The anterior center edge angle has limited ability to predict three-dimensional coverage of the femoral head in patients with developmental dysplasia of the hip undergoing curved periacetabular osteotomy

Uemura, Keisuke; Hiraiwa, Toshihito; Okamoto, Masashi; Tokunaga, Kunihiko; Anderson, Andrew E.

doi:10.1007/s00402-021-04258-4

Cited by 5 publications

(5 citation statements)

References 29 publications

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Section: Discussionmentioning

confidence: 99%

“…Another study shows that some women need to use relaxin to relax the pelvic ligaments during childbirth, but relaxin can enter the fetus through the placental barrier, which may lead to relaxation of the ligaments around the acetabulum and become a potential risk of DDH in infants and young children. Adductor tension contracture is an important pathological change in children with DDH aged 0-6 months, and most Evidence-Based Complementary and Alternative Medicine hips can be reduced after release of the adductor muscle [14,15]. e prevalence of developmental dysplasia of the hip varies between different geographic regions and races, and the prevalence in China is about 1-3 per 1,000, with the incidence in girls being about 3-6 times higher than that in boys [16].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Efficacy and Safety of Ibuprofen plus Traction, Reposition, and Hip Spica Cast in the Treatment of Developmental Dysplasia of the Hip

Feng

Liu

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To assess the clinical efficacy and safety of ibuprofen plus traction, reposition, and hip spica cast in the treatment of developmental dysplasia of the hip (DDH). Methods. Between January 2019 and July 2020, 60 children with DDH treaded in department of orthopedics of our institution were assessed for eligibility and recruited. They were assigned at a ratio of 1 : 1 to receive either traction + reposition + hip spica cast plus analgesia pump (observation group) or traction + reposition + hip spica cast plus analgesia pump and oral ibuprofen (control group). The outcome measures included clinical efficacy, pain scores, unexpected pain calls, the dosage of analgesia pump, and adverse events. Results. The two groups had similar clinical efficacy ( P > 0.05 ). The patients given oral ibuprofen were associated with significantly lower pain scores at 24 h and 72 h postoperatively versus those without oral ibuprofen ( P < 0.05 ). Analgesics with oral ibuprofen resulted in fewer unexpected pain calls versus analgesics without oral ibuprofen within 72 h postoperatively ( P < 0.05 ). The application of oral ibuprofen in the analgesia pump showed great improvement in lowering the dosage of analgesia pump versus the absence of ibuprofen ( P < 0.05 ). The incidence of adverse events was similar between the two groups of patients ( P > 0.05 ). Conclusion. Traction + reposition + hip spica cast plus analgesia pump and oral ibuprofen effectively mitigated postoperative pain in children with DDH and reduces analgesic drug dosage with a high safety profile.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy and Safety of Ibuprofen plus Traction, Reposition, and Hip Spica Cast in the Treatment of Developmental Dysplasia of the Hip

Feng

Liu

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…However, these angles cannot characterize different acetabular deficiency patterns in 3 dimensions. 13 , 17 , 30 Several investigators have assessed 3D femoral head coverage beyond 2D evaluation. 2 , 5 , 17 , 22 , 27 , 30 Nepple et al 22 measured radial coverage angles at different acetabular clockface positions in 3D computed tomography (CT) and showed considerable variability in deficiency patterns, including global and locally reduced coverage in the anterosuperior and posterosuperior regions, providing an in-depth characterization of the femoral head coverage.…”

mentioning

confidence: 99%

“… 13 , 17 , 30 Several investigators have assessed 3D femoral head coverage beyond 2D evaluation. 2 , 5 , 17 , 22 , 27 , 30 Nepple et al 22 measured radial coverage angles at different acetabular clockface positions in 3D computed tomography (CT) and showed considerable variability in deficiency patterns, including global and locally reduced coverage in the anterosuperior and posterosuperior regions, providing an in-depth characterization of the femoral head coverage. 22 , 32 Thus, 3D femoral head coverage assessment is clinically important for pre- and postoperative evaluation of hip dysplasia.…”

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confidence: 99%

Prediction of 3-Dimensional Coverage Surface Area of the Femoral Head in Hip Dysplasia Through Conventional Computed Tomography

