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Three-dimensional Morphologic Study of the Child’s Hip: Which Parameters Are Reproducible?

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

Abstract

Background

Biplanar x-ray images obtained with patients in a standing weightbearing position allow reconstruction of three-dimensional (3-D) bone geometries, with lower radiation exposure than CT scans and better bone definition than MRI.

Questions/Purposes

We determined the reproducibility of 3-D parameter values of the hips and pelves of healthy children, using biplanar x-ray images.

Methods

We built 3-D models of the hips of 33 children without musculoskeletal problems: 10 subjects younger than 9 years and 23 who were 9 years or older. Three anatomic landmarks and nine hip and pelvic parameters were computed for each reconstruction. To determine the reliability of these landmarks and parameters, each bone was reconstructed four times by two independent observers, leading to a total of 264 reconstructions, and parameters were studied for the two age groups and compared between dancers and nondancers.

Results

Taking into account all reconstructions, the interobserver reproducibility ranged from 2 to 4 mm for landmark positions or distance parameters, and 2° to 6° for angular parameters. The most reproducible point was the center of the femoral head (range, 0.2–17 mm). The distance between this center and its projection on the plane fitting the edge of the acetabulum, and the pelvic tilt were the most reproducible parameters.

Conclusions

Reproducible 3-D reconstructions of hips and pelves of children were possible using biplanar x-ray images, regardless of the children’s ages. Although we report preliminary values for 3-D parameters in healthy children’s hips, further work is needed to obtain direct validation of our parameters using CT reconstructions of cadaveric specimens to avoid high doses of radiation.

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Acknowledgments

We thank B. Sandoz PhD for his involvement in the data collection protocol. We also thank V. Vasta for the 3-D reconstructions and C. Fedelich and T. Bellot MD for technical support.

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Authors and Affiliations

  1. Service d’orthopédie pédiatrique, Hôpitaux pédiatriques de Nice, GCS CHU-Lenval, 57 avenue de la Californie, 06000, Nice, France

    Virginie Rampal MD

  2. Laboratoire de Biomecanique, Arts et métiers Paristech, Paris, France

    Virginie Rampal MD, Jérome Hausselle PhD, Patricia Thoreux PhD & Waffa Skalli PhD

  3. Service de Chirurgie Orthopédique, Hôpital Avicenne, Université Paris 13, Bobigny, France

    Patricia Thoreux PhD

  4. Hôpital Saint Vincent de Paul, Hôpital Necker Enfants Malades, Paris, France

    Philippe Wicart MD PhD

Authors
  1. Virginie Rampal MD
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  2. Jérome Hausselle PhD
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  3. Patricia Thoreux PhD
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  4. Philippe Wicart MD PhD
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  5. Waffa Skalli PhD
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Corresponding author

Correspondence to Virginie Rampal MD.

Additional information

The Laboratoire de Biomecanique, Arts et métiers Paristech has received funding from the Agence Nationale pour la Recherche (ANR, Paris, France) (project SECUR_ENFANT_06_0385) and by MEDICEN (Paris, France).

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.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

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.

This work was performed at Arts et Métiers Paristech, Paris, France.

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Rampal, V., Hausselle, J., Thoreux, P. et al. Three-dimensional Morphologic Study of the Child’s Hip: Which Parameters Are Reproducible?. Clin Orthop Relat Res 471, 1343–1348 (2013). https://doi.org/10.1007/s11999-012-2660-5

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  • DOI: https://doi.org/10.1007/s11999-012-2660-5

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