Pelvic incidence and hip disorders

Abstract

Background and purposeThe role of pelvic incidence in hip disorders is unclear. Therefore, we undertook a literature review to evaluate the evidence on that role.MethodsA search was carried out on MEDLINE, SCOPUS, CENTRAL, and CINAHL databases. Quantitative analysis was based on comparison with a reference population of asymptomatic subjects.ResultsThe search resulted in 326 records: 15 studies were analyzed qualitatively and 13 quantitatively. The estimates of pelvic incidence varied more than 10 degrees from 47 (SD 3.7) to 59 (SD 14). 2 studies concluded that higher pelvic incidence might contribute to the development of coxarthrosis while 1 study reported the opposite findings. In 2 studies, lower pelvic incidence was associated with a mixed type of femoroacetabular impingement. We formed a reference population from asymptomatic groups used or cited in the selected studies. The reference comprised 777 persons with pooled average pelvic incidence of 53 (SD 10) degrees. The estimate showed a relatively narrow 95% CI of 52 to 54 degrees. The 95% CIs of only 4 studies did not overlap the CIs of reference: 2 studies on coxarthrosis, 1 on mixed femoroacetabular impingement, and 1 on ankylosing spondylitisInterpretationWe found no strong evidence that pelvic incidence plays any substantial role in hip disorders. Lower pelvic incidence may be associated with the mixed type of femoroacetabular impingement and hip problems amongst patients with ankylosing spondylitis. The evidence on association between pelvic incidence and coxarthrosis remained inconclusive.

Acetabular labral tear is associated with high pelvic incidence with or without femoroacetabular impingement morphology

“…No differences in symptom duration, sex, or BMI were found between the two groups (Table 4). When all of the participants were divided into two groups (pelvic incidence > 55°, pelvic incidence < 55°) based on earlier studies [18,38,41], pelvic incidence greater than 55° had a sensitivity of 45.4%, specificity of 86.7%, positive predictive value of 86.3%, and negative predictive value of 71.3% for predicting acetabular labral tears in all of the patients (Table 5). In patients without FAI, pelvic incidence greater than 55° had a sensitivity of 59.8%, specificity of 87.5%, positive predictive value of 84.5%, and negative predictive value of 65.6% for predicting acetabular labral tears (Table 6).…”

Impacto femoroacetabular e lesão do lábio acetabular – Parte 2: Diagnóstico clínico, exame físico e imagiologia

“…Observou-se também em estudos de imagem que baixa incidência pélvica (definida como o ângulo entre uma linha perpendicular ao ponto central do platô sacral e uma linha a partir deste ponto até o centro axial das cabeças femorais 16 ) ( Fig. 1 ), ou seja, maior inclinação anterior da pelve pode estar associada ao IFA de tipo misto, 17 à rotação pélvica, à fase de apoio, ao movimento dos membros superiores, e ao ângulo de progressão do pé (APP), o qual é normalmente cerca de 7° em direção lateral. 18 Retroversão femoral proximal e limitação da rotação medial são vistos frequentemente em pacientes com IFA, podendo levar a um APP em rotação lateral excessiva.…”

“…Imaging studies also revealed that low pelvic views (defined as the angle between a line perpendicular to the central point of the sacral plateau and a line from this point to the axial center of the femoral heads) 16 ( Fig. 1 ), that is, a greater pelvic anterior inclination, may be associated with mixed-type FAI, 17 pelvic rotation, stance phase, upper limb movement and foot progression angle (FPA), which is usually about 7° in the lateral direction. 18 Proximal femoral retroversion and medial rotation limitation are frequently seen in FAI patients, and may lead to an excessive FPA in lateral rotation.…”

Imaging Methodology for Hip Preservation: Techniques, Parameters, and Thresholds

“…143 Relationship of sagittal balance and hip disorders is currently controversial. 151 PI is an indicator of acetabular retroversion, 152 and patients with a higher PI have more anteriorly positioned femoral heads and a better ability to compensate for sagittal imbalance with pelvic retroversion. 150 Sagittal rotation also changes the socket orientation of the acetabulum, contributing to or protecting from FAI: The L-CEA and percentage of acetabular crossover increases with pelvic forward tilt and decreases with back tilt.…”

“…In fact, decreasing values of SS may allow greater impingement-free hip flexion by effectively reducing femoral coverage anteriorly. Saltychev et al, 151 however, challenged this relationship as not showing evidence of a substantial role of pelvic incidence in hip Angle between the line perpendicular to the sacral plate at its midpoint and a line from the midpoint between the axis of the two femoral heads to the center of the surface of the sacrum PI ¼ SS þ PT Imaging Methodology for Hip Preservation Mascarenhas et al 221 This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.…”