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Anterior inferior iliac spine morphology: quantitative and qualitative assessment in an asymptomatic population

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Abstract

Purpose

To assess the prevalence of anterior inferior iliac spine (AIIS) types, and to investigate the quantitative measurements that characterize AIIS morphology in an asymptomatic adult population.

Methods

In this prospective study, 358 hips from 179 consecutive subjects (age range, 19–82 years; 91 males, 88 females), who underwent CT examination for reasons other than hip problems and were negative for hip impingement test, were analyzed. AIIS types were determined (1, flat wall of the ilium between distal end of AIIS and acetebular rim; 2, bony eminence between distal end of AIIS and acetebular rim; and 3, extension of AIIS to the anterior superior acetebular rim) and AIIS tip angle (TA), direct distance (DD) of the anterior acetabular rim to AIIS as well as projectional distances in vertical (VD) and horizontal (HD) planes were measured. Age- and gender-related factors were searched using two-way ANOVA test under three age groups (18–39, 40–59, and ≥ 60 years).

Results

There were 238 (66.5%) type 1, 118 (33.0%) type 2, and two (0.5%) type 3 AIISs, with significant difference between AIIS types among age groups and genders (P < 0.001). VD and DD showed age- and gender-related (P < 0.001, P < 0.001), and TA demonstrated gender-related differences (P < 0.001). Inter-observer agreement was good for TA and moderate to poor for other measurements.

Conclusions

Type 1 AIIS is the most common shape across all age groups in adult females and in young and middle-aged adult males. TA, DD, and VD might be reliably used for the evaluation of AIIS morphology.

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References

  1. Amar E, Druckmann I, Flusser G, Safran MR, Salai M, Rath E (2013) The anterior inferior iliac spine: size, position, and location. An anthropometric and sex survey. Arthroscopy 29:874–881. https://doi.org/10.1016/j.arthro.2013.01.023

    Article  PubMed  Google Scholar 

  2. Amar E, Warschawski Y, Sharfman ZT, Martin HD, Safran MR, Rath E (2016) Pathological findings in patients with low anterior inferior iliac spine impingement. Surg Radiol Anat 38:569–575. https://doi.org/10.1007/s00276-015-1591-8

    Article  PubMed  Google Scholar 

  3. Balazs GC, Williams BC, Knaus CM, Brooks DI, Dickens JF, McCabe MP, Anderson TD (2017) Morphological distribution of the anterior inferior iliac spine in patients with and without hip impingement: reliability, validity, and relationship to the intraoperative assessment. Am J Sports Med 45:1117–1123. https://doi.org/10.1177/0363546516682230

    Article  PubMed  Google Scholar 

  4. Blankenbaker DG, Tuite MJ (2013) Non-femoroacetabular impingement. Semin Musculoskelet Radiol 17:279–285. https://doi.org/10.1055/s-0033-1348094

    Article  PubMed  Google Scholar 

  5. Cicchetti DV (1994) Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess 6:284. https://doi.org/10.1037/1040-3590.6.4.284

    Article  Google Scholar 

  6. Ecker TM, Puls M, Steppacher SD, Bastian JD, Keel MJ, Siebenrock KA, Tannast M (2012) Computer-assisted femoral head-neck osteochondroplasty using a surgical milling device an in vitro accuracy study. J Arthroplasty 27:310–316. https://doi.org/10.1016/j.arth.2011.03.048

    Article  PubMed  Google Scholar 

  7. Ergen FB, Vudali S, Sanverdi E, Dolgun A, Aydingoz U (2014) CT assessment of asymptomatic hip joints for the background of femoroacetabular impingement morphology. Diagn Interv Radiol 20:271–276. https://doi.org/10.5152/dir.2013.13374

    Article  PubMed  Google Scholar 

  8. Hapa O, Bedi A, Gursan O, Akar MS, Guvencer M, Havitcioglu H, Larson CM (2013) Anatomic footprint of the direct head of the rectus femoris origin: cadaveric study and clinical series of hips after arthroscopic anterior inferior iliac spine/subspine decompression. Arthroscopy 29:1932–1940. https://doi.org/10.1016/j.arthro.2013.08.023

    Article  PubMed  Google Scholar 

  9. Hardcastle SA, Dieppe P, Gregson CL, Arden NK, Spector TD, Hart DJ, Edwards MH, Dennison EM, Cooper C, Williams M, Davey Smith G, Tobias JH (2014) Osteophytes, enthesophytes, and high bone mass: a bone-forming triad with potential relevance in osteoarthritis. Arthritis Rheumatol 66:2429–2439. https://doi.org/10.1002/art.38729

