Skip to main content

Advertisement

SpringerLink
Log in

Minimally Invasive Radiographic Evaluation of the Dysplastic Hip Joint Configuration in Terms of Surgical Treatment with Hip Preservation by PAO

  • Original Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Introduction

Residual developmental dysplasia of hip (RDDH) is a factor of early osteoarthritis of the hip. The main problems are pain and instability of the hip joint due to inadequate coverage of the femoral head by the acetabulum. The purpose of this study was to radiologically evaluate RDDH after Bernese periacetabular osteotomy (PAO) and to compare RDDH to healthy hips.

Materials and Methods

The radiological parameters of RDDH treated by PAO were retrospectively evaluated. Digital AP pelvic radiographs were taken, including parameters of central edge angle and femoral head coverage, medialization, distalization, and ilio-ischial angle. Clinical assessment is based on the VAS scale. The study group consisted of patients with RDDH, and the control group consisted of patients without RDDH.

Results

After PAO radiological parameters decreased: medialization by 2.68 mm, distalization by 3.65 mm, and ilio-ischial angle by 2.62°. However, there was an increase in the parameters: CEA by 17.61° and FHC by 16.46%. There was a mean 3 point decrease in pain on the VAS scale. There was also a statistically significant radiological difference in the structure of dysplastic hip joints before surgery and healthy hip joints of the control group.

Conclusions

Radiological studies confirmed the effectiveness of the PAO method in the treatment of RDDH. Based on all radiological parameters, differences between healthy and dysplastic hip joints were demonstrated. We believe that a thorough understanding of the values of radiological parameters used to describe dysplastic hip joints will allow us to improve the imaging diagnosis of this condition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

Abbreviations

RDDH:

Residual developmental dysplasia of hip

PAO:

Bernense periacetabular osteotomy

DDH:

Developmental dysplasia of hip

CEA:

Central edge angle

FHC:

Femoral head coverage

LCEA:

Lateral center edge angle

AP:

Antero-posterior

CT:

Computed tomography

HLI:

Head lateralization index

DBSPFH:

Distance between symphysis pubis and femoral head

MRI:

Magnetic resonance imaging

mm:

Millimeters

deg:

Degrees

References

  1. Mimura, T., Mori, K., Kawasaki, T., Imai, S., & Matsusue, Y. (2014). Triple pelvic osteotomy: Report of our mid-term results and review of literature. World Journal of Orthopedics, 5(1), 14–22.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Naito, M., & Nakamura, Y. (2014). Curved periacetabular osteotomy for the treatment of dysplastic hips. Clinics in Orthopedic Surgery, 6(2), 127–137.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Takahashi, Y., Takahira, N., Uchiyama, K., Fukushima, K., Moriya, M., Shibuya, M., Tsuda, K., Tozaki, K., Kudo, S., Kaneda, H., Sekita, J., & Takaso, M. (2020). Sports activity participation after curved periacetabular osteotomy for acetabular dysplasia. BMC Musculoskeletal Disorders, 21, 637.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Lehmann, Ch., Nepple, J., Baca, G., Schoenecker, P., & Clohisy, J. (2012). Do fluoroscopy and postoperative radiographs correlate for periacetabular osteotomy corrections? Clinical Orthopaedics and Related Research, 470(12), 3508–3514.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Albers, Ch., Steppacher, S., Ganz, R., Tannast, M., & Siebenrock, K. (2013). Impingement adversely affects 10-year survivorship after periacetabular osteotomy for DDH. Clinical Orthopaedics and Related Research, 471(5), 1602–1614.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Clohisy, J., Schutz, A., John, L., Schoenecker, P., & Wright, R. (2009). Periacetabular osteotomy a systematic literature review. Clinical Orthopaedics and Related Research, 467(8), 2041–2052.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Clohisy, J., Barrett, S., Gordon, J., Delgado, E., & Schoenecker, P. (2004). Medial translation of the hip joint center associated with the bernese periacetabular osteotomy. Iowa Orthopaedic Journal, 24, 43–48.

