中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (21): 5485-5493.doi: 10.12307/2026.377

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髋臼覆盖度与特发性股骨头坏死发病的相关性分析

黄志健1，2，张  程1，何海军1，董亚玮1，孙轶飞1，2，高  睿1，2，杜鹏程1，2   

  1. 1中国中医科学院望京医院，北京市   100102；2北京中医药大学，北京市   100029
  • 接受日期:2025-06-27 出版日期:2026-07-28 发布日期:2026-03-04
  • 通讯作者: 何海军，硕士，主任医师，中国中医科学院望京医院，北京市 100102
  • 作者简介:黄志健，男，2002年生，湖南省耒阳市人，汉族，北京中医药大学在读硕士。
  • 基金资助:
    中国中医科学院望京医院自主选题专项(WJYY-ZZXT-2023-05)，项目负责人：何海军；中国中医科学院望京医院高水平中医医院建设项目中医药临床循证研究专项(WJYY-XZKT-2023-28)，项目负责人：何海军；首都卫生发展科研专项(首发2024-2-4164)，项目负责人：何海军

Correlation analysis between acetabular coverage and the onset of idiopathic osteonecrosis of the femoral head

Huang Zhijian1, 2, Zhang Cheng1, He Haijun1, Dong Yawei1, Sun Yifei1, 2, Gao Rui1, 2, Du Pengcheng1, 2   

  1. 1Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China; 2Beijing University of Chinese Medicine, Beijing 100029, China

  • Accepted:2025-06-27 Online:2026-07-28 Published:2026-03-04
  • Contact: He Haijun, MS, Chief physician, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
  • About author:Huang Zhijian, Master candidate, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China; Beijing University of Chinese Medicine, Beijing 100029, China
  • Supported by:
    Independent Topic Special Project of Wangjing Hospital of China Academy of Chinese Medical Sciences, No. WJYY-ZZXT-2023-05 (to HHJ); Clinical Evidence-Based Research Special Project of High-level Traditional Chinese Medicine Hospital Construction Project of Wangjing Hospital of China Academy of Chinese Medical Sciences, No. WJYY-XZKT-2023-28 (to HHJ); Capital Health Development Research Special Project, No. 2024-2-4164 (to HHJ)

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摘要：

文题释义：

特发性股骨头坏死：指没有明确创伤或其他已知高危因素的原发性股骨头坏死。
髋臼覆盖度：是用于评估髋关节的重要指标，主要反映髋臼对股骨头的覆盖情况，它在诊断和治疗髋关节疾病(如髋关节发育不良)中具有重要意义。

摘要
背景：现有研究提示髋臼覆盖度可能是特发性股骨头坏死发病的危险因素，但目前尚缺乏不同亚型股骨头坏死之间髋臼覆盖度比较的研究。
目的：探讨髋臼覆盖度与特发性股骨头坏死发病的关联。
方法：收集2018年1月至2024年6月在中国中医科学院望京医院就诊的特发性股骨头坏死患者54例(87髋)，配对组162例(261髋)，包括激素性股骨头坏死、酒精性股骨头坏死和无明显髋关节病变患者。通过标准化影像学测量方法，由独立研究者测量骨盆正位X射线片的4项髋臼形态参数：中心边缘角、髋臼角、髋臼深度比及髋臼头指数。
结果与结论：①特发性股骨头坏死组中心边缘角显著小于配对组[(27.4±4.5)° vs. (32.4±5.7)°]，特发性股骨头坏死组髋臼角显著大于配对组[(40.2±3.5)° vs. (38.7±2.9)°]，特发性股骨头坏死组髋臼深度比(276.4±33.3 vs. 319.3±31.6)和髋臼头指数(82.4±5.1 vs. 85.4±4.2)显著小于配对组(均P < 0.001)；②与激素性股骨头坏死亚组相比，特发性股骨头坏死组中心边缘角更小[(27.4±4.5)° vs. (33.0±5.2)°]、髋臼角更大[(40.2±3.5)° vs. (38.7±3.1)°]，髋臼深度比和髋臼头指数更低(均P < 0.05)；③与酒精性股骨头坏死亚组相比，特发性股骨头坏死组同样表现出更小的中心边缘角[(27.4±4.5)° vs. (32.7±5.4)°]、更大的髋臼角[(40.2±3.5)° vs. (38.7±3.0)°]，以及更低的髋臼深度比和髋臼头指数(均P < 0.05)。结果表明，特发性股骨头坏死患者存在特征性的髋臼覆盖不足，表现为中心边缘角减小、髋臼角增大、髋臼深度比和髋臼头指数降低，这一解剖学特征可能作为特发性股骨头坏死的潜在危险因素，并有助于与其他股骨头坏死亚型鉴别诊断。建议在临床评估中关注髋臼形态，以优化早期筛查和个体化干预策略。