Kamenaga,

Ritacco,

Slullitel

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: Assessment of 3-dimensional (3D) femoral head coverage is critical in evaluating, preoperative planning, and treating hip dysplasia. Purpose: To (1) propose a mathematical model to establish 3D femoral head coverage using conventional computed tomography (CT), (2) determine the correlation of 2D parameters with 3D coverage, and (3) characterize the patterns of dysplasia based on 3D morphology. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We identified 30 patients (n = hips) with symptomatic dysplasia and 30 patients (n = hips) without dysplasia. Patients with dysplastic hips were matched with regard to sex, age, and body mass index to those with nondysplastic hips. Preoperative CTs were analyzed using 3D software, and 3D femoral head surface area coverage (FHSAC; in %) was assessed in 4 quadrant zones: anteromedial, anterolateral, posteromedial, and posterolateral. To assess lateral coverage of the femoral head, we introduced the anterolateral femoral head coverage angle (ALFC) and the posterolateral femoral head coverage angle (PLFC). Results: Reduced femoral head coverage was more pronounced in dysplastic versus nondysplastic hips in the anterolateral quadrant (18% vs 40.7%, respectively) and posterolateral quadrant (35.8% vs 56.9%, respectively) ( P < .0001 for both). Dysplastic hips had smaller ALFC and PLFC (18.4° vs 38.7°; P < .0001; 47.2° vs 72.3°; P = .0002). Anterolateral and posterolateral FHSAC were strongly correlated with the ALFC ( r = 0.88; P < .0001) and the PLFC ( r = 0.82; P < .0001) along with the lateral center-edge angle (anterolateral, r = 0.75; P < .0001; posterolateral, r = 0.73; P < .0001). Prediction models established for FHSAC had strong agreement with explanatory CT variables (anterolateral: r = 0.91; P < .0001; posterolateral: r = 0.90; P < .0001). The cutoff values for anterolateral and posterolateral FHSAC were 25% and 41%, respectively. In dysplastic hips, global deficiency was most common (15/30 hips), 9 hips showed an anterolateral deficiency, and 4 hips had a posterolateral deficiency pattern. Conclusion: The ALFC and The PLFC were strongly correlated with 3D lateral FHSAC and were able to predict 3D coverage accurately.

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“… 3 , 5 , 6 Some researchers have used the anterior bone edge as the anterior edge of the acetabulum, on which it is easier to select points for measurement, instead of the edge of the acetabular sourcil. 12 , 23 , 30 However, these measurements have proven to be different in patients with normal or mild acetabular dysplasia. To our knowledge, it has not yet been determined which landmark can be a more instructive measurement for guiding hip preservation surgery.…”

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confidence: 99%

Comparison of Anterior Center-Edge Angle Measured From the Acetabular Sourcil Versus the Anterior Bone-Edge of the Acetabulum: A Descriptive Laboratory Study

Cheng,

Ren,

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: Measuring anterior hip coverage on false-profile (FP) radiographs is important for judging anterior hip coverage. Conventionally, the anterior center-edge angle (ACEA) is measured from the anterior edge of the acetabular sourcil (sourcil ACEA); however, the anterior bone edge is also used as the anterior landmark. Purpose: To determine whether the sourcil ACEA or the bone-edge ACEA better represents the anterior coverage of the hip joint. Study Design: Descriptive laboratory study. Methods: We retrospectively observed 49 hips in 49 patients who underwent isolated periacetabular osteotomy. The sourcil ACEA was measured according to the standard procedure. Then, 3-dimensional (3D) volumetric models were made from computed tomographic data. The acetabular surface of the 3D model was labeled and projected onto a simulated FP radiograph, enabling the edge of the acetabulum to be identified. This simulated FP radiograph was used to measure the “true ACEA,” as well as the sourcil ACEA and the bone-edge ACEA, and the 3 measurements were compared. Statistical analysis was performed—including testing for normal distribution, measuring interobserver agreement, evaluating differences between measurements, and validating correlation. Results: The mean sourcil ACEA was 8.6° (range, –3.9° to 31.7°) smaller than that of the true ACEA ( P < .001); there was a strong correlation ( r = 0.81; P < .001) between the 2. The mean bone-edge ACEA was 16.8° (range, –1.7° to 45.4°) greater than that of the true ACEA ( P < .001); there was a moderate correlation ( r = 0.57; P < 0.001) between the 2. Conclusion: Both the sourcil ACEA and bone-edge ACEA differed from the true ACEA. However, compared with the bone-edge ACEA, the sourcil ACEA was numerically closer to the true ACEA and had a stronger correlation with it . Clinical Relevance: While the exact edge of the true bearing surface of the articular cartilage may not be visible on the FP radiograph, the sourcil ACEA can be effectively utilized as a reliable surrogate when evaluating the anterior acetabular coverage in hip preservation surgery.

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The anterior center edge angle has limited ability to predict three-dimensional coverage of the femoral head in patients with developmental dysplasia of the hip undergoing curved periacetabular osteotomy

Cited by 5 publications

References 29 publications

Clinical Efficacy and Safety of Ibuprofen plus Traction, Reposition, and Hip Spica Cast in the Treatment of Developmental Dysplasia of the Hip

Clinical Efficacy and Safety of Ibuprofen plus Traction, Reposition, and Hip Spica Cast in the Treatment of Developmental Dysplasia of the Hip

Prediction of 3-Dimensional Coverage Surface Area of the Femoral Head in Hip Dysplasia Through Conventional Computed Tomography

Comparison of Anterior Center-Edge Angle Measured From the Acetabular Sourcil Versus the Anterior Bone-Edge of the Acetabulum: A Descriptive Laboratory Study

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