Adolescent Femoroacetabular Impingement: Gender Differences in Hip Morphology

作者：Hooper Perry^*; Oak Sameer R; Lynch T Sean; Ibrahim Gehan; Goodwin Ryan; Rosneck James

来源：Arthroscopy-The Journal of Arthroscopic and Related Surgery, 2016, 32(12): 2495-2502.

DOI：10.1016/j.arthro.2016.06.015

Purpose: To compare the hip morphology of adolescent male patients and female patients who underwent hip arthroscopy for femoroacetabular impingement (FAI) and determine if gender differences exist. Methods: We retrospectively reviewed the records of 177 adolescents, aged 13 to 18 years, who were treated for FAI with hip arthroscopy. We examined and analyzed preoperative magnetic resonance imaging (MRI) scans and plain radiographs, measuring the lateral center-edge angle, Tonnis angle, and alpha angle. The intraclass correlation coefficient between readers was calculated. We created multiple linear regression models incorporating age, gender, and body mass index (BMI) with the radiographic measurements. Intraoperative findings using the Outerbridge grading system, as well as procedure performed, were documented. We compared these findings with our preoperative imaging measurements using the chi(2) test and the Wilcoxon rank sum test. Results: The intraclass correlation coefficient showed moderate to strong agreement between the 3 image readers. The BMI and age-adjusted mean alpha angle was higher in male patients than female patients on both plain radiographs (55.9 degrees vs 45.2 degrees, P < .0001) and axial oblique MRI scans (54.1 degrees vs 42.5 degrees, P < .0001). An alpha angle greater than 55 degrees was found in 38.9% of male patients compared with only 1% of female patients (P < .0001). The lateral center-edge angle and Tonnis angle on MRI scans and plain radiographs displayed no statistically significant differences between genders after we controlled for BMI and age. Male patients were more likely to have chondral damage intraoperatively than female patients (56.3% vs 32.5%, P = .0041). Conclusions: Distinct differences between genders were seen both on preoperative imaging and at the time of hip arthroscopy. We found that male patients with FAI displayed a larger mean alpha angle, and therefore a more severe cam-type deformity, than female patients. Our study also found that male patients were more likely to show evidence of chondral damage than female patients at the time of surgery. Level of Evidence: Level IV.

• 出版日期2016-12