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 股骨头坏死, 特发性, 髋臼覆盖度, 横断面研究, 危险因素, 中心边缘角(CE角), 髋臼角(Sharp角) 

Abstract: BACKGROUND: Current studies suggest that acetabular coverage may be a risk factor for idiopathic osteonecrosis of the femoral head; however, there is a lack of comparative studies on acetabular coverage among different subtypes of osteonecrosis of the femoral head.
OBJECTIVE: To investigate the association between acetabular coverage and the onset of idiopathic osteonecrosis of the femoral head.  
METHODS: Fifty-four patients (87 hips) with idiopathic osteonecrosis of the femoral head who were admitted to the Wangjing Hospital of the China Academy of Chinese Medical Sciences between January 2018 and June 2024 and a matched group of 162 patients (261 hips) were enrolled, including patients with steroid-induced osteonecrosis of the femoral head, alcohol-induced osteonecrosis of the femoral head, and patients without obvious hip joint disease. Four acetabular morphological parameters were measured on anteroposterior pelvic radiographs using standardized imaging methods: center-edge angle, Sharp angle, acetabular depth ratio, and acetabular head index. 
RESULTS AND CONCLUSION: (1) The central-edge angle in the idiopathic osteonecrosis of the femoral head group was significantly smaller than that in the matched group [(27.4±4.5)° vs. (32.4±5.7)°], and the Sharp angle in the idiopathic osteonecrosis of the femoral head group was significantly larger than that in the matched group [(40.2±3.5)° vs. (38.7±2.9)°]. The acetabular depth ratio (276.4±33.3 vs. 319.3±31.6) and acetabular head index (82.4±5.1 vs. 85.4±4.2) in the idiopathic osteonecrosis of the femoral head group were significantly smaller than those in the matched group (all P < 0.001). (2) Compared with the steroid-induced osteonecrosis of the femoral head subgroup, the idiopathic osteonecrosis of the femoral head group had a smaller central-edge angle [(27.4±4.5)° vs. (33.0±5.2)°] and a larger Sharp angle [(40.2±3.5)° vs. (38.7±3.1)°], lower acetabular depth ratio and acetabular head index (all P < 0.05). (3) Compared with the alcoholic osteonecrosis of the femoral head subgroup, the idiopathic osteonecrosis of the femoral head subgroup also showed a smaller center-edge angle [(27.4±4.5)° vs. (32.7±5.4)°], a larger Sharp angle [(40.2±3.5)° vs. (38.7±3.0)°], and a lower acetabular depth ratio and acetabular head index (all P < 0.05). These results suggest that patients with idiopathic osteonecrosis of the femoral head have characteristic acetabular undercoverage, manifested by a reduced center-edge angle, increased Sharp angle, decreased acetabular depth ratio, and acetabular head index. This anatomical feature may serve as a potential risk factor for idiopathic osteonecrosis of the femoral head and aid in differentiating it from other subtypes of osteonecrosis of the femoral head. It is recommended to focus on acetabular morphology in clinical evaluations to optimize early screening and individualized intervention strategies. 

Key words: osteonecrosis of the femoral head, idiopathic, acetabular coverage, cross-sectional study, risk factor, center-edge angle, sharp angle

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