Radiographic measurements of hip dysplasia at skeletal maturity—new reference intervals based on 2,038 19-year-old Norwegians

Laborie, Lene Bjerke; Engesæter, Ingvild Øvstebø; Lehmann, Trude G; Sera, Francesco; Dezateux, Carol; Engesæter, Lars B.; Rosendahl, Karen

doi:10.1007/s00256-013-1574-y

Cited by 43 publications

(53 citation statements)

References 68 publications

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“…In this study we established a target range of radiographic parameters based on a normal range [7,18] and determined the proportion of hips that were corrected within this established range. We also investigated factors predictive of undercorrection, defined as LCEA \ 22°, which has been reported to be associated with PAO failure at minimum 10-year followup [1].…”

Section: Discussionmentioning

confidence: 99%

“…We assumed that there would be minimal change between the radiographic parameters after 1 month of surgery; however, it is possible that small differences could potentially result from variation of radiographic projection and healing of the osteotomy. Correction of LCEA between 25°and 40° [ 26,34,35,38], ACEA between 18°and 38° [7,21], Tönnis angle between 0°and 10° [7,18,33], and EI B 20% [7,18] were defined as the target ranges for radiographic correction after PAO based on previously published normative values [7,18,21,27,33,39]. For the purpose of this study, values within the established targets were considered adequately corrected, whereas those inferior to the target were considered undercorrected and those above the target were considered overcorrected.…”

Section: Methodsmentioning

confidence: 99%

“…In this retrospective study, we defined a target of acetabular correction for individual radiographic parameters based on reported normative values [7,18,21,27,33,39] and we specifically asked: (1) What is the proportion of patients undergoing PAO in which the acetabular correction as assessed by the lateral center-edge angle (LCEA), anterior center-edge angle (ACEA), acetabular inclination (AI), and extrusion index (EI) is within defined target ranges? (2) What patient or preoperative factors are associated with undercorrection of the acetabulum as defined by LCEA \ 22°, a factor that has been reported to be associated with PAO failure at 10-year followup?…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Do Radiographic Parameters of Dysplasia Improve to Normal Ranges After Bernese Periacetabular Osteotomy?

Novais

Duncan

Nepple

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background The goal of periacetabular osteotomy (PAO) is to improve the insufficient coverage of the femoral head and achieve joint stability without creating secondary femoroacetabular impingement. However, the complex tridimensional morphology of the dysplastic acetabulum presents a challenge to restoration of normal radiographic parameters. Accurate acetabular correction is important to achieve long-term function and pain improvement. There are limited data about the proportion of patients who have normal radiographic parameters restored after PAO and the factors associated with under-and overcorrection. Questions/purposes (1) What is the proportion of patients undergoing PAO in which the acetabular correction as assessed by the lateral center-edge angle (LCEA), anterior center-edge angle (ACEA), acetabular inclination (AI), and extrusion index (EI) is within defined target ranges? (2) What patient and preoperative factors are associated with undercorrection of the acetabulum as defined by a LCEA\ 22°, a factor that has been reported to be associated with PAO failure at 10-year followup? Methods Between January 2007 and December 2011 we performed 132 PAOs in 116 patients for treatment of symptomatic acetabular dysplasia. One patient with LeggCalvé-Perthes disease, one with multiple osteochondromatosis, and two with concomitant femoral osteotomy were excluded. A total of 128 hips (112 patients) were included. The hip cohort was 76% (97 of 128) female and the mean age at surgery was 28.5 years (SD 8.7 years). Correction of LCEA between 25°and 40°, ACEA between 18°and 38°, Tönnis angle between 0°and 10°, and EI B 20% were defined as adequate based on normative values. Values lower than the established parameters were o has been previously associated with PAO failure at a minimum of 10-year followup, in this study we sought to measure whether demographic factors including age, gender, body mass index, and severity of acetabular dysplasia assessed by preoperative LCEA, ACEA, AI, and EI were associated with undercorrection. Postoperative radiographs were obtained at minimum of 1 month after surgery (mean, 7 months; range, 1-44 months) and were measured by a professional research assistant and a hip reconstruction fellow not involved in the clinical care of the patients. No patient was lost to followup. Results Of the 128 hips, the proportion of hips with radiographic parameters within the established range was 78% (100 hips) for the LCEA, 86% (110 hips) for the ACEA, 89% (114 hips) for the AI, and 80% (102 hips) for the EI. For hips with an inadequate correction, the LCEA was more often undercorrected than overcorrected (20% versus 2%; 95% confidence interval [CI], 11%-27%; p\0.001), whereas the ACEA was more often overcorrected than undercorrected (11% versus 3%; 95% CI, 1%-15%; p = 0.03) After adjusting for age, sex, body mass index, and preoperative radiographic parameters including ACEA, AI, and EI, we found that the preoperative LCEA was the only independent factor associated with a postoperative LCEA\...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Do Radiographic Parameters of Dysplasia Improve to Normal Ranges After Bernese Periacetabular Osteotomy?

