Comment on Jia et al.: Three dimensional CT evaluation of femoral neck anteversion, acetabular anteversion and combined anteversion in unilateral DDH in an early walking age group

Mootha, Aditya Krishna; Saini, Raghav

doi:10.1007/s00264-012-1558-x

Cited by 5 publications

(8 citation statements)

References 2 publications

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“…Since applying this method in the clinic, we have achieved good therapeutic effect, because we calculated the rotation angle of proximal femoral osteotomy based on the FNA measured by 3D-CT method before surgeries, and performed osteotomy according to the calculation result mentioned above. Previous studies have shown that the stability and repeatability in measurement results of our 3D-CT method are signi cantly better than that of 2D-CT method, but some scholars still question the accuracy of our measurement results [13]. It is di cult to accurately measure the femur structure in human body, and DDH patients are children, so we cannot take the real femur for accurate FNA measurement.…”

Section: Discussionmentioning

confidence: 91%

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Accuracy of CT for Measuring Femoral Neck Anteversion in Children With Developmental Dislocation of the Hip Verified Using 3D Printing Technology

Cai¹,

Piao

Zhang

et al. 2021

Preprint

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Background: Accurate femoral neck anteversion angle (FNA) measurement is of great significance in the diagnosis and treatment of developmental dysplasia of the hip (DDH) in children. The FNA measurement still remains a controversy. We aimed to verify the accuracy of our CT method by 3D printing technology , and to evaluate its clinical value. Methods: Sixty-eight children with unilateral DDH were enrolled, and their FNA was measured using 2D-CT and 3D-CT, respectively, by three observers. This procedure was repeated 3 months later. The above measurement outcomes were then compared with the results in the 3D-printed femur (3D-PF) model. The FNA in the 3D-PF model was measured by three observers collectively through electronic angle instrument. Results: The primary measurement of FNA at the affected hips by 2D-CT was 44.0±6.1, 49.5±8.9 and 52.8±7.9 degrees, respectively. On the 3D-CT, it was 47.6±5.4, 49.3±6.8 and 48.6±6.2 degrees. Three months later, the FNA on 2D-CT was 49.3±10.5, 42.8±7.4 and 45.1±9.3 degrees, and it was 48.0±6.5, 48.9±7.2 and 49.0±5.7 degrees on 3D-CT, respectively. The FNA in the 3D-PF model at the affected and unaffected hips was 48.5±6.6 and 36.9±13.1 degrees. There were significant differences between 2D-CT and 3D-PF measurements, but no significant difference was found between 3D-CT and 3D-PF measurements. The results by 2D-CT showed significant differences among groups and between the groups. However, the results by 3D-CT had no significant differences among groups or between the groups. Conclusion: The results of our study showed that 3D-CT is a more precise, and reproducible method for FNA measurement in DDH. The FNA at the affected hips is 11.6 degree larger than the unaffected in DDH children aged 3-8 years.

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Section: Discussionmentioning

confidence: 91%

“…We also have designed a FNA 3D-CT measurement method [12], and found that this method has good stability, repeatability, and high clinical value. However, the accuracy still raised some doubts [13].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of CT for Measuring Femoral Neck Anteversion in Children With Developmental Dislocation of the Hip Verified Using 3D Printing Technology

Cai¹,

Piao

Zhang

et al. 2021

Preprint

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“…It is widely accepted that increased anteversion angles of untreated dislocated hips in older children may reflect a remodeling failure secondary to an altered hip position. 18 The gradual decline in anteversion angle from birth to maturity is unlikely to occur when the hip remains dislocated. Our results suggest that the increase in femoral anteversion may be a secondary phenomenon or the result of an increased risk of failure of reduction in infants under 1 year of age.…”

Section: Discussionmentioning

confidence: 99%

Femoral morphology in Ortolani’s anatomical collection of developmental dysplasia of the hip: Anteversion is unrelated to severity of infantile dysplasia

