Limited Intraobserver and Interobserver Reliability for the Common Measures of Hip Joint Congruency Used in Dysplasia

Larson, A. Noelle; Rabenhorst, Brien M; Rocha, Adriana De La; Sucato, Daniel J.

doi:10.1007/s11999-011-2136-z

Cited by 15 publications

(16 citation statements)

References 18 publications

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“…The dysplastic hip has been described qualitatively as less congruent than the normal hip based on two-dimensional radiographs [17, 18]. This qualitative description has resulted in poor inter- and intra-observer reliability in reporting congruency in dysplastic hips [19, 20]. Further, congruency has previously been described globally and only on the bony surfaces [17, 18].…”

Section: Introductionmentioning

confidence: 99%

Patient-specific analysis of cartilage and labrum mechanics in human hips with acetabular dysplasia

Henak

Abraham

Anderson

et al. 2014

Osteoarthritis and Cartilage

144

128

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BACKGROUND Acetabular dysplasia is a major predisposing factor for development of hip osteoarthritis, and may result from alterations to chondrolabral loading. Subject-specific finite element (FE) modeling can be used to evaluate chondrolabral mechanics in the dysplastic hip, thereby providing insight into mechanics that precede osteoarthritis. OBJECTIVE To evaluate chondrolabral contact mechanics and congruency in dysplastic hips and normal hips using a validated approach to subject-specific FE modeling. METHODS FE models of ten subjects with normal acetabula and ten subjects with dysplasia were constructed using a previously validated protocol. Labrum load support, and labrum and acetabular cartilage contact stress and contact area were compared between groups. Local congruency was determined at the articular surface for two simulated activities. RESULTS The labrum in dysplastic hips supported 2.8 to 4.0 times more of the load transferred across the joint than in normal hips. Dysplastic hips did not have significantly different congruency in the primary load-bearing regions than normal hips, but were less congruent in some unloaded regions. Normal hips had larger cartilage contact stress than dysplastic hips in the few regions that had significant differences. CONCLUSIONS The labrum in dysplastic hips has a far more significant role in hip mechanics than it does in normal hips. The dysplastic hip is neither less congruent than the normal hip, nor subjected to elevated cartilage contact stresses. This study supports the concept of an outside-in pathogenesis of osteoarthritis in dysplastic hips and that the labrum in dysplastic hips should be preserved during surgery.

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Section: Introductionmentioning

confidence: 99%

Patient-specific analysis of cartilage and labrum mechanics in human hips with acetabular dysplasia

Henak

Abraham

Anderson

et al. 2014

Osteoarthritis and Cartilage

144

128

View full text Add to dashboard Cite

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“…However, there is always uncertainty in measureing bony parameters for unsure margin of the bony acetabulum [10]. In our study, congruence of articulating is seen at every position in the normal hip joint during development.…”

Section: Discussionmentioning

confidence: 57%

“…Margin of the bony acetabulum was hard to identify in some cases for irregular ossification. There is similar trouble when we measure acetabular angle (AA) in radiography, which result in inaccurate quantitative evaluation [10]. Base on the ball-and-socket shape the hip joint, radial scanning through the centre of femoral head can better reflect the physiological status of the joint.…”

Section: Discussionmentioning

confidence: 99%

Coverage of Femoral Head at Weight-Bearing Interface of the Hip Joint in Children: An MRI Analysis

Zeng¹,

Liu²,

Xu³

et al. 2013

OJMI

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Objective: To analyze the features of coverage of femoral head at weight-bearing interface of the hip joints in children. Material and Methods: MRI scans of the hips were performed in 95 normal children aged from 1 to 8 years. Radial scans of the hip joints were performed using FFE sequence. Review the morphological features of weight-bearing interface of the acetabulum and the femoral head. Total covering angle (TCA), acetabular covering angle (ACA) and labral covering angle (LCA) were measured, inter-group comparison and correlation analysis were done. Result: The acetabulum and the femoral head had congruent articulating surface at each weight-bearing position. There was no statistical TCA difference at each position. Average ACA increased, while average LCA decreased from anterior to posterior. TCA correlated with LCA, ACA negatively correlated with LCA. Conclusion: TCA is a good index in indicating stability of the hip joint. Cartilage ossifies slower at posterior than anterior positions. Cartilage acetabulum and the labrum serve as complementary structures that contribute in total stabilizing of the hip joint in development.

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“…Interobserver reliability of these measurements was excellent for preoperative radiographs but dropped to moderate for the postoperative radiographs. One author referenced review of several methods of measuring hip joint congruity of Larson et al 77 in a hip dysplasia population. 54 Larson et al found poor intra-and interobserver reliabilities of these methods, and they have not been described in an acetabular fracture population.…”

Section: Discussionmentioning

confidence: 99%

“…9,28,77 Their work demonstrates that CT scans are more accurate at identifying residual articular steps and gaps at the joint surface after surgery when compared with plain radiography. In the largest study, however, Archdeacon et al found that management was changed in only 2.5% of cases based on the postoperative CT scan.…”

Section: Discussionmentioning

confidence: 99%

Radiographic Measurement of Displacement in Acetabular Fractures: A Systematic Review of the Literature

Dodd

Osterhoff

Guy

et al. 2016

Journal of Orthopaedic Trauma

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OBJECTIVES: To report methods of measurement of radiographic displacement and radiographic outcomes in acetabular fractures described in the literature. METHODS: A systematic review of the English literature was performed using EMBASE and Medline in August 2014. Inclusion criteria were studies of operatively treated acetabular fractures in adults with acute (<6 weeks) open reduction and internal fixation that reported radiographic outcomes. Exclusion criteria included case series with <10 patients, fractures managed >6 weeks from injury, acute total hip arthroplasty, periprosthetic fractures, time frame of radiographic outcomes not stated, missing radiographic outcome data, and non-English language articles. Basic information collected included journal, author, year published, number of fractures, and fracture types. Specific data collected included radiographic outcome data, method of measuring radiographic displacement, and methods of interpreting or categorizing radiographic outcomes. DATA SYNTHESIS: The number of reproducible radiographic measurement techniques (2/64) and previously described radiographic interpretation methods (4) were recorded. One radiographic reduction grading criterion (Matta) was used nearly universally in articles that used previously described criteria. Overall, 70% of articles using this criteria documented anatomic reductions. CONCLUSIONS: The current standard of measuring radiographic displacement in publications dealing with acetabulum fractures almost universally lacks basic description, making further scientific rigor, such as testing reproducibility, impossible. Further work is necessary to standardize radiographic measurement techniques, test their reproducibility, and qualify their validity or determine which measurements are important to clinical outcomes. LEVEL OF EVIDENCE: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Limited Intraobserver and Interobserver Reliability for the Common Measures of Hip Joint Congruency Used in Dysplasia

Cited by 15 publications

References 18 publications

Patient-specific analysis of cartilage and labrum mechanics in human hips with acetabular dysplasia

Patient-specific analysis of cartilage and labrum mechanics in human hips with acetabular dysplasia

Coverage of Femoral Head at Weight-Bearing Interface of the Hip Joint in Children: An MRI Analysis

Radiographic Measurement of Displacement in Acetabular Fractures: A Systematic Review of the Literature

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