The Prevalence of Acetabular Retroversion Among Various Disorders of the Hip

Ezoe, Masamitsu; Naito, Masatoshi; Inoue, Takuya

doi:10.2106/00004623-200602000-00017

Cited by 82 publications

(66 citation statements)

References 16 publications

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“…Although these impingement patterns differ, they often co-exist in persons with intra-articular pathology [14]. Recent literature has provided increasing evidence that cam and pincer FAI cause distinct patterns of articular cartilage and labral damage and may serve as an etiologic factor of "idiopathic" OA [14,17,18,[51][52][53][54][55][56][57].…”

Section: Femoroacetabular Impingementmentioning

confidence: 99%

“…One study included a prospective design with a 6-year follow-up [58]. Eight studies had a cross-sectional design [17,18,[51][52][53][54][55][56].…”

Section: Femoroacetabular Impingementmentioning

confidence: 99%

“…Although the evidence is limited, there is sufficient literature to suggest a relationship between FAI and OA. All of the studies that we reviewed reported an association between FAI and OA; however, 8 studies were cross-sectional studies that were rated level 4 [17,18,[51][52][53][54][55][56]. Similar to AD, measures taken to represent FAI, such as alpha angle or CEA, may be affected by the disease process of OA.…”

Section: Qualitative Analysismentioning

confidence: 99%

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Relationship of Acetabular Dysplasia and Femoroacetabular Impingement to Hip Osteoarthritis: A Focused Review

Harris‐Hayes

Royer

2011

PM&R

100

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Hip osteoarthritis (OA) leads to significant functional limitations and economic burden. If modifiable risk factors for hip OA are identified, it may be possible to implement preventative measures. Bony abnormalities associated with acetabular dysplasia (AD) and femoroacetabular impingement (FAI) have been recently implicated as risk factors for hip osteoarthritis (OA). The purpose of this focused review is to summarize the available evidence describing the relationship between bony abnormalities and hip OA. A librarian-assisted database search using PubMed, Embase and Central was performed. Relevant articles were identified and assessed for inclusion criteria. The authors reviewed cohort and case control studies that reported on the association between abnormal hip morphology and hip OA. The available literature suggests that an association exists between bony abnormalities found in AD and FAI and hip OA and preliminary evidence suggests that AD is a risk factor for OA, however these conclusions are based on limited evidence. Prospective, longitudinal studies are needed to confirm the causal relationship between abnormal hip morphology and the future development of hip OA.

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Section: Femoroacetabular Impingementmentioning

confidence: 99%

“…One study included a prospective design with a 6-year follow-up [58]. Eight studies had a cross-sectional design [17,18,[51][52][53][54][55][56].…”

Section: Femoroacetabular Impingementmentioning

confidence: 99%

Section: Qualitative Analysismentioning

confidence: 99%

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Relationship of Acetabular Dysplasia and Femoroacetabular Impingement to Hip Osteoarthritis: A Focused Review

Harris‐Hayes

Royer

2011

PM&R

100

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“…This prevalence is much higher than rates reported in normal asymptomatic populations (5%-15%). [47][48][49][50] In a previous retrospective review of pain distributions in patients undergoing hip arthroscopy for treatment of an acetabular labral tear with and without femoral osteotomies, 20% of patients were found to present with posterior pelvic pain in addition to groin and or lateral hip pain. 13 Although all but 16% of patients reported satisfactory pain and functional improvement following hip arthroscopy, 58.3% of patients presenting with posterior pelvic pain as part of their symptom complex continued to have low-grade pain (average 1.4 numeric pain score) after hip arthroscopy.…”

Section: Discussionmentioning

confidence: 99%

Hip Radiograph Findings in Patients Aged 40 Years and Under with Posterior Pelvic Pain

Prather

Decker

Bonnette

et al. 2019

PM&R

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Background Several sacroiliac joint (SIJ) provocative tests used to assess posterior pelvic pain involve moving and stressing the hip. It is unknown if there is a subgroup of patients with posterior pelvic pain who have underlying hip deformity that could potentially influence performance and interpretation of these tests. Objective To describe the prevalence of radiographic hip deformity and hip osteoarthritis in a group of adults 40 years old and under who met the clinical diagnostic criteria for treatment of posterior pelvic pain with an image guided intra‐articular SIJ injection. Design Retrospective cohort study. Setting Tertiary university orthopedic department Patients (or Participants) One hundred and forty‐eight patients were evaluated (83% (123/148) female; mean age 31.3 ± 6.2 years). All had completed a trial of comprehensive noninvasive treatment for posterior pelvic pain and had a minimum of three positive SIJ provocative tests on physical examination. Methods Retrospective review identified patients undergoing SIJ injection for pain recommended and performed by seven physiatrists between 2011 and 2017. Hip radiographs were read by a physician with expertise in hip measurements with previously demonstrated excellent intrarater reliability. Main Outcome Measurements Percentage of patients with hip deformity findings. Results No patients meeting the inclusion criteria had significant radiographic hip osteoarthritis (Tonnis ≥2 indicating moderate or greater radiographic hip osteoarthritis) and 4/148 (3%) were found to have mild radiographic hip osteoarthritis. Prearthritic hip disorders were identified in 123 (83%, 95% CI: 76, 89%) patients. For those patients with prearthritic hip disorders, measurements consistent with femoroacetabular impingement (FAI) were seen in 61 (41%) patients, acetabular dysplasia in 49 (33%) patients, and acetabular retroversion in 85 (57%) patients. Acetabular retroversion was identified in 43% (crossover sign) and 39% (prominent ischial spine) of patients. Conclusions Approximately 57% of adult patients under the age of 40 years with the clinical symptom complex of SIJ pain were found to have radiographic acetabular retroversion. This is a higher percentage than the 5%‐15% found in asymptomatic people in the current literature. Further study is needed to assess links between hip structure, hip motion, and links to pelvic pain including peri and intra‐articular SIJ pain. Level of Evidence III

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“…8,10,17 In 34 patients (50 hips) with LCPD, Ezoe identified acetabular retroversion by a positive cross over sign in 42% of the hips, and 68% of the hips with femoral head deformities ranging from ovoid to flattened shape (Stulberg radiographic outcome class III/IV/V). 18 Sankar and Flynn found acetabular retroversion on axial imaging of 44 patients (53 hips) with LCPD, but at skeletal maturity, 31% of these hips had cross over sign suggesting acetabular retroversion. 8 Larson et al observed that acetabular retroversion, as evidenced by a positive prominence of the ischial spine sign, was present early in the disease process in 37 of the 41 skeletally immature hips.…”

mentioning

confidence: 96%

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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The Prevalence of Acetabular Retroversion Among Various Disorders of the Hip

Cited by 82 publications

References 16 publications

Relationship of Acetabular Dysplasia and Femoroacetabular Impingement to Hip Osteoarthritis: A Focused Review

Relationship of Acetabular Dysplasia and Femoroacetabular Impingement to Hip Osteoarthritis: A Focused Review

Hip Radiograph Findings in Patients Aged 40 Years and Under with Posterior Pelvic Pain

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

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