Sex Differences in Cartilage Topography and Orientation of the Developing Acetabulum: Implications for Hip Preservation Surgery

Peterson, Jonathan B.; Doan, Josh; Bomar, James D.; Wenger, Dennis R.; Pennock, Andrew T.; Upasani, Vidyadhar V.

doi:10.1007/s11999-014-4109-5

Cited by 35 publications

(39 citation statements)

References 23 publications

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“…Staw biodrowy per se także cechuje się pewnym zróżnicowaniem płcio wym, choć wiedza na ten temat wymaga wciąż dowodów naukowych. W dotychczas przeprowadzonych badaniach stwierdzono, iż panewka żeńska w porównaniu z męską jest mniejsza i bardziej zwrócona ku przodowi, równocześnie gdy koniec bliższy kości udowej nie wykazuje istotnych różnic [4][5][6][7][8].…”

Section: Wstępunclassified

“…Różnice płciowe w jej ustawieniu mają znaczenie nie tylko w sensie antropometrycznym i antropologicznym, lecz mogą być kluczowe w prawidłowym osadzeniu elementu panewkowego endoprotezy cał kowitej stawu biodrowego, operacyjnym leczeniu kon fliktu panewkowo-udowego (FAI) czy przy planowaniu za biegów osteotomii w obrębie miednicy zmieniają -cych ustawienie i kształt panewki [4][5][6][7][8].…”

Section: Wstępunclassified

“…Normy dotyczące orientacji prze strzennej panewek nie są jednak wystarczająco określone i często opierają się o płaszczyzny, których dokładność wyznaczania jest niepewna [4][5][6][7][8]11,[20][21][22][23][24]. Równocześnie różnice w strukturze i ustawieniu panewek stawu biodrowego w zależności od płci, choć już opisywane, wymagają nadal uwierzytelnienia naukowego [5][6][7][8], co istotnie może wpłynąć na zrozumienie problemu klinicznego i pośrednio na jakość wykonywanych zabiegów ortopedycznych. W związku z powyższym badanie to ma na celu porów-nanie różnic płciowych w budowie i w przestrzennym ustawieniu panewek miednicy, w celu lepszego zrozumienia anatomii stawu biodrowego.…”

Section: Wstępunclassified

“…The hip joint itself also displays certain sex-specific characteristics, although the details still need scientific evidence. Studies conducted to date have revealed that female acetabula are smaller and more forward-oriented, while the proximal femurs do not show significant differences [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Sex differences in acetabular orientation are not only important for anthropometric and anthropological studies but they also may be crucial for appropriate placement of the acetabular part during total hip replacement procedures and surgical treatment of femoroacetabular impingement (FAI) of for planning pelvic osteotomy surgery to alter the orientation and shape of the acetabulum [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Sexual Dimorphism of Acetabular Anatomy Based on Three-dimensional Computed Tomography Images of Pelvises

Musielak

Rychlik

Jóźwiak

2016

Ortop Traumatol Rehabil

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STRESZCZENIEWstęp. Prezentowane badanie ma na celu porównanie różnic płciowych w budowie i w przestrzennym ustawieniu panewek miednicy, w celu lepszego zrozumienia anatomii stawu biodrowego.Materiał i metody. Badanie wykonano w oparciu o trójwymiarowe rekonstrukcje tomografii komputerowych 50 panewek żeńskich oraz 50 panewek męskich. Na ich podstawie wykonano analizę przestrzenną panewek stawu biodrowego w stosunku do podstawy kości krzyżowej, jako płaszczyzny referencyjnej. W oparciu o analizę statystyczną, porównywano wartości kątowe parametrów opisujących rzeczywistą oś panewki (kąt inklinacji, kąt antewersji, kąt pochylenia) oraz objętość i powierzchnię wewnętrzną panewki stawu biodrowego.Wyniki. Zarówno kąt inklinacji, jak i kąt pochylenia panewki nie różniły się istotnie pomiędzy porównywanymi grupami i wyniosły odpowiednio: 68,61° i 26,53° w panewkach kobiecych oraz 70,56° i 30,19° w męskich (p>0,05). Kąt antewersji był istotnie większy w przypadku panewek żeńskich i wyniosł 38,27°, gdy w męskich -32,05° (p=0,0008), natomiast ich objętość i powierzchnia były istotnie mniejsze u kobiet (odpowiednio p=0,0007 i 0,0001).Wnioski. 1. Ustawienie panewki stawu biodrowego różni się w zależności od płci -panewki żeńskie zorientowane są bardziej ku przodowi niż męskie. 2. Objętość oraz powierzchnia wewnętrzna panewki także się różnią -są mniejsze u kobiet. 3. Niezależnie od wykorzystanej płaszczyzny odniesienia, dymorfizm płciowy panewki stawu biodrowego jest stały. 4. Znajomość powyższych różnic płciowych jest niezbędna dla planowania przedoperacyjnego w zabiegach ortopedycznych (jak w przypadku alloplastyki stawu biodrowego czy leczenia operacyjnego FAI).Słowa kluczowe panewka stawu biodrowego, orientacja przestrzenna panewki, rekonstrukcje trójwymiarowe, inżynieria odwrotna, różnice płciowe SUMMARY Background. The study aimed to compare sex differences in the morphology and spatial orientation of pelvic acetabula to advance the understanding of hip anatomy.Material and methods. The study was based on three-dimensional reconstructions of computed tomography images of 50 female and 50 male acetabula. The images were used for spatial analysis of hip acetabula relative to the base of the sacral bone as the plane of reference. Statistical analysis was performed to compare angles relevant to the actual axis of the acetabulum (inclination angle, anteversion angle, tilt angle) as well as the volume and inner surface area of the acetabulum.Results. Both the inclination and tilt angles of the acetabulum did not differ significantly between the groups, the respective values being: 68. 61° and 26.53° in females and 70.56° and 30.19° in males (p>0.05). The anteversion angle was significantly larger for female acetabula (38.27° compared to 32.05° in men, with p=0.0008), while the volume and the inner surface area were significantly smaller in women (p=0.0007 and 0.0001 respectively).Conclusions. 1. Acetabular orientation is sex-specific, with female acetabula being more forward-oriented than those of men. 2. The volume and inn...

