨膜窦的超声表现一例[J/OL]. 中华医学超声杂志（电子版）, 2024, 21(11): 1089-1091.
[2] 史学兵, 谢迎东, 谢霓, 徐超丽, 杨斌, 孙帼. 声辐射力弹性成像对不可切除肝细胞癌门静脉癌栓患者放射治疗效果的评价[J/OL]. 中华医学超声杂志（电子版）, 2024, 21(08): 778-784.
[3] 严华悦, 刘子祥, 周少波. 磷酸烯醇式丙酮酸羧激酶-1在恶性肿瘤中的研究进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 452-456.
[4] 高俊颖, 张海洲, 区泓乐, 孙强. FOLFOX-HAIC 为基础的肝细胞癌辅助转化治疗的应用进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 457-463.
[5] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[6] 陈浩, 王萌. 胃印戒细胞癌的临床病理特征及治疗选择的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 108-111.
[7] 刘柏隆, 周祥福. 压力性尿失禁阶梯治疗的项目介绍[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 125-125.
[8] 刘柏隆. 女性压力性尿失禁阶梯治疗之手术治疗方案选择[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 126-126.
[9] 中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[10] 李浩, 陈棋帅, 费发珠, 张宁伟, 李元东, 王硕晨, 任宾. 慢性肝病肝纤维化无创诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 863-867.
[11] 谭瑞义. 小细胞骨肉瘤诊断及治疗研究现状与进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 781-784.
[12] 崔军威, 蔡华丽, 胡艺冰, 胡慧. 亚甲蓝联合金属定位夹及定位钩针标记在乳腺癌辅助化疗后评估腋窝转移淋巴结的临床应用价值探究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 625-632.
[13] 王誉英, 刘世伟, 王睿, 曾娅玲, 涂禧慧, 张蒲蓉. 老年乳腺癌新辅助治疗病理完全缓解的预测因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 641-646.
[14] 王子阳, 王宏宾, 刘晓旌. 血清标志物对甲胎蛋白阴性肝细胞癌诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 677-681.
[15] 陈慧, 邹祖鹏, 周田田, 张艺丹, 张海萍. 皮肤镜对头皮红斑性皮肤病辅助鉴别诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 692-698.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号

AI
小
编
AI小编
你好！我是《中华医学电子期刊资源库》AI小编，有什么可以帮您的吗？