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The Relationship Between Subluxation Percentage of the Femoroacetabular Joint and Acetabular Width in Asian Women with Developmental Dysplasia of the Hip.
- Source :
-
The Journal of bone and joint surgery. American volume [J Bone Joint Surg Am] 2017 Apr 05; Vol. 99 (7), pp. e31. - Publication Year :
- 2017
-
Abstract
- Background: Implantation of the acetabular cup insert in the "true" location of the acetabulum is a fundamental principle of total hip arthroplasty for the treatment of secondary osteoarthritis due to developmental dysplasia of the hip (DDH). As knowledge of the morphology of the acetabulum is required for accurate placement, we investigated the relationship between acetabular width and the Crowe classification of subluxation percentage of the hip. We also analyzed factors associated with the acetabular width ratio (AWR), defined as the acetabular width of the dysplastic hip divided by that of the unaffected, contralateral hip.<br />Methods: We completed a retrospective review of the preoperative standard anteroposterior radiographs and computed tomography (CT) scans of 207 female patients who underwent primary total hip arthroplasty for unilateral DDH. The "true" acetabular plane was defined on each CT reconstruction as a plane perpendicular to the anterior pelvic plane, parallel to the teardrop line, and passing through the center of the femoral head on the unaffected, contralateral side. The acetabular width was measured for both the affected hip and the contralateral, reference hip on the true acetabular plane, with the acetabular width defined as the distance between the edges of the anterior and posterior walls of the acetabulum. All hips were classified according to the Crowe groupings on the basis of the subluxation percentage of the dysplastic hip; the subluxation percentage increased from groups I to IV, with group IVb showing joint dislocation.<br />Results: The acetabular width decreased from Crowe groups I to IVb, with a negative correlation found between the AWR and the subluxation percentage (Spearman correlation coefficient, ρ = -0.404; p < 0.001). Multivariate regression analysis identified subluxation percentage and femoral neck-shaft angle as independent factors associated with the AWR.<br />Conclusions: Characterization of factors associated with the AWR, namely subluxation percentage and femoral neck-shaft angle, will guide surgeons in correctly implanting the acetabular cup insert during total hip arthroplasty in patients with DDH.
- Subjects :
- Acetabulum diagnostic imaging
Aged
Arthroplasty, Replacement, Hip
Asia ethnology
Epidemiologic Methods
Female
Hip Dislocation, Congenital diagnostic imaging
Hip Dislocation, Congenital ethnology
Hip Joint diagnostic imaging
Humans
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed
Acetabulum pathology
Hip Dislocation, Congenital pathology
Hip Joint pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1535-1386
- Volume :
- 99
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- The Journal of bone and joint surgery. American volume
- Publication Type :
- Academic Journal
- Accession number :
- 28375895
- Full Text :
- https://doi.org/10.2106/JBJS.16.00444