Abstract
Background: Patients with developmental dysplasia of the hip are prone to the development of degenerative changes in the affected hip. The aim of this study was to evaluate the prevalence, morphological features, and clinical relevance of acetabular retroversion in these patients. Methods: We investigated the version and morphological features of the acetabulum using pelvic radiographs and computed tomography images of ninety-six hips in fifty-nine patients with developmental dysplasia of the hip. A diagnosis of acetabular retroversion was based on the presence of a positive cross-over sign on the pelvic radiograph. Using computed tomography images, we determined the acetabular anteversion angle at various levels in the axial plane. The acetabular sector angle served as an indicator of acetabular coverage of the femoral head. We evaluated the association between acetabular version and the patient's age at the onset of pain. Fifty normal hips were examined as controls. Results: Weobserved acetabular retroversion in 18% (seventeen) of the ninety-six hips in the patients with developmental dysplasia of the hip. The mean acetabular anteversion angle in the hips with acetabular retroversion was significantly smaller, at all levels, than that in the hips with acetabular anteversion; this tendency was more evident at proximal levels. There was significantly less posterior and posterosuperior coverage in the hips with acetabular retroversion than in those with acetabular anteversion, but superior acetabular coverage did not differ between the groups. Multivariate analysis showed that the onset of pain occurred at a significantly earlier age in patients with acetabular retroversion (27.9 years) than in those with acetabular anteversion (40.5 years), regardless of the severity of the dysplasia (p = 0.003). Conclusions: In patients with developmental dysplasia of the hip, acetabular retroversion results from relatively deficient coverage by the posterior portion of the acetabulum. Developmental dysplasia with acetabular retroversion is associated with an earlier onset of pain than is developmental dysplasia with anteversion, suggesting a correlation between deficiency of the posterior acetabular wall and the earlier onset of pain. Level of Evidence: Prognostic Level IV. See Instructions to Authors for a complete description of levels of evidence.
| Original language | English |
|---|---|
| Pages (from-to) | 895-903 |
| Number of pages | 9 |
| Journal | Journal of Bone and Joint Surgery - Series A |
| Volume | 92 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 1 2010 |
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All Science Journal Classification (ASJC) codes
- Surgery
- Orthopedics and Sports Medicine
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Acetabular retroversion in developmental dysplasia of the hip. / Fujii, Masanori; Nakashima, Yasuharu; Yamamoto, Takuaki; Mawatari, Taro; Motomura, Goro; Matsushita, Akinobu; Matsuda, Shuichi; Jingushi, Seiya; Iwamoto, Yukihide.
In: Journal of Bone and Joint Surgery - Series A, Vol. 92, No. 4, 01.04.2010, p. 895-903.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Acetabular retroversion in developmental dysplasia of the hip
AU - Fujii, Masanori
AU - Nakashima, Yasuharu
AU - Yamamoto, Takuaki
AU - Mawatari, Taro
AU - Motomura, Goro
AU - Matsushita, Akinobu
AU - Matsuda, Shuichi
AU - Jingushi, Seiya
AU - Iwamoto, Yukihide
PY - 2010/4/1
Y1 - 2010/4/1
N2 - Background: Patients with developmental dysplasia of the hip are prone to the development of degenerative changes in the affected hip. The aim of this study was to evaluate the prevalence, morphological features, and clinical relevance of acetabular retroversion in these patients. Methods: We investigated the version and morphological features of the acetabulum using pelvic radiographs and computed tomography images of ninety-six hips in fifty-nine patients with developmental dysplasia of the hip. A diagnosis of acetabular retroversion was based on the presence of a positive cross-over sign on the pelvic radiograph. Using computed tomography images, we determined the acetabular anteversion angle at various levels in the axial plane. The acetabular sector angle served as an indicator of acetabular coverage of the femoral head. We evaluated the association between acetabular version and the patient's age at the onset of pain. Fifty normal hips were examined as controls. Results: Weobserved acetabular retroversion in 18% (seventeen) of the ninety-six hips in the patients with developmental dysplasia of the hip. The mean acetabular anteversion angle in the hips with acetabular retroversion was significantly smaller, at all levels, than that in the hips with acetabular anteversion; this tendency was more evident at proximal levels. There was significantly less posterior and posterosuperior coverage in the hips with acetabular retroversion than in those with acetabular anteversion, but superior acetabular coverage did not differ between the groups. Multivariate analysis showed that the onset of pain occurred at a significantly earlier age in patients with acetabular retroversion (27.9 years) than in those with acetabular anteversion (40.5 years), regardless of the severity of the dysplasia (p = 0.003). Conclusions: In patients with developmental dysplasia of the hip, acetabular retroversion results from relatively deficient coverage by the posterior portion of the acetabulum. Developmental dysplasia with acetabular retroversion is associated with an earlier onset of pain than is developmental dysplasia with anteversion, suggesting a correlation between deficiency of the posterior acetabular wall and the earlier onset of pain. Level of Evidence: Prognostic Level IV. See Instructions to Authors for a complete description of levels of evidence.
AB - Background: Patients with developmental dysplasia of the hip are prone to the development of degenerative changes in the affected hip. The aim of this study was to evaluate the prevalence, morphological features, and clinical relevance of acetabular retroversion in these patients. Methods: We investigated the version and morphological features of the acetabulum using pelvic radiographs and computed tomography images of ninety-six hips in fifty-nine patients with developmental dysplasia of the hip. A diagnosis of acetabular retroversion was based on the presence of a positive cross-over sign on the pelvic radiograph. Using computed tomography images, we determined the acetabular anteversion angle at various levels in the axial plane. The acetabular sector angle served as an indicator of acetabular coverage of the femoral head. We evaluated the association between acetabular version and the patient's age at the onset of pain. Fifty normal hips were examined as controls. Results: Weobserved acetabular retroversion in 18% (seventeen) of the ninety-six hips in the patients with developmental dysplasia of the hip. The mean acetabular anteversion angle in the hips with acetabular retroversion was significantly smaller, at all levels, than that in the hips with acetabular anteversion; this tendency was more evident at proximal levels. There was significantly less posterior and posterosuperior coverage in the hips with acetabular retroversion than in those with acetabular anteversion, but superior acetabular coverage did not differ between the groups. Multivariate analysis showed that the onset of pain occurred at a significantly earlier age in patients with acetabular retroversion (27.9 years) than in those with acetabular anteversion (40.5 years), regardless of the severity of the dysplasia (p = 0.003). Conclusions: In patients with developmental dysplasia of the hip, acetabular retroversion results from relatively deficient coverage by the posterior portion of the acetabulum. Developmental dysplasia with acetabular retroversion is associated with an earlier onset of pain than is developmental dysplasia with anteversion, suggesting a correlation between deficiency of the posterior acetabular wall and the earlier onset of pain. Level of Evidence: Prognostic Level IV. See Instructions to Authors for a complete description of levels of evidence.
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UR - http://www.scopus.com/inward/citedby.url?scp=77951933021&partnerID=8YFLogxK
U2 - 10.2106/JBJS.I.00046
DO - 10.2106/JBJS.I.00046
M3 - Article
C2 - 20360513
AN - SCOPUS:77951933021
VL - 92
SP - 895
EP - 903
JO - Journal of Bone and Joint Surgery - Series A
JF - Journal of Bone and Joint Surgery - Series A
SN - 0021-9355
IS - 4
ER -