Acetabular Cartilaginous Angle

Zamzam, Mohammed M.; Kremli, Mamoun K.; Khoshhal, Khalid I.; Abak, Alshahid A.; Bakarman, Khalid A.; Alsiddiky, Abdul Monem M.; Alzain, Kholoud O.

doi:10.1097/bpo.0b013e31817c4e6d

Cited by 40 publications

(19 citation statements)

References 29 publications

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“…In our study, the average C-HTE and O-HTE angles from the 27 healthy hips in group 2 corroborated with previous researches [15, 19, 20, 23, 24].…”

Section: Discussionsupporting

confidence: 92%

“…While plain radiographs evaluate the bony anatomy, they are insufficient to evaluate the cartilage and labrum, both of which contribute to the global coverage of the femoral head [22]. The cartilaginous part of the acetabulum seems to be an early and reliable predictor of acetabular development [20], as it’s fully formed at birth and, theoretically, it is supposed to represent the bony margins of the acetabulum at adulthood after full ossification [22–24].…”

Section: Introductionmentioning

confidence: 99%

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Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study

et al. 2019

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PurposeIn case of residual hip dysplasia (RHD) in children, pelvic radiographs are sometimes insufficient to precisely evaluate the entire coverage of the femoral head, when trying to decide on the need for further reconstructive procedures.MethodsThis study retrospectively compares the bony and the cartilaginous acetabular angle of Hilgenreiner (HTE) of 60 paediatric hips on pelvic MRI separated in two groups. Group 1 included 31 hips with RHD defined by a bony HTE > 20°. Group 2 included 27 hips with a HTE < 20°. They were compared by introducing a new ratio calculated from the square of cartilaginous HTE above the bony HTE on frontal MRI. The normal upper limit for this acetabular angle ratio was extrapolated from the published normal values of cartilaginous HTE and bony HTE in children.ResultsThe acetabular angle ratio was statistically significantly increased in the hips with RHD with a mean value of 7.1 ± 4.7 compared to the hips in the control group presenting a mean value of 2.1 ± 1.9 (p < 0.00001).ConclusionsThis newly introduced ratio seems to be a helpful tool to orientate the further treatment in children presenting borderline RHD.

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“…In our study, the average C-HTE and O-HTE angles from the 27 healthy hips in group 2 corroborated with previous researches [15, 19, 20, 23, 24].…”

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study

et al. 2019

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“…Regarding the latter, 11% of hips in this study were treated with a subsequent acetabuloplasty and/or femoral osteotomy, although that rate will likely rise with continued follow-up. In comparison, rates of further corrective surgery across the literature range as high as 57% to 100%,19,22,38 with the majority of published studies identifying a frequency ≤35% 5,16,21,23,25,36,37,39. In contrast to the acetabular index, we did observe that increased age at the time of CR predicted a higher rate of further corrective surgery, which is consistent with Luhmann et al’s37 observation that delaying CR may increase the need for later intervention.…”

Section: Discussionmentioning

confidence: 99%

Closed Reduction for Developmental Dysplasia of the Hip: Early-term Results From a Prospective, Multicenter Cohort

Sankar

Gornitzky

Clarke

et al. 2019

Journal of Pediatric Orthopaedics

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Level II-prospective observational cohort.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.

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“…Zamzam et al 14 . defined the acetabular cartilage angle, measured arthrographically, and suggested that the cartilage acetabulum should be measured, as it plays an important role in acetabular development.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of cartilage coverage with magnetic resonance imaging in residual dysplasia and its impact on surgical timing

Doğan¹,

Caliskan²,

Duran³

et al. 2019

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveThe aim of this study was to measure the cartilaginous coverage of the acetabulum using magnetic resonance imaging (MRI) and to analyze its effect on the timing and necessity of secondary operations in residual acetabular dysplasia (RAD).MethodsThe MRI results of 33 children (30 girls and 3 boys) aged between 5 and 9 years who were operated on unilaterally via a posteromedial limited approach were compared with the radiographical findings of acetabular dysplasia at follow-up. The acetabular index (AI) and the center-edge (CE) angles were measured. MRI was used to measure the osseous acetabular index (OAI), cartilage acetabular index (CAI), and cartilaginous center-edge angles (CCE). The Children's Hospital's Oakland Hip Evaluation Score (CHOHES) was used for the assessment of clinical and functional results. The Severin scoring system was used to evaluate the radiographic results. The Mann-Whitney U test and Spearman correlation tests were used for statistical analysis.ResultsIn all, 30 (90.9%) girls and 3 (9.1%) boys with an average age of 7.4 years (range: 5–9 years) and a mean follow-up period of 6.1 years (range: 4–8 years) were included. While there was a significant difference between non-dislocated hips and operated hips in 3 measurements (AI, Wiberg CE, and Ogata CE) using X-rays (p < 0.05), no significant difference was found in the MRI measurements (OAI, CAI, and CCE) (p > 0.05). The CAI values were lower than the AI measured on X-ray (p = 0.035). The mean CCE was higher than the mean CE (p = 0.022). The mean CHOHES score was 83.1 (range: 52–100) and the score of 62% patients was above 90. There was no significant difference in terms of CHOHES score according to age at the time of operation (p = 0.43). Three (9.1%) patients were Severin class I, 8 (24.3%) patients were class II, 12 (36.3%) patients were class III and 10 (30.3%) patients were class IV. There was no correlation between preoperative hip dislocation and Severin score (p = 0.056). No significant difference was found between the ambulatory and non-ambulatory groups in terms of Severin classification (p = 0.063).ConclusionCartilaginous acetabulum should be taken into account in RAD measurements. MRI may be a more appropriate option for the evaluation of acetabular cartilaginous coverage in the evaluation of RAD and the decision to perform surgery, though X-rays are currently the most used method. The results revealed no effect on functional or radiological scores as a result of being of walking age.Level of studyLevel III, Diagnostic Study.

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Acetabular Cartilaginous Angle

Cited by 40 publications

References 29 publications

Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study

Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study

Closed Reduction for Developmental Dysplasia of the Hip: Early-term Results From a Prospective, Multicenter Cohort

Evaluation of cartilage coverage with magnetic resonance imaging in residual dysplasia and its impact on surgical timing

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