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Pelvic Deformity Influences Acetabular Version and Coverage in Hip Dysplasia

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

Abstract

Background

Although a wide variety of acetabular deformities in developmental dysplasia of the hip (DDH) have been reported, the morphologic features of the entire pelvis in DDH are not well characterized and their correlation with acetabular deformity is unknown.

Questions/purposes

We determined whether there was a rotational deformity of the entire innominate bone, and if so, whether it related to acetabular version and coverage.

Patients and Methods

We examined the morphologic features of the pelvis using CT for 50 patients with DDH (82 hips). Forty normal hips were used as controls. The innominate rotation angle was determined at three levels in the axial plane. The acetabular sector angle served as an indicator of acetabular coverage of the femoral head. We evaluated the association between innominate rotation angles and acetabular version and coverage.

Results

We observed greater internal rotation of the innominate bone in patients with DDH than in the control subjects. Internal rotation of the innominate bone was associated with increased acetabular anteversion angle and acetabular inclination angle. In hips with acetabular retroversion (nine of 82 hips; 11.0 %), the entire innominate bone was externally rotated, compared with hips with acetabular anteversion. Internal rotation of the innominate bone also was associated with decreased anterior and superior acetabular coverage.

Conclusion

Our observations suggest structural abnormalities exist throughout the pelvis in DDH, and the morphologic abnormalities of the acetabulum are not caused solely by local dysplasia around the hip, but are influenced by the morphologic features of the entire pelvis.

Level of Evidence

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

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Acknowledgments

We thank Drs Takuaki Yamamoto, Taro Mawatari, Goro Motomura, Takashi Itokawa, and Akinobu Matsushita for helpful advice during this study.

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Authors and Affiliations

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

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

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

Correspondence to Yasuharu Nakashima MD.

Additional information

One author (YN) has received funding from the Hip Joint Foundation of Japan, Inc.

Each author certifies that his or her institution approved the human protocol for this investigation and 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 the Department of Orthopaedic Surgery, Kyushu University.

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Fujii, M., Nakashima, Y., Sato, T. et al. