Acetabular retroversion in developmental dysplasia of the hip

Masanori Fujii, Yasuharu Nakashima, Takuaki Yamamoto, Taro Mawatari, Goro Motomura, Akinobu Matsushita, Shuichi Matsuda, Seiya Jingushi, Yukihide Iwamoto

Research output: Contribution to journalArticle

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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 languageEnglish
Pages (from-to)895-903
Number of pages9
JournalJournal of Bone and Joint Surgery - Series A
Volume92
Issue number4
DOIs
Publication statusPublished - Apr 1 2010

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Hip Dislocation
Hip
Pain
Acetabulum
Tomography
Thigh
Age of Onset
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

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 journalArticle

Fujii, Masanori ; Nakashima, Yasuharu ; Yamamoto, Takuaki ; Mawatari, Taro ; Motomura, Goro ; Matsushita, Akinobu ; Matsuda, Shuichi ; Jingushi, Seiya ; Iwamoto, Yukihide. / Acetabular retroversion in developmental dysplasia of the hip. In: Journal of Bone and Joint Surgery - Series A. 2010 ; Vol. 92, No. 4. pp. 895-903.
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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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