    PubMed  PubMed Central  Google Scholar 

  8. Dede, O., & Ward, T. (2013). Bernese periacetabular osteotomy in the surgical management of adolescent acetabular dysplasia. Operative Techniques in Orthopaedics, 23(3), 127–133.

    Article  Google Scholar 

  9. Fujii, M., Nakashima, Y., Sato, T., Akiyama, M., & Iwamoto, Y. (2011). Pelvic deformity influences acetabular version and coverage in hip dysplasia. Clinical Orthopaedics and Related Research, 469(6), 1735–1742.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Lankester, B. J. A., & Gargan, M. F. (2004). Adolescent hip dysplasia. Ortopaedics & Trauma, 18(4), 262–272.

    Google Scholar 

  11. Leunig, M., & Ganz, R. (2007). Bernese periacetabular osteotomy. Current Orthopaedics, 21(2), 100–108.

    Article  Google Scholar 

  12. Siebenrock, K., Leunig, M., & Ganz, R. (2001). Periacetabular osteotomy: the bernese experience. JBJS, 83(3), 449.

    Article  Google Scholar 

  13. Steppacher, S., Tannast, M., Ganz, R., & Siebenrock, K. (2008). Mean 20-year follow up of Bernese periacetabular osteotomy. Clinical Orthopaedics and Related Research, 466(7), 1633–1644.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Zhu, J., Chen, X., Cui, Y., Shen, Ch., & Cai, G. (2013). Mid-term results of Bernese periacetabular osteotomy for developmental dysplasia of hip in middle aged patients. International Orthopaedics., 37(4), 589–594.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Zhang, D., Pan, X., Zhang, H., Luo, D., Cheng, H., & Xiao, K. (2020). The lateral center-edge angle as radiographic selection criteria for periacetabular osteotomy for developmental dysplasia of the hip in patients aged above 13 years. BMC Musculoskeletal Disorders, 21, 493.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Goronzy, J., Franken, L., Hartmann, A., Thielemann, F., Blum, S., Günther, K. P., Nowotny, J., & Postler, A. (2020). Acetabular- and femoral orientation after periacetabular osteotomy as a predictor for outcome and osteoarthritis. BMC Musculoskeletal Disorders, 21, 846.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ganz, R., Klaue, K., Vinh, T. S., & Mast, J. W. (1988). A new periacetabular osteotomy for the treatment of hip dysplasia. Technique and preliminary results. Clinical Orthopaedics and Related Research., 232, 26–36.

    Article  Google Scholar 

  18. Gottschalk, F., Kourosh, S., & Leveau, B. (1989). The functional anatomy of tensor fasciae latae and gluteus medius and minimus. Journal of Anatomy, 166, 179–189.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Lubovsky, O., Wright, D., Hardisty, M., Kiss, A., Kreder, H., & Whyne, C. (2012). Acetabular orientation: anatomical and functional measurement. International Journal of Computer Assisted Radiology and Surgery., 7(2), 233–240.

    Article  PubMed  Google Scholar 

  20. Tanaka, Y., Moriyama, Sh., Nakamura, Y., & Naito, M. (2014). Analysis of medialisation of the femoral head in periacetabular osteotomy using three-dimensional computer tomography. Hip International, 24(6), 624–630.

    Article  PubMed  Google Scholar 

  21. Anda, S., Svenningsen, S., Dale, L. G., & Benum, P. (1986). The acetabular sector angle of the adult hip determind by computed tomography. Acta radiologica: Diagnosis (Stockh), 27(4), 443–447.

    Article  CAS  Google Scholar 

  22. Azuma, H., Taneda, H., Igarashi, H., & Fujioka, M. (1990). Preoperative and postoperative assessment of rotational acetabular osteotomy for dysplastic hips in children by three-dimensional surface reconstruction computed tomography imaging. Journal of Pediatric Orthopaedics, 10(1), 33–38.

    Article  CAS  PubMed  Google Scholar 

  23. Roach, J. W., Hobatho, M. C., Baker, K. J., & Ashman, R. B. (1997). Three-dimensional computer analysis of complex acetabular insufficiency. Journal of Pediatric Orthopaedics, 17(2), 158–164.

