Lateral Center-edge Angle on Conventional Radiography and Computed Tomography

141

128

Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Are Normal Hips Being Labeled as Pathologic? A CT-based Method for Defining Normal Acetabular Coverage

Larson

Moreau–Gaudry

Kelly

et al. 2015

141

128

“…2A-C) [2,14]. The LCEA was measured using a coronal slice corresponding to the center of the acetabulum [4,26]. In measuring LCEA in an SCFEaffected hip when the femoral head was nonspherical, we utilized the medial part of epiphysis as a guide and assumed a spherical shape from that contour.…”

Section: Methodsmentioning

confidence: 99%

Is the Acetabulum Retroverted in Slipped Capital Femoral Epiphysis?

Monazzam

Venkatadass

Bittersohl

et al. 2013

Self Cite

Background Recent biplanar radiographic studies have demonstrated acetabular retroversion and increased superolateral femoral head coverage in hips with slipped capital femoral epiphysis (SCFE), seemingly divergent from earlier CT-based studies suggesting normal acetabular version. Question/purposes We therefore asked: Are there differences in (1) acetabular version at the superior 1 .4 of the acetabular dome (AV sup ), (2) acetabular version at the center of the femoral head (AV cen ), and (3) superolateral femoral head coverage (lateral center-edge angle [LCEA]) among affected SCFE hips, unaffected hips, and normal controls? Methods We identified 32 patients with SCFE who underwent CT between 2007 and 2012. Twenty-three met our inclusion criteria. Seventy-six age-and sex-matched normal patients comprised the control group. Pelvic rotation, tilt, and inclination were corrected on each CT. AV sup , AV cen , and LCEA were measured. Results The mean AV sup of the affected hips (À1.71°) demonstrated retroversion compared to the unaffected hips and the control group; the mean AV sup of the unaffected hips was similar to that of the normal controls. Mean AV cen was similar among the three groups. The LCEA was higher in affected and unaffected SCFE hips than in the control group (34.3°versus 34.5°versus 28.9°, respectively), but we found no difference between affected and unaffected hips. Conclusions Our data suggest an association of superior acetabular retroversion and increased superolateral femoral head coverage in SCFE. Whether this represents a primary abnormal morphology or a secondary pathologic response remains unclear. Further studies investigating the role of acetabular morphology in SCFE and its implications for development of symptomatic femoroacetabular impingement are warranted.

“…Thus, pre-and postoperative radiographs were measured as previously described [1,6,16] for the acetabular index, lateral centeredge angle (LCEA), anterior center-edge angle (ACEA), and Tönnis Grade of Osteoarthritis by an experienced clinician other than the operating surgeon (JAE). The reproducibility of these measures has been demonstrated as adequate to excellent in the literature [1,3,4,10,12,21]. The postoperative correction goals were defined as an acetabular index of 0°to 10°and center-edge angles (lateral and anterior) of 20°to 35°and remained consistent throughout the study.…”

Section: Variables Outcome Measures Data Sources and Biasmentioning

confidence: 99%

Preservation of the Rectus Femoris Origin During Periacetabular Osteotomy Does Not Compromise Acetabular Reorientation

Peters

Erickson

Anderson

et al. 2015

Background The early recovery period after periacetabular osteotomy (PAO) can be limited by pain and activity restrictions. Modifications of the Bernese PAO, including sparing the rectus tendon and discontinuing routine arthrotomy, may accelerate early postoperative recovery compared with the standard approach. Questions/purposes Does a modified approach for PAO (1) lead to improved pain control immediately after surgery; (2) lead to improved ambulation during the hospital stay; (3) lead to shorter stays, less blood loss, and shorter surgical times; and (4) compromise acetabular correction? Methods We retrospectively reviewed all 75 patients who underwent PAO for developmental dysplasia of the hip between August 2009 and May 2013. The control group included 44 consecutive patients who underwent a standard Bernese PAO with rectus takedown (RT). The study group consisted of 31 consecutive patients who underwent PAO using a modified rectus-sparing (RS) approach without routine arthrotomy. The groups were similar in age, body mass index, and American Society of Anesthesiologists score, but the RT group was comprised of a greater percentage of men than the RS group. Outcome variables were collected from patient charts and included inpatient pain, inpatient ambulation as well as length of stay, estimated blood loss, surgical time, and postoperative radiographic measurements. Cohen's f 2 was used to calculate the effect size in the regression analysis and effects were considered small for values \ 0.15, moderate for 0.15 to 0.34, and large for values [ 0.35. Results Patients who underwent PAO with a RS approach had less overall pain (RT median 4 versus RS median 2); however, the difference may not have been perceptible to the typical patient (p = 0.001, f 2 = 0.059). Patients treated with the RS approach ambulated similar distances during the hospital stay with a median 11 feet (interquartile range [IQR], 0-72.5) for the RT group and a median 30 feet (IQR, 0-100) for the RS group (p = 0.215, f 2 = 0.095).