Analysis Of Abnormal Anatomy Of Hip Joint In Patients With Alcohol-induced Osteonecrosis Of Femoral Head

Objective:Osteonecrosis of the femoral head(ONFH)is a common orthopaedic disease.According to its etiology,it can be divided into traumatic ONFH and non-traumatic ONFH.Alcohol-induced ONFH gradually occupies the dominant position in non-traumatic ONFH.At present,there are many hypotheses about the etiology and mechanism of alcohol-induced ONFH,but at present there is still a lack of a recognized theory to explain the whole process of alcohol-induced ONFH from the occurrence of disease to the collapse of femoral head.Many scholars also believe that alcohol-induced ONFH is a disease caused by multiple factors.Some scholars have found that abnormal anatomical structure of hip joint is the influencing factor of idiopathic femoral head necrosis.We found that many alcohol-induced ONFH patients often associated with Cam-type femoroacetabular impingement in clinical work.Therefore,we speculate that alcohol-induced ONFH may also be associated with abnormal anatomical structure.Methods:A retrospective matched control study of 1:1 was used in this study.From January 1,2015 to December 31,2017,the case group was diagnosed as alcohol-induced ONFH in Affiliated Zhongshan Hospital of Dalian University,and then the case group was established according to the inclusion criteria and exclusion criteria of the case group.Finally,39 patients(57 hips)were included.Obtain general data(sex,age,height,weight,average daily alcohol consumption and years of alcohol consumption,time of diagnosis of alcoholic ONFH)and hip X-ray and CT imaging of the case group.The control group came from the recruited drinking volunteers.The drinking volunteers were included according to the the exclusion criteria and matchingconditions,Finally,39 cases(57 hips)were included.General data(gender,age,height,weight,average daily alcohol consumption and years of drinking)were obtained from control group,and standard hip radiographs and hip joint CT examinations were performed at Affiliated Zhongshan Hospital of Dalian University.The image data of the two groups were desensitized and then ordered randomly.The hip anatomical parameters(Femoral neck-shaft angle,Sharp angle,Center-edge angle,α angle,βangle,Acetabular coverage rate,Acetabular version)were measured by two physicians at two times,take the average value.The internal consistency and the consistency between two physicians were evaluated by percentage consistency rate and Kappa-test.The Age,BMI,Femoral neck-shaft angle,Sharp angle,Center-edge angle,α angle,β angle,Acetabular coverage rate,Acetabular version were measured by T-test.Results: The intra-observer and inter-observer consistency of the Femoral neck-stem angle,Sharp angle,center-edge angle,α angle,β angle,Acetabular coverage rate and Acetabular version measured by two doctors was better(r > 0.95,P < 0.05).There were no statistical differences in sex(both male),age(p = 0.311),height(p=0.298),body weight(p=0.386),BMI(p = 0.142),total alcohol intake(p = 0.884)between the two groups.The analysis of imaging data showed that α angle increased(p < 0.001),β angle decreased(p < 0.001)and Femoral neck-shaft angle decreased(p < 0.05)had statistical difference.There was no statistical difference in Sharp angle(p = 0.490),Center-edge angle(p = 0.139),Acetabular coverage(p = 0.052)and Acetabular version(p = 0.183)between the two groups.Conclusion: We found that there were statistical differences in Femoral neck-stem angle,α angle and β angle of hip joint between alcohol-induced osteonecrosis of femoral head and healthy people.The abnormal anatomy of hip joint is related to alcohol-induced osteonecrosis of of femoral head.