    Article  CAS  PubMed  Google Scholar 

  24. Crowe, J. F., Mani, V. J., & Ranawat, C. S. (1979). Total hip replacement in congenital dislocation and dysplasia of the hip. Journal of Bone and Joint Surgery American, 61(1), 15–23.

    Article  CAS  Google Scholar 

  25. Mavcic, B., Pompe, B., Antolic, V., Daniel, M., Iglic, A., & Kralj-Iglic, V. (2002). Mathematical estimation of stress distribution in normal and dysplastic human hips. Journal of Orthopaedic Research, 20(5), 1025–1030.

    Article  CAS  PubMed  Google Scholar 

  26. Delp, S. L., & Maloney, W. (1993). Effects of hip center location on the moment- generating capacity of the muscles. Journal of Biomechanics., 26(4–5), 485–499.

    Article  CAS  PubMed  Google Scholar 

  27. Chang, J. S., Oh, H. K., Kim, J. W., & Hong, S. H. (2008). Periacetabular osteotomy in hip dysplasia with deformed femoral head. Journal of the Korean Orthopaedic Association, 43(6), 718–727.

    Article  Google Scholar 

  28. Spiker, A. M., Fields, K. G., Nguyen, J. T., Wong, A. C., & Sink, E. L. (1993). Characterization of version in the dysplastic hip and the need for subsequent femoral derotational osteotomy after periacetabular osteotomy. Journal of Hip Preservation Surgery, 7(3), 575–582.

    Article  Google Scholar 

  29. Fowler, L. M., Nepple, J. J., Devries, C., Harris, M. D., & Clohisy, J. C. (2021). Medialization of the hip’s center with periacetabular osteotomy: Validation of assessment with plain radiographs. Clinical Orthopaedics and Related Research, 479(5), 1040–1049.

    Article  PubMed  Google Scholar 

  30. Pun, S. Y. (2021). Medialization of the hip’s center with periacetabular osteotomy: Validation of assessment with plain radiographs. Clinical Orthopaedics and Related Research, 479(5), 1050–1051.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Czubak, J. (2004). Periacetabular Ganz osteotomy in the treatment of developmental dysplasia of the hip in adolescents and adults: Surgical technique and early results. Orthopaedics Traumatology Rehabilitation, 6(1), 51–59.

    Google Scholar 

  32. Okano, K., Yamaguchi, K., Ninomiya, Y., Matsubayashi, S., Osaki, M., & Takahashi, K. (2013). Femoral head deformity and severity of acetabular dysplasia of the hip. The Bone & Joint Journal, 95, 1192–1196.

    Article  Google Scholar 

Download references

Funding

There was no financial support associated with preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Children’s Orthopaedics and Traumatology, Gruca Orthopaedic and Trauma Teaching Hospital, Konarskiego Street 13, 05-400, Otwock, Poland

    Kamil Kołodziejczyk, Adam Czwojdziński, Andrzej Sionek & Jarosław Czubak

  2. Centre of Postgraduate Medical Education, Warsaw, Poland

    Kamil Kołodziejczyk, Adam Czwojdziński, Andrzej Sionek & Jarosław Czubak

Authors
  1. Kamil Kołodziejczyk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Adam Czwojdziński
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrzej Sionek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jarosław Czubak
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kamil Kołodziejczyk.

Ethics declarations

Conflicts of Interest

Kamil Kołodziejczyk, Adam Czwojdziński, Andrzej Sionek, and Jarosław Czubak declare that they have no conflict of interest.

Ethics Approval

Consent of the bioethics commission Medical Centre of Postgraduate Education 83/PB/2015 18.11.2015 Warsaw. Informed consent was obtained from all patients participating in the study.

Informed consent

Informed consent was obtained from all patients to participate in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kołodziejczyk, K., Czwojdziński, A., Sionek, A. et al. Minimally Invasive Radiographic Evaluation of the Dysplastic Hip Joint Configuration in Terms of Surgical Treatment with Hip Preservation by PAO. JOIO 56, 2214–2222 (2022). https://doi.org/10.1007/s43465-022-00757-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43465-022-00757-7

Keywords

Search

Navigation