中国医学装备2025，Vol.22Issue(12)：39-43,5.DOI:10.3969/j.issn.1672-8270.2025.12.008
基于MRI分期的股骨头坏死患者Harris髋关节功能评分对比分析
Comparative analysis of functional scores based on MRI staging for Harris hip joint in ONFH patients
摘要
Abstract
Objective:To investigate the correlation between the severity of functional impairment of hip joint and the progression of magnetic resonance imaging(MRI)staging in patients with osteonecrosis of femoral head(ONFH)at different MRI staging.Methods:A design with retrospective cohort study was conducted,including 120 unilateral ONFH patients who admitted to the Department of Orthopedics at Yongzhou Central Hospital between January 2021 and May 2024.They were divided into three groups according to the Association Research Circulation Osseous(ARCO)staging system of Chinese Medical Association:group Stage Ⅰ(n=42),group Stage Ⅱ(n=54),and group Stage Ⅲ(n=24).The functional status of hip joint was assessed by using the Harris Hip Score(HHS),and its association with imaging parameters,including the ratio of necrotic area and the extent of bone marrow edema,was analyzed.Results:There were significant differences in total glucocorticoid dosage,ratio of necrotic area,extent of bone marrow edema,and bone density T-score among three groups(F=5.432,132.756,157.892,6.345,P＜0.05).The degree of collapse of group Stage Ⅲ was significantly higher that of group Stage Ⅰ and Ⅱ(F=218.765,P＜0.05),respectively.Visual Analog Scale(VAS)pain scores increased with the progression of ARCO staging,and the group Stage Ⅲ reached to(6.34±1.89),and the differences were significant(F=35.672,P＜0.05).The HHS total score significantly declined with the progression of ARCO staging(Stage Ⅰ＞Stage Ⅱ＞Stage Ⅲ),and the differences were significant(F=98.765,P＜0.05).The pain scores decreased from group Stage Ⅰ(38.45±4.12)to group Stage Ⅲ(24.56±6.78),and the difference was significant(F=76.432,P＜0.05).The ratio of necrotic area and extent of bone marrow edema showed a strong negative correlations with HHS(r=-0.812,-0.785,P＜0.001),respectively.Multiple regression analysis identified the ratio of necrotic area,extent of bone marrow edema,and collapse degree were independent predictors for HHS(β=-0.532,-0.467,-0.356,P＜0.05).There were not significant differences were found in gender,body mass index(BMI),and underlying disease among different groups(P＞0.05).Conclusion:The severity of functional impairment of hip joint in ONFH patients is positive correlation with MRI-based staging progression.The ratio of necrotic area and extent of bone marrow edema are key influence indicators in assessing function.关键词
股骨头坏死(ONFH)/磁共振成像(MRI)/中华医学会骨科学分会骨分期系统(ARCO)/Harris髋关节评分(HHS)/骨坏死面积/骨髓水肿Key words
Osteonecrosis of femoral head(ONFH)/Magnetic resonance imaging(MRI)/Association Research Circulation Osseous(ARCO)staging system of Chinese Medical Association/Harris hip score(HHS)/Necrotic area/Bone marrow edema分类
医药卫生引用本文复制引用
朱智波,廖玲凤,杨毅,袁云峰..基于MRI分期的股骨头坏死患者Harris髋关节功能评分对比分析[J].中国医学装备,2025,22(12):39-43,5.基金项目
湖南省自然科学基金(2022JJ30036) Hunan Provincial Natural Science Foundation(2022JJ30036) （2022JJ30036）