Novais

Duncan

Nepple

et al. 2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Several radiological parameters, such as the center-edge angle (CE angle), Tönnis angle, and the femoral-head extrusion index (FHEI), have been utilized to diagnose adult acetabular dysplasia (1,7,8). Tönnis angle has been described with different terms in previous studies (1,(9)(10)(11)(12), such as weight-bearing acetabular index, Lequesne's acetabular index, acetabular roof obliquity and horizontal toit externe angle. It is one of the most common radiological parameters used to evaluate the adult hip.…”

Section: Introductionmentioning

confidence: 99%

Reliability of a New Radiological Parameter Named the Modified Tönnis Angle for the Evaluation of Acetabular Dysplasia in Adults

Shao

Meng

et al. 2018

Iran J Radiol

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Objectives: To evaluate the reliability of Tönnis angle and modified Tönnis angle on pelvic radiographs in adults. Methods: Conventional anterior-posterior pelvic radiographs of patients were selected from the picture archiving communication system (PACS) in the department of medical radiology of the Second Hospital of Shandong University. Tönnis angle and modified Tönnis angle were measured. All measurements were performed by two experienced observers who worked independently of each other. These measurements were performed again after one month. They were performed digitally using tools of the PACS. Reliability of Tönnis angle and modified Tönnis angle was assessed by intraclass correlation coefficients and Bland and Altman plot.

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“…Detailed descriptions of the digital measurement program, of its accuracy and of the measurements included have been reported previously. 25,26 The following measurements were performed digitally. Markers for acetabular dysplasia (Fig 4 A-D): The centeredge (CE) angle of Wiberg, 27 the femoral head extrusion index (FHEI), 28 the acetabular depth-width ratio (ADR), 29 and Sharp' s angle.…”

Section: Figurementioning

confidence: 99%

Screening Strategies for Hip Dysplasia: Long-term Outcome of a Randomized Controlled Trial

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Only 2 randomized controlled trials have addressed effects of ultrasound screening for developmental hip dysplasia. Both concluded that adding universal or selective ultrasound to routine clinical examination gave a nonsignificant reduction in rates of late presenting cases, but higher treatment rates. WHAT THIS STUDY ADDS:This maturity review assesses long-term outcome of one of these trials. Rates of radiographic findings indicating acetabular dysplasia and degenerative change were similar across the 3 screening groups in young adulthood. Increased treatment rates were not associated with avascular necrosis. abstract OBJECTIVE: Screening for hip dysplasia is controversial. A previous randomized controlled trial revealed that adding universal or selective ultrasound to routine clinical examination gave a nonsignificant reduction in rates of late presenting cases, but with higher treatment rates. This study assesses differences in outcome at skeletal maturity for the 3 newborn screening strategies in terms of radiographic markers of acetabular dysplasia and early degenerative change and avascular necrosis (AVN) secondary to neonatal treatment. METHODS:From the initial trial including 11 925 newborns, a populationbased sample of 3935 adolescents was invited for follow-up at age 18 to 20 years. A standardized weight-bearing anteroposterior view was obtained. The outcomes evaluated were the radiographic findings of dysplasia (center-edge angle, femoral head extrusion-index, acetabular depth-width ratio, Sharp' s angle, subjective evaluation of dysplasia) and degenerative change (joint-space width). Signs of AVN were documented. RESULTS:Of the 3935 subjects invited, 2038 (51.8%) attended the maturity review, of which 2011 (58.2% female patients) were included: 551, 665, and 795 subjects from the universal, selective, and clinical groups, respectively. Rates per group of positive radiographic findings associated with dysplasia or degenerative change varied depending on radiographic marker used. No statistically significant differences were detected between groups. No AVN was seen. CONCLUSIONS:Although both selective and universal ultrasound screenings gave a nonsignificant reduction in rates of late cases when compared with expert clinical programs, we were unable to demonstrate any additional reduction in the rates of radiographic findings associated with acetabular dysplasia or degenerative change at maturity. Increased treatment rates were not associated with AVN. Pediatrics 2013;132:492-501

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Radiographic measurements of hip dysplasia at skeletal maturity—new reference intervals based on 2,038 19-year-old Norwegians

Cited by 43 publications

References 68 publications

Do Radiographic Parameters of Dysplasia Improve to Normal Ranges After Bernese Periacetabular Osteotomy?

Do Radiographic Parameters of Dysplasia Improve to Normal Ranges After Bernese Periacetabular Osteotomy?

Reliability of a New Radiological Parameter Named the Modified Tönnis Angle for the Evaluation of Acetabular Dysplasia in Adults

Screening Strategies for Hip Dysplasia: Long-term Outcome of a Randomized Controlled Trial

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