凸轮型股骨髋臼撞击综合征患者手术取出的凸轮畸形和关节囊的组织表达

Catherine Yuh, Philip Malloy, Steven P Mell, Zeeshan Khan, Shane J Nho, Robin Pourzal, Jorge Chahla, Deborah J Hall
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摘要

简介凸轮型股骨髋臼撞击综合征(FAIS)是一种关节炎前髋关节疾病,定义为股骨近端骨质增生,导致关节接触异常。对 FAIS 中凸轮畸形和关节囊的组织表现仍缺乏研究。本研究的目的是:1)评估FAIS患者凸轮畸形和关节囊的组织病理学特征;2)评估关节囊局部炎症的程度;3)确定凸轮畸形组织构成与α角和患者因素之间的关系。方法:从接受关节镜手术的FAIS患者身上采集凸轮畸形和关节囊组织。对样本进行组织学处理,使用光学显微镜和偏振光显微镜成像,并通过点计数进行评估。进行相关性统计以确定与α角和患者因素相关的特征。结果:在评估的 21 个凸轮畸形样本中,共计数了 16,259 个点。在不同的样本中,凸轮畸形内的组织被观察到是异质的,由 16 种不同的结构组成,跨越不同的存活状态。在有关节软骨的样本中,组织高度破坏和/或钙化。纤维软骨、坏死软骨和血管的存在与α角有明显的中低度相关性。在对关节囊组织质量进行评估时,大多数样本中都发现了滑膜炎。结论凸轮畸形具有复杂性和异质性,无论是在凸轮畸形个体内部还是在 FAIS 患者之间都是如此。一些凸轮畸形组织特征与α角、年龄、性别和体重指数相关。在这些样本中观察到的异质性表明,不同的 FAIS 患者凸轮畸形的组织特性各不相同,这可能会影响髋关节镜手术的效果以及患者随后发展为骨关节炎的风险水平。我们的研究结果表明FAIS存在不同的组织表型,这可能是FAIS治疗策略的一个重要考虑因素。
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Tissue expression in surgically retrieved cam deformity and capsule from patient hips with Cam-type Femoroacetabular Impingement Syndrome
Introduction: Cam-type femoroacetabular impingement syndrome (FAIS) is a pre-arthritic hip condition, defined as a bony growth on the proximal femur that causes abnormal joint contact. The tissue presentation of the cam deformity and capsule in FAIS remains understudied. The purpose of this study was to 1) evaluate histopathological features in cam deformity and capsule from FAIS patients, 2) assess the extent of local inflammation within the capsule, and 3) determine relationships between cam deformity tissue composition versus α angle and patient factors. Methods: Cam deformity and capsular tissues were collected from FAIS patients undergoing arthroscopic surgery. Samples were histologically processed, imaged using light and polarized light microscopy, and assessed with point counting. Correlation-based statistics were performed to identify features correlated with α angle and patient factors. Results: Across 21 cam deformity samples assessed, a total of 16,259 points were counted. The tissue within the cam deformity was observed to be heterogeneous between specimens, comprised of 16 distinct structures spanning different states of viability. In samples with articular cartilage, the tissue was highly disrupted and/or calcified. The presence of fibrocartilage, necrotic cartilage, and vasculature had significant low-moderate correlations with α angle. During assessment of capsular tissue quality, synovitis was observed in most samples. Conclusion: The cam deformity is complex and heterogeneous, both within individual cam deformities and between individuals with FAIS. Several cam deformity tissue features were correlated with α angle, age, sex, and BMI. The heterogeneity observed in these samples indicates that tissue properties within the cam deformity varies between patients with FAIS, which may contribute to outcomes of hip arthroscopic surgery and a patient's level of risk for the subsequent development of osteoarthritis. Our findings suggest distinct tissue phenotypes of FAIS exist, which may be an important consideration for FAIS treatment strategies.
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