Anterior centre-edge angle on sagittal CT: a comparison of normal hips to dysplastic hips

Pan

BMC Musculoskelet Disord

et al. 2020

Background This retrospective study sought to delineate the radiographic characteristics of DDH patients over 13 years of age and investigate whether the lateral center-edge angle (LCEA) could serve as radiographic selection criteria for periacetabular osteotomy. Methods We enrolled patients with Hartofilakidis type I DDH without dislocation who underwent periacetabular osteotomy between August 2009 and August 2012. LCEA, anterior central edge angle (ACEA), femoral neck-shaft angle (FNSA), Shenton line and Tönnis acetabular index (AI) were evaluated by anteroposterior and 65° false⁃profile pelvic X-ray radiographs in the standing position. Femoral neck anteversion angle (FNA), labral lesion, labral inversion and cartilage lesion were evaluated by direct magnetic resonance arthrography. DDH was categorized by LCEA into four grades (grade I: 10° ≤ LCEA< 20°, grade II: 0° ≤ LCEA< 10°, grade III: -10° ≤ LCEA< 0°, grade IV: LCEA<-10) and osteoarthritis (OA) severity was assessed using Tönnis OA classification. Pearson correlation analysis was done between LCEA and other variables. Results Totally patients (274 hips) with a mean age of 27.3 years (range 13–47 years) were included. The mean LCEA was 3.5° (range: − 30° to 20°). Based on LCEA grades, grade I DDH was present in 104 hips, grade II in 40 hips, grade III in 76 hips, and grade IV in 54 hips. Based on Tönnis OA classification, 54.5% hips (150/274) were grade 0, 33.1% hips (91/274) grade 1, 8.4% hips (23/274) grade 2 and 4% hips (11/274) grade 3. Pearson correlation analysis showed a negative correlation between LCEA grade and Tönnis OA grades ( r = 0.3987; P < 0.001). Cochran-Armitage trend test further showed a positive correlation between LCEA grades and labral lesion ( P < 0.001) and interrupted Shenton line ( P < 0.001). Conclusion The LCEA classification scheme offers a simple and practical approach to categorize the level of acetabulum coverage on the femoral head, hip deformity and characteristics of DDH. Our findings could provide clinically useful guidance for orthopedic surgeons in preparation for periacetabular osteotomy in DDH patients aged above 13 years.

Section: Discussionmentioning

confidence: 99%

The lateral center-edge angle as radiographic selection criteria for periacetabular osteotomy for developmental dysplasia of the hip in patients aged above 13 years

Pan

BMC Musculoskelet Disord

et al. 2020

Journal of the Chinese Medical Association

“…2C). 24 Femoral neck version was measured on the oblique axial plane. The angle was measured between a horizontal line and a line along the femoral neck axis (Fig.…”

Section: Imaging Analysismentioning

confidence: 99%

The correlation between hip alpha angle and acetabular labral tear location and size: A cross-sectional study

Lin,

Chiang,

et al. 2023

Background: Explore the correlation between hip morphology and labral tear location/size. Methods: This retrospective study analyzed patients with hip pain who received MR arthrography at our institution, between January 2017 and December 2020. Imaging analysis include labral tear location and size, and hip morphology measurement with alpha angle, lateral center-edge (CE) angle, anterior CE angle, and femoral neck version. The correlation between hip morphology angles and labral tear location/size were evaluated using multiple regression, followed by stratification analysis with Chi-square test to investigate interactions between the variables. Results: A total of 103 patients (105 hips) with hip pain who received MR arthrography (mean age, 50 years ±15[SD]) were included, with mean alpha angle of 57.7º ±9.9º[SD], mean lateral CE angle of 32.6º ±6.8º[SD], mean anterior CE angle of 58.2º ±8.1º[SD], mean femoral neck version of 17.1º ±8.2º[SD]. Large alpha angle (>57º) and older age were both correlated with superior and posterosuperior labral tear incidence (p<0.05) and larger tear size (p<0.05). Furthermore, alpha angle is significantly correlated with superior labral tear incidence in young-age subgroup (age <45 years) (p<0.05), also significantly correlated with posterosuperior labral tear incidence and larger tear size in middle-age subgroup (45 ≤ age ≤ 60 years) (p<0.05). Conclusion: A large alpha angle (>57º) is significantly correlated with increased incidence of superior and posterosuperior labral tear, and larger tear size in patients with hip pain, and the relationships depend on age.

“…It was believed that only the ACEA CT sagittal reconstruction could indicate the real anterior coverage of the hip [ 8 ]. At present, there is no well-accepted reference value for the ACEA CT, and the relationship between the ACEA CT and long-term results has not yet been proven [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Determining anterior hip coverage in patients with hip dysplasia using the anterior center-edge angle on Lequesne’s false-profile radiograph and on computed tomography

Cheng

Journal of Hip Preservation Surgery

Luo

et al. 2023

Anterior hip coverage is important for hip stability. As a parameter of anterior hip coverage, the anterior center-edge angle on false-profile radiograph (ACEA FP) is associated with clinical outcomes. With the widespread application of computed tomography (CT), the anterior center-edge angle on CT (ACEA CT) has also been used to measure anterior hip coverage. Little is known about the reproducibility of the ACEA FP and ACEA CT in patients with hip dysplasia or the correlation between the ACEA CT and ACEA FP. In total, 49 hips of 49 patients who underwent periacetabular osteotomy in our center were included. The lateral center-edge angle, Tönnis angle, ACEA FP and ACEA CT were determined. We assessed the intraobserver and interobserver reliability of the ACEA FP and ACEA CT, the effect of the Tönnis angle on the reliability of the ACEA FP and ACEA CT and the correlation between the ACEA CT and ACEA FP. The intraobserver and interobserver interclass correlation coefficients of the ACEA FP were good, and those of the ACEA CT were very good. The Tönnis angle was weakly correlated with inconsistent ACEA FP measurements (P = 0.008) but not with inconsistent ACEA CT measurements (P = 0.600). No correlation between ACEA FP and ACEA CT measurements was observed (P = 0.213–0.665). The reproducibility of the ACEA CT is more consistent than that of the ACEA FP. The oblique acetabular roof had an effect on determining the ACEA FP but not on determining the ACEA CT. No correlation was observed between the measured ACEA FP and ACEA CT values, so the clinical evidence obtained from the ACEA FP cannot be directly applied to the ACEA CT.