    Article  PubMed  PubMed Central  Google Scholar 

  10. Hetsroni I, Larson CM, Dela Torre K, Zbeda RM, Magennis E, Kelly BT (2012) Anterior inferior iliac spine deformity as an extra-articular source for hip impingement: a series of 10 patients treated with arthroscopic decompression. Arthroscopy 28:1644–1653. https://doi.org/10.1016/j.arthro.2012.05.882

    Article  PubMed  Google Scholar 

  11. Hetsroni I, Poultsides L, Bedi A, Larson CM, Kelly BT (2013) Anterior inferior iliac spine morphology correlates with hip range of motion: a classification system and dynamic model. Clin Orthop Relat Res 471:2497–2503. https://doi.org/10.1007/s11999-013-2847-4

    Article  PubMed  PubMed Central  Google Scholar 

  12. Krol A, Polak M, Szczygiel E, Wojcik P, Gleb K (2017) Relationship between mechanical factors and pelvic tilt in adults with and without low back pain. J Back Musculoskelet Rehabil 30:699,705. https://doi.org/10.3233/BMR-140177

    Article  Google Scholar 

  13. Larson CM, Kelly BT, Stone RM (2011) Making a case for anterior inferior iliac spine/subspine hip impingement: three representative case reports and proposed concept. Arthroscopy 27:1732–1737. https://doi.org/10.1016/j.arthro.2011.10.004

    Article  PubMed  Google Scholar 

  14. Morales-Avalos R, Leyva-Villegas JI, Sanchez-Mejorada G, Mendez-Aguirre O, Galindo-Aguilar OU, Quiroga-Garza A, Villarreal-Silva EE, ez-Cavazos FV, Galvan JRB, Elizondo-Omana RE, Guzman-Lopez S (2015) A new morphological classification of the anterior inferior iliac spine. Relevance in subspine hip impingement. Int J Morphol 33:626–631

    Article  Google Scholar 

  15. Philippon MJ, Michalski MP, Campbell KJ, Goldsmith MT, Devitt BM, Wijdicks CA, LaPrade RF (2014) An anatomical study of the acetabulum with clinical applications to hip arthroscopy. J Bone Jt Surg Am 96:1673–1682. https://doi.org/10.2106/JBJS.M.01502

    Article  Google Scholar 

  16. Roussouly P, Nnadi C (2010) Sagittal plane deformity: an overview of interpretation and management. Eur Spine J 19:1824–1836. https://doi.org/10.1007/s00586-010-1476-9

    Article  PubMed  PubMed Central  Google Scholar 

  17. Shoji T, Yasunaga Y, Yamasaki T, Izumi S, Adachi N, Ochi M (2016) Anterior inferior yiliac spine bone morphology in hip dysplasia and its effect on hip range of motion in total hip arthroplast. J Arthroplasty 31:2058–2063. https://doi.org/10.1016/j.arth.2016.02.018

    Article  PubMed  Google Scholar 

  18. Sutter R, Pfirrmann CW (2013) Atypical hip impingement. AJR Am J Roentgenol 201:W437–W442. https://doi.org/10.2214/AJR.13.10692

    Article  PubMed  Google Scholar 

  19. Tannenbaum EP, Ross JR, Bedi A (2014) Pros, cons, and future possibilities for use of computer navigation in hip arthroscopy. Sports Med Arthrosc 22:e33–e41. https://doi.org/10.1097/JSA.0000000000000035

    Article  PubMed  Google Scholar 

  20. Tonnis D (1976) Normal values of the hip joint for the evaluation of X-rays in children and adults. Clin Orthop Relat Res 119:39–47

    Google Scholar 

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Authors and Affiliations

Authors

Contributions

OMT: Project development, Data Collection, Data Analysis, Manuscript writing/editing. FBE: Project development, Data Collection, Data Analysis, Manuscript writing/editing. SA: Data Collection. TCankurtara: Data Collection. AD: Data Analysis. UA: Manuscript writing/editing.

Corresponding author

Correspondence to F. Bilge Ergen.

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The authors declare that they have no conflict of interest.

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Topcuoğlu, O.M., Ergen, F.B., Ardalı, S. et al. Anterior inferior iliac spine morphology: quantitative and qualitative assessment in an asymptomatic population. Surg Radiol Anat 40, 1275–1281 (2018). https://doi.org/10.1007/s00276-018-2075-4

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  • DOI: https://doi.org/10.1007/s00276-018-2075-4

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