Morphometric analysis of acetabular dysplasia in cerebral palsy

Abstract

We carried out a morphometric analysis of acetabular dysplasia in patients with cerebral palsy requiring hip surgery using three-dimensional CT. We evaluated 54 hips in 27 patients. The contralateral normal hips of ten patients with unilateral Perthes' disease were used as a control group. The acetabular defects were assessed qualitatively as anterior, posterior or global. Quantitative assessments were made using three-directional acetabular indices (anterosuperior, superolateral and posterosuperior) and measured by multiplanar reformation, from which we calculated the acetabular volume. In the qualitative study, posterior defects were most common in the subluxation group whereas global defects predominated in the dislocation group. In the quantitative study, all acetabular indices in both the subluxation and dislocation groups were higher than those in the control group and the superolateral indices showed a tendency to elevation in the dislocation group. The acetabular volume was largest in the control group, smallest in the dislocation group, and intermediate between the two in the subluxation group.

Morphometric changes in the acetabulum after Dega osteotomy in patients with cerebral palsy

“…6,9,13 We found that the volume was increased after Dega osteotomy. Previously, Ozgur et al 13 used the coronal image obtained on MRI to calculate acetabular volume in DDH.…”

“…1). The acetabular volume was determined by integrating the acetabular area in the axial image and the slice thickness, 6 a method which has been verified by Slomczykowski et al 9 In order to establish the inter-and intra-observer reliability of the CT measurements, they were undertaken by two orthopaedic surgeons (CYC, MSP) and a chief resident. The orthopaedic surgeons had 20 and five years' experience, respectively.…”

“…1,2 The acetabular defects in cerebral palsy differ from those in developmental dysplasia of the hip (DDH) and posterior, anterior, superior and global wall defects have been reported. [2][3][4][5] In a previous study, 6 we carried out a morphometric analysis of the acetabulum in patients with cerebral palsy. Quantitative measurements of the acetabular shape showed a lack of anterosuperior, superolateral and posterosuperior cover and a decrease in volume.…”

“…Quantitative measurements of the acetabular shape showed a lack of anterosuperior, superolateral and posterosuperior cover and a decrease in volume. 6 The Dega osteotomy has been modified to obtain posterior cover in patients with cerebral palsy, 1,2 but the morphometric changes have not so far been clarified. In this study, we have examined the acetabular changes after a Dega osteotomy using three-dimensional (3D) CT, and its effect on acetabular cover.…”

Determinants of Hip Displacement in Children With Cerebral Palsy

“…The degree of acetabular dysplasia has been known to correlate with the migration percentage of hip displacement [6,9,17]. With femoral deformities, imbalance of muscle forces and lack of ambulation lead to excessive anteversion and coxa valga that increase with the levels of gross motor function [31].…”