High prevalence of acetabular retroversion in both affected and unaffected hips after Legg-Calvé-Perthes disease

Shinya Kawahara, Yasuharu Nakashima, Hiroshi Oketani, Akifusa Wada, Masanori Fujii, Takuaki Yamamoto, Taro Mawatari, Goro Motomura, Taishi Sato, Mio Akiyama, Toshio Fujii, Kazuyuki Takamura, Yukihide Iwamoto

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background Acetabular retroversion is observed in hips after various pediatric hip diseases. This study sought to examine the frequency of acetabular retroversion in both affected and unaffected hips after Legg-Calvé- Perthes disease and its correlation with the prominence of the ischial spine. Methods We retrospectively investigated the version and morphological features of the acetabulum using pelvic radiographs after Legg-Calvé-Perthes disease (107 affected hips treated non-operatively and 72 unaffected hips from the contralateral side). The diagnosis of acetabular retroversion was made based on the presence of a positive cross-over sign on anteroposterior pelvic radiographs. The correlation between the presence of a positive cross-over sign and modified Stulberg classes, the onset age of Legg-Calvé-Perthes disease, radiographic parameters for acetabular dysplasia and the prominence of the ischial spine were examined. Results The prevalence of a positive cross-over sign was 49.5 % (45 of 91 hips) in affected hips and 45.8 % (33 of 72 hips) in unaffected hips. Hips with a positive cross-over sign were significantly coexistent bilaterally. The prevalence of prominence of the ischial spine in the positive cross-over sign group was 71.4 % in the affected side and 81.8 % in the unaffected side, indicating a significant correlation between the cross-over sign and the prominence of the ischial spine in both affected and unaffected hips. The positive cross-over sign did not have any correlation with the parameters for acetabular dysplasia and the onset age, however, had a significant correlation with the severity of the femoral head deformity. Conclusions High prevalence of acetabular retroversion in both affected and unaffected hips after Legg-Calvé-Perthes disease was demonstrated. Symmetric acetabular deformity and the coexistence of prominence of the ischial spine suggested the effects of the Legg-Calvé-Perthes disease lesions on the skeletal development of the whole pelvis. Further follow-up is needed to clarify the pathological significance of acetabular retroversion after Legg-Calvé-Perthes disease.

Original languageEnglish
Pages (from-to)226-232
Number of pages7
JournalJournal of Orthopaedic Science
Volume17
Issue number3
DOIs
Publication statusPublished - May 2012

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

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