Role of the Anterior Center-Edge Angle on Acetabular Stress Distribution in Borderline Development Dysplastic of Hip Determined by Finite Element Analysis

Abstract

Background: The joint with hip dysplasia is more likely to develop osteoarthritis because of the higher contact pressure, especially in the socket. The lateral center-edge angle (LCEA) is the major indicator for hip dysplasia via radiography. However, the pathological conditions of LCEA angles in the range of 18°–25° are still controversial, which challenges precise diagnosis and treatment decision-making.Objective: The purpose of this study is to investigate the influence of anterior center-edge angle (ACEA) on the mechanical stress distribution of the hip joint, via finite element analysis, to provide insights into the severity of the borderline development dysplasia.Methods: From 2017 to 2019, there were 116 patients with borderline developmental dysplasia of the hip (BDDH) enrolled in this research. Based on the inclusion criteria, nine patients were involved and categorized into three LCEA groups with the maximal ACEA differences. Patient-specific hip joint models were reconstructed from computed tomography scans, and the cartilages, including the labrum, were established via a modified numerical method. The finite element analysis was conducted to compare the stress distributions due to the different ACEA.Results: As ACEA decreased, the maximum stress of the acetabulum increased, and the high stress area developed toward the edge. Quantitative analysis showed that in the cases with lower ACEA, the area ratio of high stress increased, and the contact facies lunata area significantly affected the stress distribution.Conclusion: For patients with BDDH, both the ACEA and the area of facies lunata played essential roles in determining the severity of hip dysplasia and the mechanical mechanism preceding osteoarthritis.

Understanding Hip Contact Stress Based on Hip Morphometry and Types of Physical Activity : A Systematic Review

“…A more favorable angle provides improved joint congruency and stability, distributing forces more evenly across the joint. [18,48,49] Three studies exploring the role of Center Edge Angle (CEA) to evaluate hip joint contact stress, but did not nd any consistent effect between the degree of CEA and hip contact stress. Furthermore, there was no evident correlation between changes in the CEA and hip contact stress (Fig.…”

Can we determine anterior hip coverage from pelvic anteroposterior radiographs? A study of patients with hip dysplasia

“…However, the lack of anterior hip coverage can cause symptoms around the hip joint as well as lack of lateral coverage [2][3][4]. Following the increasing understanding of the 3D morphology of the hip joint, an increasing emphasis has been placed on the importance of anterior hip coverage by not only joint surgeons [2,5,6] but also pediatric orthopedic surgeons [3,7] and sports medicine surgeons [8][9][10], especially for borderline hip dysplasia [3,9,[11][12][13].…”

“…It is widely accepted by hip surgeons that the anterior center edged angle (ACEA) measured on FP radiographs can be utilized in determining the anterior coverage of the hip joint, although there is one study that found that the ACEA (measured by a different method) may have limited ability to predict threedimensional coverage of the femoral head in patients with developmental dysplasia of the hip [25]. An association between ACEA and clinical outcomes has been revealed in previous studies [3,9,12,[26][27][28][29], with it being a powerful predictor of a surgery [3].…”

Can we determine anterior hip coverage from pelvic anteroposterior radiographs? A study of patients with hip dysplasia

“…[1][2][3] Following the increasing understanding of the 3D morphology of the hip joint, an increasing emphasis has been placed on the importance of anterior hip coverage by not only joint surgeons [1,4,5] but also sports medicine surgeons[6-8] and pediatric orthopedic surgeons [2,9], especially for borderline hip dysplasia. [2,7,[10][11][12] An accurate measurement of anterior hip coverage is crucial to determine whether patients with hip dysplasia need hip preservation surgery. It is also a crucial factor in estimating the outcome of hip preservation surgery.…”