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Section: Wstępunclassified

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sexual Dimorphism of Acetabular Anatomy Based on Three-dimensional Computed Tomography Images of Pelvises

Musielak

Rychlik

Jóźwiak

2016

Ortop Traumatol Rehabil

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Ischemic femoral head osteonecrosis in a piglet model causes three dimensional decrease in acetabular coverage

Upasani

Jeffords

Farnsworth

et al. 2017

Journal Orthopaedic Research

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Legg-Calve-Perthes disease (LCPD) is a childhood form of ischemic osteonecrosis marked by development of severe femoral head deformity and premature osteoarthritis. The pathogenesis of femoral head deformity has been studied extensively using a piglet model of ischemic osteonecrosis, however, accompanying acetabular changes have not been investigated. The purpose of this study was to determine if acetabular changes accompany femoral head deformity in a well-established piglet model of LCPD and to define the acetabular changes using three dimensional computed tomography (3-D CT) and modeling. Twenty-four piglets were surgically induced with ischemic osteonecrosis on the right side. The contralateral hip was used as control. At 8 weeks postoperative, pelvi were retrieved and imaged with CT. Custom software was used to measure acetabular morphologic parameters on 3-D CT images. Moderate to severe femoral head deformities were present in all animals. Acetabula with accompanying femoral head deformity had a significant decrease in acetabular version and tilt (p < 0.001) and in coverage angle in the superior, posterior, and inferior quadrants (p < 0.05). These findings indicate that the development of femoral head deformity following ischemic osteonecrosis produces specific and predictable changes to the shape of the acetabulum. Acetabular changes described in patients with LCPD were observed in the piglet model. This model may serve as a valuable tool to elucidate the relationship between femoral head and acetabular deformities. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1173-1177, 2018.

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Persistently elevated joint contact stress after periacetabular osteotomy is associated with joint failure at minimum 10‐year follow‐up

Aitken,

Goetz,

Glass

et al. 2024

Journal Orthopaedic Research

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Periacetabular osteotomy (PAO) is a common treatment for prearthritic hip dysplasia. The goal of this investigation was to determine if computationally assessed hip contact mechanics are associated with joint failure at minimum 10‐year follow‐up. One hundred patients with hip dysplasia (125 hips) completed patient‐reported outcomes an average of 13.8 years (range 10.0–18.0 years) after PAO. 63/125 hips were classified as having failed: 26 converted to total hip arthroplasty (THA) and 37 with significant disability indicated by modified Harris Hip Score (mHHS) ≤ 70. Differences in discrete element analysis‐computed contact mechanics were compared between (1) preserved and failed hips, (2) preserved hips and hips that failed by THA, and (3) preserved hips and hips that failed by mHHS ≤ 70. Failed hips had significantly higher preoperative contact stress and exposure metrics (p < 0.001–0.009) than preserved hips. Failed hips also had significantly higher postoperative peak contact stress (p = 0.018), higher mean contact stress (p < 0.001), and smaller contact area (p = 0.044). When assessed based on type of failure, hips that failed by THA had significantly higher postoperative contact stress and exposure metrics than preserved hips (p < 0.001–0.020). In hips that failed by mHHS ≤ 70, mean postoperative contact stress exposure was significantly higher compared to preserved hips (p = 0.043). Despite improved radiographic measures of dysplasia after PAO, pathologic joint contact mechanics can persist and predict treatment failure at minimum 10 years after surgery. Operative and nonoperative techniques specifically intended to reduce harmful contact mechanics in dysplastic hips may have the potential to further improve clinical outcomes after PAO.

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Sex Differences in Cartilage Topography and Orientation of the Developing Acetabulum: Implications for Hip Preservation Surgery

Cited by 35 publications

References 23 publications

Sexual Dimorphism of Acetabular Anatomy Based on Three-dimensional Computed Tomography Images of Pelvises

Sexual Dimorphism of Acetabular Anatomy Based on Three-dimensional Computed Tomography Images of Pelvises

Ischemic femoral head osteonecrosis in a piglet model causes three dimensional decrease in acetabular coverage

Persistently elevated joint contact stress after periacetabular osteotomy is associated with joint failure at minimum 10‐year follow‐up

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