Huayamave

Chambers

Fantoni

et al. 2023

Journal of Children's Orthopaedics

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Purpose: This study evaluated and quantified femoral anteversion and femoral head sphericity in healthy and dysplastic hips of post-mortem infant specimens from Ortolani’s collection. Methods: Healthy hips and hips with cases of dysplasia, with a large variety of severity, were preserved. Morphological measurements were taken on 14 specimens (28 hips), with a mean age of 4.68 months. The degree of dysplasia was classified as mild (A) to severe (D); 11 hips were Grade A, 6 hips were Grade B, 7 hips were Grade C, and 4 hips were Grade D. The femoral anteversion angle, the minimum femoral head diameter, and the maximum femoral head diameter were measured. The minimum and maximum femoral head diameters were used to estimate femoral head sphericity. Results: The mean femoral anteversion angle was 30.81 degrees ± 11.07 degrees in cases and 29.69 degrees ± 12.69 degrees in controls. There were no significant differences between the normal-to-mild group and moderate-to-severe group when comparing the femoral anteversion angle (p = 0.836). The mean estimated sphericity was 1.08 mm ± 0.50 mm in cases and 0.81 mm ± 0.65 mm in controls, with no statistically significant difference between the groups (p = 0.269). Conclusion: Ortolani’s collection showed no significant differences between healthy and dysplastic hips in specimens under 1 year of age. While the femoral head appeared slightly more flattened in dysplastic hips, it was not statistically significant. The findings in the unique collection add to the knowledge of the pathoanatomy of infantile hip dysplasia. Clinical Relevance: Femoral anteversion may not play a role in the etiology and pathogenesis of DDH.

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“…Since applying this method in the clinic, we have achieved good therapeutic effect, because we calculated the rotation angle of proximal femoral osteotomy based on the FNA measured by 3D-CT method before surgeries, and performed osteotomy according to the calculation result mentioned above. Previous studies have shown that the stability and repeatability in measurement results of our 3D-CT method are significantly better than that of 2D-CT method, but some scholars still question the accuracy of our measurement results [ 16 , 33 ]. It is difficult to accurately measure the femur structure in human body, and DDH patients are children, so we cannot take the real femur for accurate FNA measurement.…”

Section: Discussionmentioning

confidence: 99%

“…We also have designed a FNA 3D-CT measurement method [ 15 ] and found that this method has good stability, repeatability, and high clinical value. However, the accuracy has still raised some doubts [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of CT for measuring femoral neck anteversion in children with developmental dislocation of the hip verified using 3D printing technology

et al. 2021

View full text Add to dashboard Cite

Background Accurate femoral neck anteversion angle (FNA) measurement is of great significance in the diagnosis and treatment of developmental dysplasia of the hip (DDH) in children. The FNA measurement still remains a controversy. We aimed to verify the accuracy of our CT method by 3D printing technology and to evaluate its clinical value. Methods Sixty-eight children with unilateral DDH were enrolled, and their FNA was measured using 2D-CT and 3D-CT, respectively, by three observers. This procedure was repeated 3 months later. The above measurement outcomes were then compared with the results in the 3D-printed femur (3D-PF) model. The FNA in the 3D-PF model was measured by three observers (two radiologists and one orthopedist; all were professors) collectively through electronic angle instrument. Results The primary measurement of FNA at the affected hips by 2D-CT was 44.0 ± 6.1, 49.5 ± 8.9, and 52.8 ± 7.9°, respectively. On the 3D-CT, it was 47.6 ± 5.4, 49.3 ± 6.8, and 48.6 ± 6.2°. Three months later, the FNA on 2D-CT was 49.3 ± 10.5, 42.8 ± 7.4, and 45.1 ± 9.3°, and it was 48.0 ± 6.5, 48.9 ± 7.2, and 49.0 ± 5.7° on 3D-CT, respectively. The FNA in the 3D-PF model at the affected and unaffected hips was 48.5 ± 6.6 and 36.9 ± 13.1°. There were significant differences between 2D-CT and 3D-PF measurements, but no significant difference was found between 3D-CT and 3D-PF measurements. The results by 2D-CT showed significant differences among groups and between the groups. However, the results by 3D-CT had no significant differences among groups or between the groups. Conclusion The results of our study showed that 3D-CT is a more precise, and reproducible method for FNA measurement in DDH. The FNA at the affected hips is 11.6° larger than the unaffected in DDH children aged 3–8 years.

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Comment on Jia et al.: Three dimensional CT evaluation of femoral neck anteversion, acetabular anteversion and combined anteversion in unilateral DDH in an early walking age group

Cited by 5 publications

References 2 publications

Accuracy of CT for Measuring Femoral Neck Anteversion in Children With Developmental Dislocation of the Hip Verified Using 3D Printing Technology

Accuracy of CT for Measuring Femoral Neck Anteversion in Children With Developmental Dislocation of the Hip Verified Using 3D Printing Technology

Femoral morphology in Ortolani’s anatomical collection of developmental dysplasia of the hip: Anteversion is unrelated to severity of infantile dysplasia

Accuracy of CT for measuring femoral neck anteversion in children with developmental dislocation of the hip verified using 3D printing technology

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