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Acetabular Tilt Correlates with Acetabular Version and Coverage in Hip Dysplasia

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The rotational position of the acetabulum to the pelvis (acetabular tilt) may influence acetabular version and coverage of the femoral head. To date, the pathologic significance of acetabular tilt in hip dysplasia is unknown.

Questions/Purposes

We determined whether acetabular tilt in hip dysplasia is different from that in normal hips and whether this correlates with acetabular version and coverage.

Methods

We measured the acetabular tilt angle on the lateral view of three-dimensional pelvic CT images of 40 patients (72 hips) with hip dysplasia. Forty normal hips from 40 patients were used as controls. The acetabular sector angle was measured as an index for acetabular coverage of the femoral head.

Results

The mean acetabular tilt angle was increased in dysplastic hips compared with controls. In dysplastic hips, a posteriorly rotated acetabulum (increased acetabular tilt) was associated with increased acetabular anteversion and with decreased anterior and anterosuperior acetabular coverage. No correlation was found in controls. In dysplastic hips with a posterior acetabular deficiency, the acetabulum was rotated anteriorly (decreased acetabular tilt) compared with hips with anterior and lateral deficiencies.

Conclusions

We observed a correlation between the rotational position of the acetabulum in the pelvis with acetabular version and coverage in hip dysplasia. Our observations confirmed anterior rotation of the acetabular fragment during periacetabular osteotomies is an anatomically reasonable maneuver for hips with anterolateral acetabular deficiencies, while the maneuver can exacerbate posterior coverage and should be avoided in hips with a posterior acetabular deficiency.

Level of Evidence

Level IV, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Takuaki Yamamoto, MD, PhD, Taro Mawatari, MD, PhD, Goro Motomura, MD, PhD, and Akinobu Matsushita, MD, PhD (Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University) for invaluable advice for this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Masanori Fujii MD, PhD, Yasuharu Nakashima MD, PhD, Taishi Sato MD, Mio Akiyama MD & Yukihide Iwamoto MD, PhD

Authors
  1. Masanori Fujii MD, PhD
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  2. Yasuharu Nakashima MD, PhD
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  3. Taishi Sato MD
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  4. Mio Akiyama MD
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  5. Yukihide Iwamoto MD, PhD
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Corresponding author

Correspondence to Yasuharu Nakashima MD, PhD.

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Each author certifies that he or she, or a member of their immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Fujii, M., Nakashima, Y., Sato, T. et al. Acetabular Tilt Correlates with Acetabular Version and Coverage in Hip Dysplasia. Clin Orthop Relat Res 470, 2827–2835 (2012). https://doi.org/10.1007/s11999-012-2370-z

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  • DOI: https://doi.org/10.1007/s11999-012-2370-z

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