Hip-spine relationship: a radio-anatomical study for optimization in acetabular cup positioning

Lazennec, Jean Yves; Charlot, N.; Gorin, Michael A.; Röger, B.; Arafati, N.; Bissery, Anne; Saillant, G

doi:10.1007/s00276-003-0195-x

Cited by 213 publications

(71 citation statements)

References 20 publications

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“…Sacral gradient was defined as the angle between the upper endplate of S1 and the horizontal plane. The sacral gradient averages 60° in the supine position [38], 40° in standing [19], and between 0° and 29° in the sitting position [18]. These authors [38] found anteversion measurements in all three positions diminished with forward pelvic tilt.…”

Section: Discussionmentioning

confidence: 99%

Multilevel Measurement of Acetabular Version Using 3-D CT-generated Models: Implications for Hip Preservation Surgery

Perreira

Hunter

Laird

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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BackgroundNumerous structural deformities of the acetabulum are associated with hip osteoarthritis (OA). Acetabular retroversion has been implicated in the development of femoroacetabular impingement. However, it is unknown if retroversion occurs from isolated excessive bone in the superior acetabulum or a torsional phenomenon of the entire pelvic segment.Questions/purposesA method was developed to measure acetabular version (AV) using 3-D models thus eliminating positional factors. This method was used to determine if acetabular retroversion is an isolated entity or an effect involving the entire pelvic segment containing the acetabulum.MethodFifty pelvic CT scans were selected from a large database. Measurements were performed for abduction, ischial spine position, and AV at multiple levels. The relationships between anteversion at multiple levels and between midacetabular anteversion and ischial spine position were analyzed.ResultsThe mean upper and midlevel acetabular anteversion values were 14.4° ± 10.5° and 21.3° ± 5.8°, respectively. The mean abduction was 39.7° ± 4.3°. The prevalence of acetabular retroversion was 7%. Females had greater anteversion than males at all levels. Correlations were found between Levels 1 and 4 version (r = 0.74) and the ischial spine index and Level 4 version (r = 0.67).ConclusionsThese data suggest retroversion involves the acetabulum at all levels and includes the entire pelvic segment containing the acetabulum and the ischial spine.Clinical RelevanceThese data are relevant for surgeons in providing targets for normal positioning of the acetabulum during periacetabular osteotomies and acetabular recontouring procedures.

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Section: Discussionmentioning

confidence: 99%

Multilevel Measurement of Acetabular Version Using 3-D CT-generated Models: Implications for Hip Preservation Surgery

Perreira

Hunter

Laird

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…The measurement of its angle with the vertical often exceeds 45° [17, 18]. This can be seen on scout views of pelvic CT scan.…”

Section: Fundamental Principles: Postural Variations Of the Lumbopelvmentioning

confidence: 99%

“…Most of the time these slices, perpendicular to the plane of the examination table, do not correspond to the anatomic plane because the position of the supine subject has a more or less marked sagittal pelvic tilt [17]. The variation in the anteversion measured is approximately 0.5 for 1° of rotation of the plane of the slice in relation to the pelvis [18, 34, 35]. …”

Section: Influence Of Sagittal Posture On Cross-sectional Acetabular mentioning

confidence: 99%

Hip–spine relations and sagittal balance clinical consequences

2011

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IntroductionThe role of the pelvic area in sagittal balance is evident for spinal surgeons, but the influence of the coxofemoral joint is underestimated and inadequately explained by conventional imagery. Comprehensive analysis of the pelvic and subpelvic sectors as part of the sagittal, frontal and cross-sectional balance of the trunk sheds new light on some spinal diseases and their relation to the pelvis.MethodsThis analysis, based on innovative radiologic methods as the EOS® technology but also on a new look at conventional imaging makes it possible to better analyze standing lateral images and seated images.ResultsDisturbances can come from atypical morphotypes or from unusual postures as in aging spine. The measurement of available extension and the concept of available flexion provide new information regarding individual’s adaptation to the imbalance induced by disorders of the spine or lower limbs.ConclusionA comprehensive assessment of each patient and in particular of the complex comprising the spine and the pelvis, is essential for understanding each individual’s adaptation to the imbalance induced by disorders of the spine or lower limbs.

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“…Acetabular parameters are less used in the management of CP: 1) acetabular anteversion (AAnt) reflects the rotation of the acetabulum around the vertical axis [22]. In order to render this angle morphological, the vertical axis was defined as the perpendicular to the sacral plate; 2) acetabular inclination (AInc) reflects the rotation of the acetabulum around the postero-anterior axis, defined as a parallel to the sacral plate [22,23]; 3) acetabular tilt reflects the rotation of the acetabulum around the mediolateral axis of the pelvis [24]. The list and the description of each of these parameters are detailed in Table 2 and displayed in Fig.…”

Section: Radiological Parametersmentioning

confidence: 99%

Three-dimensional evaluation of skeletal deformities of the pelvis and lower limbs in ambulant children with cerebral palsy

et al. 2016

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Skeletal abnormalities, affecting posture and walking pattern, increase with motor impairment in children with cerebral palsy (CP). However, it is not known whether these skeletal malalignments occur in children with slight motor impairment. Our aim was to evaluate skeletal malalignment at the level of the pelvis and lower limbs in ambulant children with CP, with slight motor impairment, using a low dose biplanar X-ray technique. Twenty-seven children with spastic CP (mean age: 10.9±4years, 7 Hemiplegia, 20 Diplegia, GMFCS levels I:17, II:10), with no previous treatments at the hips and knees, underwent EOS(®) biplanar X-rays. A control group consisting of 22 typically developing children was also included. Three-dimensional reconstructions of the pelvis and lower limbs were performed in order to calculate 11 radiological parameters related to the pelvis, acetabulum and lower limbs. Pelvic incidence and sacral slope were significantly increased in children with CP compared to TD children (48°±7° vs. 43°±8°, 42°±7° vs. 38°±5°, respectively, p=0.003). Acetabular parameters did not significantly differ between the two groups. Femoral anteversion and neck shaft angle were significantly increased in children with CP (25°±12° vs. 14°±7°, p<0.001; 134°±5° vs. 131°±5°, p=0.005 respectively). No difference was found for tibial torsion. This study showed that even slightly impaired children with CP have an anteverted and abducted femur and present positional and morphological changes of the pelvis in the sagittal plane. The orientation of the acetabulum in 3D seems to not be affected when children with CP present slight motor impairment.

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Hip-spine relationship: a radio-anatomical study for optimization in acetabular cup positioning

Cited by 213 publications

References 20 publications

Multilevel Measurement of Acetabular Version Using 3-D CT-generated Models: Implications for Hip Preservation Surgery

Multilevel Measurement of Acetabular Version Using 3-D CT-generated Models: Implications for Hip Preservation Surgery

Hip–spine relations and sagittal balance clinical consequences

Three-dimensional evaluation of skeletal deformities of the pelvis and lower limbs in ambulant children with cerebral palsy

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