The Conservative Treatment of Congenital Dysplasia and Dislocation of the Hip

Tönnis, Dietrich

doi:10.1007/978-3-642-71038-4_16

Cited by 49 publications

(66 citation statements)

References 142 publications

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“…Pelvic tilt was measured on the lateral radiographs and defined as the angle between a horizontal line and a line connecting the pubic symphysis with the sacral promontory (PS-SP line) (Fig. 1) [26][27][28]. The PS-SP line was chosen because the corresponding landmarks are easily visible on the lateral radiographs.…”

Section: Methodsmentioning

confidence: 99%

Estimation of pelvic tilt on anteroposterior X-rays—a comparison of six parameters

et al. 2005

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Objective: To compare six different parameters described in literature for estimation of pelvic tilt on an anteroposterior pelvic radiograph and to create a simple nomogram for tilt correction of prosthetic cup version in total hip arthroplasty. Design: Simultaneous anteroposterior and lateral pelvic radiographs are taken routinely in our institution and were analyzed prospectively. The different parameters (including three distances and three ratios) were measured and compared to the actual pelvic tilt on the lateral radiograph using simple linear regression analysis. Patients: One hundred and four consecutive patients (41 men, 63 women with a mean age of 31.7 years, SD 9.2 years, range 15.7-59.1 years) were studied. Results: The strongest correlation between pelvic tilt and one of the six parameters for both men and women was the distance between the upper border of the symphysis and the sacrococcygeal joint. The correlation coefficient was 0.68 for men (P<0.001) and 0.61 for women (P<0.001). Based on this linear correlation, a nomogram was created that enables fast, tilt-corrected cup version measurements in clinical routine use. Conclusion: This simple method for correcting variations in pelvic tilt on plain radiographs can potentially improve the radiologist's ability to diagnose and interpret malformations of the acetabulum (particularly acetabular retroversion and excessive acetabular overcoverage) and post-operative orientation of the prosthetic acetabulum.

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Section: Methodsmentioning

confidence: 99%

Estimation of pelvic tilt on anteroposterior X-rays—a comparison of six parameters

et al. 2005

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“…Medialization allows one to reduce the joint contact forces by reducing the body weight lever arm. If correction (adduction) is best assessed by normalizing the weight bearing surface or sourcil of the acetabulum (Tönnis angle) (Tönnis 1987). The lateral margin of the weight bearing surface should be just superior to the medial margin ( Figure 9).…”

Section: Medializationmentioning

confidence: 99%

Lessons learned after more than 250 periacetabular osteotomies

Trousdale

Cabanela

2003

Acta Orthopaedica Scandinavica

105

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“…The control subjects with elevated (C 55°) alpha angles also showed a larger mean omega zone of 20% (95% CI, 18-22; p = 0.004) and 16% (95% CI, 13-19; p = 0.007) for 60°and 90°of flexion, respectively, compared with the patients with FAI. Furthermore, the mean omega zone at 0°a nd 30°was larger with 23% (95% CI, 19-27; p = 0.017) and 22% (95% CI, 19-26; p = 0.004), respectively, whereas the mean omega zone in patients with FAI was 18% (95% CI, [15][16][17][18][19][20][21][22] and 16% (95% CI, [11][12][13][14][15][16][17][18][19][20] (Table 3). In contrast, the omega zone was similar in both control groups at any of the flexion positions (0°p = 0.806, 30°p = 0.925, 60°p = 0.345, 90°p = 0.136).…”

Section: Resultsmentioning

confidence: 99%

“…The institutional review boards of the involved hospitals decided no ethical approval was necessary. Hips with radiographic joint space narrowing (Tönnis Grade C 2 [21]), posttraumatic abnormalities, or any osteophyte formation that could influence measurements were excluded.…”

Section: Methodsmentioning

confidence: 99%

Can Combining Femoral and Acetabular Morphology Parameters Improve the Characterization of Femoroacetabular Impingement?

Bouma

Hogervorst

Audenaert

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Femoroacetabular impingement (FAI) presupposes a dynamic interaction of the proximal femur and acetabulum producing clinical symptoms and chondrolabral damage. Currently, FAI classification is based on alpha angle and center-edge angle measurements in a single plane. However, acetabular and femoral version and neck-shaft angle also influence FAI. Furthermore, each of these parameters has a reciprocal interaction with the others; for example, a shallow acetabulum delays impingement of the femoral head with the acetabular rim. Questions/purposes We introduce the new parameter ''omega zone,'' which combines five parameters into one: the alpha and center-edge angles, acetabular and femoral version, and neck-shaft angle. We sought to determine whether the omega zone could differentiate patients with FAI from (1) normal control subjects (alpha \ 55°), but also from (2) control subjects with elevated alpha angles (C 55°). Methods We evaluated CT data of 20 hips of male patients with symptomatic cam-type FAI and of 35 male hips extracted from 110 anonymized CT scans for vascular diagnosis. We excluded hips with osteoarthritis, developmental dysplasia, or coxa profunda (center-edge angle 20°-45°on AP pelvic view or corresponding coronal CT views). With dedicated software, femoral and pelvic orientation was standardized; we tested the omega zone in four hip positions in three distinct groups: patients with cam-type FAI (alpha [ 60°) and control subjects with normal (\ 55°) and high alpha angles (C 55°). Results The omega zone was smaller in patients with cam-type FAI than normal control subjects (alpha angle \ 55°) at 60°and 90°of flexion (mean, 12%; 95% confidence interval [CI], 7-17; p = 0.008; Cohen's d = 9%; 95% CI, 4-13; p = 0.003). Furthermore, the omega zone was smaller in all positions in patients with cam-type FAI than control subjects with high alpha angles (0°p = 0.017, 30°p = 0.004, 60°p = 0.004, 90°p = 0.007). In contrast, the omega zone did not differ between control subjects with normal or high alpha angles. In all hips, the omega zone decreased with flexion, corresponding to a decrease in remaining impingement-free motion with flexion.

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The Conservative Treatment of Congenital Dysplasia and Dislocation of the Hip

Cited by 49 publications

References 142 publications

Estimation of pelvic tilt on anteroposterior X-rays—a comparison of six parameters

Estimation of pelvic tilt on anteroposterior X-rays—a comparison of six parameters

Lessons learned after more than 250 periacetabular osteotomies

Can Combining Femoral and Acetabular Morphology Parameters Improve the Characterization of Femoroacetabular Impingement?

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