Pelvic Deformity Influences Acetabular Version and Coverage in Hip Dysplasia

Fujii, Masanori; Nakashima, Yasuharu; Sato, Taishi; Akiyama, Mio; Iwamoto, Yukihide

doi:10.1007/s11999-010-1746-1

Cited by 104 publications

(139 citation statements)

References 32 publications

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“…Our observation was comparable to these studies. It was reported that a principal pelvic deformity in hip dysplasia is an inwardly rotated innominate bone with an iliac wing that opens inwardly relative to the ischiopubis, and the morphologic features of the entire pelvis were correlated with morphologic features of the acetabulum [13]. Our observations support the suggestion of the study by Fujii et al [13] that the structural abnormalities exist throughout the pelvis in patients with hip dysplasia.…”

Section: Discussionsupporting

confidence: 89%

“…Fourth, all measurements using CT images were performed by one observer (MF); this raises the concern for assessment bias. However, intra-and interobserver reliabilities of measurements on multiplanar reconstructed images has been validated in previous studies [13,14] and we assume the effect of assessment bias on the study results is negligible.…”

Section: Discussionmentioning

confidence: 79%

“…Radiographic coxa profunda is determined by the relative position of the floor of the acetabular fossa and the ilioischial line [8,28], and the relationship of these projection lines should be affected by various morphologic characteristics other than acetabular coverage or depth. Inward rotation of the innominate bone was reported to be associated with increased acetabular anteversion [13]. The inward rotation of the innominate bone, especially in the distal ilium to the ischiopubic portion, should be a potent morphologic factor that makes the acetabulum more anteverted and shifts the floor of the acetabular fossa medially relative to the ilioischial line, resulting in the presence of the coxa profunda (Fig.…”

Section: Discussionmentioning

confidence: 98%

“…3). We determined the acetabular sector angles in anterior, superior, and posterior directions [13]. The axial acetabular sector angle was defined as the sum of the anterior and posterior acetabular sector angles.…”

Section: Ct Evaluationsmentioning

confidence: 99%

“…To evaluate the morphologic features of the pelvis, we measured the innominate rotation angles at three levels on the axial plane [13] (Fig. 6): the superior iliac angle, the inferior iliac angle, and the ischiopubic angle.…”

Section: Ct Evaluationsmentioning

confidence: 99%

See 4 more Smart Citations

Does Radiographic Coxa Profunda Indicate Increased Acetabular Coverage or Depth in Hip Dysplasia?

Fujii

Nakamura

Hara

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Although radiographic coxa profunda has been considered an indicator of acetabular overcoverage, recent studies suggest that radiographic coxa profunda is a nonspecific finding seen even in hip dysplasia. The morphologic features of coxa profunda in hip dysplasia and the frequency with which the two overlap are not well defined. Questions/purposes We determined (1) the prevalence of radiographic coxa profunda in patients with hip dysplasia;(2) the morphologic differences of the acetabulum and pelvis between patients with hip dysplasia and control subjects; and (3) the morphologic differences between hip dysplasia with and without coxa profunda. Methods We retrospectively reviewed the pelvic radiographs and CT scans of 70 patients (70 hips) with hip dysplasia. Forty normal hips were used as controls. Normal hips were defined as those with a lateral center-edge angle between 25°and 40°. Coxa profunda was defined as present when the acetabular fossa was observed to touch or was medial to the ilioischial line on an AP pelvic radiograph. CT measurements included acetabular version, acetabular coverage, acetabular depth, and rotational alignment of the innominate bone. Results The prevalence of coxa profunda was 44% (31 of 70 hips) in dysplastic hips and 73% (29 of 40 hips) in the control hips (odds ratio, 3.32; 95% CI, 1.43-7

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 98%

Section: Ct Evaluationsmentioning

confidence: 99%

Section: Ct Evaluationsmentioning

confidence: 99%

See 3 more Smart Citations

Does Radiographic Coxa Profunda Indicate Increased Acetabular Coverage or Depth in Hip Dysplasia?

