Relationship Between the Lateral Center-Edge Angle and 3-Dimensional Acetabular Coverage

Wylie, James D.; Kapron, Ashley L.; Peters, Christopher L.; Aoki, Stephen K.; Maak, Travis G.

doi:10.1177/2325967117700589

Cited by 48 publications

(43 citation statements)

References 19 publications

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“…However, previous studies have reported that the inclination of the pelvis in the sagittal plane (pelvic sagittal inclination [PSI]) changes with patient posture and is altered after hip surgery. Understanding how PSI changes in several postures is important as it affects the measurements of femoral head coverage 1‐4 as well as the functional location of the acetabular cup in the setting of total hip arthroplasty (THA) 5,6 . As abnormal changes in PSI lead to progression of hip osteoarthritis and dislocation of the hip, 7,8 many studies have quantified PSI in different postures, with some of these including a large clinical cohort, 8,9 and a postoperative period of more than 10 years 10 …”

Section: Introductionmentioning

confidence: 99%

Can measurements from an anteroposterior radiograph predict pelvic sagittal inclination?

Uemura

Atkins

Okamoto

et al. 2020

Journal Orthopaedic Research

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Pelvic sagittal inclination (PSI) is often evaluated in patients with hip pathology using lateral radiographs. However, it would be useful if PSI could be predicted from an anteroposterior radiograph since this film is ubiquitous in the evaluation of hip pathology. Herein, computer‐modeling was applied to predict PSI from radiographic measurements assessed in the anteroposterior plane. Three‐dimensional surface models of the pelvis, femur, and sacrum were reconstructed from computed tomography images of 50 women with hip dysplasia. This study cohort was selected as changes in PSI alter femoral head coverage, which is relevant to the diagnosis and treatment of hip dysplasia, a known cause of hip osteoarthritis. Five radiographic parameters commonly used to independently estimate PSI were evaluated after bone surfaces were projected to an anteroposterior plane, including the symphysis to sacrococcygeal joint distance (S‐S distance), the pelvic foramen aspect ratio (PF ratio), the distance between the symphysis and a line connecting the femoral head centers (S‐H distance), the sacro‐femoral‐pubic angle (SFP angle), and the pelvic vertical ratio (PVR). Regression models determined the ability of these parameters to predict PSI from −20° to 20° at 1° increment. All five parameters showed a strong correlation with the PSI (all r > 0.9). From the regression models, PSI was estimated with a median (maximum) absolute error of 3.6° (18.4°), 3.8° (17.7°), 5.2° (17.9°), 5.8° (28.8°), and 3.2° (23.5°) for the S‐S distance, PF ratio, S‐H distance, SFP angle, and PVR, respectively. The regression model for S‐S distance had a mean slope of 2.18 that ranged from 1.98 to 2.41 when the sacrococcygeal joint was located superior to the symphysis. Results indicated that substantial errors occur when estimating the actual value of PSI from an anteroposterior radiograph. However, the change in PSI could be estimated from the S‐S distance, which may aid surgeons to successfully increase head coverage through periacetabular osteotomy and to locate the acetabular cup in a functional position for total hip arthroplasty.

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Section: Introductionmentioning

confidence: 99%

Can measurements from an anteroposterior radiograph predict pelvic sagittal inclination?

Uemura

Atkins

Okamoto

et al. 2020

Journal Orthopaedic Research

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“…56,60 It is important to distinguish precisely between W-CEA and L-CEA. 17,59,61,62 The W-CEA represents the weightbearing supero/lateral coverage and the L-CEA expresses the bony acetabular extension laterally.…”

Section: Acetabular Assessmentsmentioning

confidence: 99%

“…10c). The location of point E on the lateral margin of the weightbearing zone may be difficult to determine; by CT, it is located where the concave acetabular roof ends laterally 56,61 or at the lateral margin of the dense subchondral bone. 56 On MRI, the point of the transition between the acetabular cartilage and the labrum was suggested.…”

Section: Acetabular Assessmentsmentioning

confidence: 99%

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

Mascarenhas

Ayeni

Egund

et al. 2019

Semin Musculoskelet Radiol

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The concept of hip impingement and hip-preserving surgery has been appreciated in more detail since 2001 when a new surgical approach was reported and a hypothesis linking femoroacetabular impingement (FAI) with osteoarthritis was presented. Paralleling the introduction of hip arthroscopy, these events led to an increasing interest in the hip, and the number of publications has risen rapidly over the past 15 years, despite limited evidence levels and inconsistent methodology. Accordingly, etiology, diagnosis, prognosis, and the effects of treatment for FAI are still elusive due to a number of uncertainties and a lack of clear diagnostic criteria.Future research must focus on developing high-quality scientific studies, so thorough and reproducible methodology is needed. This review provides researchers, radiologists, and clinicians with a comprehensive approach to hip imaging with a focus on strategies to help guide the clinical diagnosis. Using evidence from current literature and knowledge from experienced clinicians, some of the imaging methodology challenges are deciphered.

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“…Using this coordinate system, the nodes of the femoral head were sorted into quadrants about the transverse axis ( Fig. 2C) (Harris et al, 2014;Wylie et al, 2017).…”

Section: Analysis Of Total and Regional Femoral Head Coveragementioning

confidence: 99%

“…A major limitation of these prior studies is that 3-D coverage was based on reconstructions of volumetric images acquired in the supine position. Previous 2-D radiographic studies found a difference in coverage among supine and standing positions (Henebry and Gaskill, 2013;Pullen et al, 2014;Wylie et al, 2017). Thus, it follows that femoral head coverage could change during gait, but these measurements are not available.…”

Section: Introductionmentioning

confidence: 96%

Three‐dimensional femoral head coverage in the standing position represents that measured in vivo during gait

et al. 2018

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Individuals with over- or under-covered hips may develop hip osteoarthritis. Femoral head coverage is typically evaluated using radiographs, and/or computed tomography (CT) or magnetic resonance images obtained supine. Yet, these static assessments of coverage may not provide accurate information regarding the dynamic, three-dimensional (3-D) relationship between the femoral head and acetabulum. The objectives of this study were to: (1) quantify total and regional 3-D femoral head coverage in a standing position and during gait, and (2) quantify the relationship between 3-D femoral head coverage in standing to that measured during gait. The kinematic position of the hip during standing and gait was measured in vivo for 11 asymptomatic morphologically normal subjects using dual fluoroscopy and model-based tracking of 3-D CT models. Percent coverage in the standing position and during gait was measured overall and on a regional basis (anterior, superior, posterior, inferior). Coverage in standing was correlated with that measured during gait. For total coverage, very little change in coverage occurred during gait (range: 35.0-36.7%; mean: 36.2%). Coverage at each time point of gait strongly correlated with coverage during standing (r = 0.929-0.989). The regions thought to play an important role in weight bearing (i.e. anterior, superior, posterior) were significantly correlated with coverage in standing during the stance phase. Our results suggest that coverage measured in a standing position is a good surrogate for coverage measured during gait. Clin. Anat. 9999:1-7, 2018. © 2018 Wiley Periodicals, Inc.

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Relationship Between the Lateral Center-Edge Angle and 3-Dimensional Acetabular Coverage

Cited by 48 publications

References 19 publications

Can measurements from an anteroposterior radiograph predict pelvic sagittal inclination?

Can measurements from an anteroposterior radiograph predict pelvic sagittal inclination?

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

Three‐dimensional femoral head coverage in the standing position represents that measured in vivo during gait

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