Fujii

Nakamura

Hara

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Morphology of the dysplastic hip and the relationship with sex and acetabular version

Mechlenburg,

De Raedt,

Achterberg

et al. 2024

Clinical Anatomy

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The dysplastic hip is characterized by incomplete coverage of the femoral head, resulting in increased risk of early osteoarthritis. The morphological variation of the hip joint is diverse and clear differences exist between females and males. The aim of this observational study was therefore to investigate the relationship between the morphology of the hip, sex, and hip dysplasia using a three‐dimensional model. Statistical shape models of the combined femur and pelvic bones were created from bilateral hips of 75 patients. Using manual angle measurements and regression analysis, the characteristic shape differences associated with sex and hip dysplasia were determined. The model showed clear differences associated with sex and hip dysplasia. We found that the acetabular anteversion in females was significantly higher (p < 0.0001) than in males while no significant difference in acetabular anteversion was found between normal and dysplastic hips (p = 0.11). The model showed that decreased acetabular anteversion resulted in the appearance of the cross‐over sign and the prominent ischial spine sign commonly associated with retroversion. Sex could be predicted with an area under the curve of 0.99 and hip dysplasia could be predicted with an area under the curve of ≥0.73. Our findings suggest that retroversion is a result of decreased anteversion of the acetabulum and is primarily associated with sex. This finding should be taken into account during the reorientation of the acetabulum in the surgical treatment of hip dysplasia.

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Three‐dimensional hip joint congruity evaluation of the borderline dysplasia: Zonal‐acetabular radius of curvature

Irie

Orías

Nho

et al. 2020

Journal Orthopaedic Research

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In theory, a hemispherical acetabulum provides the ideal hip congruity in any hip position. However, it remains unknown how the three‐dimensional acetabular morphology of borderline dysplastic and frank dysplastic hips compare to normal hips. This study inquires if borderline dysplastic zonal‐acetabular curvatures in the anterior, superior, and posterior zones are different from normal or dysplastic hips three‐dimensionally. One‐hundred and fifteen hips, grouped as control (25°≤ LCEA <40°), 36 hips; borderline (20°≤ LCEA <25°), 32 hips; dysplasia (LCEA ≤20°), 47 hips were analyzed. The radii of acetabular curvature for the anterior, superior, and posterior zones were calculated as the zonal‐acetabular radius of curvature (ZARC). The mean acetabular roof obliquity of the borderline (10.6 ± 4.3 [SD]°) was significantly larger than the control (3.0° ± 5.4°; P < .001) and smaller than the dysplasia (19.3° ± 5.7°; P < .001). Although the mean acetabular anteversion angle of the borderline (21.3° ± 3.7°) was significantly larger than control (17.9 ± 3.5°; P = .001), that of the borderline was not different from the dysplasia (23.3° ± 4.0°; P = .053). The mean anterior ZARC in the borderline (29.8 ± 2.6 mm) was significantly larger than the control (28.0 ± 2.2 mm; P = .011) and smaller than the dysplasia (31.5 ± 2.7 mm; P = .009). The mean superior ZARC in the borderline (25.7 ± 3.0 mm) was not different from the control (25.9 ± 2.2 mm; P = .934) or the dysplasia (25.8 ± 2.5 mm; P = .991). Although the mean posterior ZARC in the borderline (27.2 ± 2.5 mm) was not different from the control (26.4 ± 1.9 mm; P = .455), that of the borderline group was significantly smaller than the dysplasia (30.4 ± 3.3 mm; P < .001); that is, the severity of lateral under‐coverage affects the anterior and/or posterior zonal‐acetabular curvature.

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Pelvic Deformity Influences Acetabular Version and Coverage in Hip Dysplasia

Cited by 104 publications

References 32 publications

Does Radiographic Coxa Profunda Indicate Increased Acetabular Coverage or Depth in Hip Dysplasia?

Does Radiographic Coxa Profunda Indicate Increased Acetabular Coverage or Depth in Hip Dysplasia?

Morphology of the dysplastic hip and the relationship with sex and acetabular version

Three‐dimensional hip joint congruity evaluation of the borderline dysplasia: Zonal‐acetabular radius of curvature

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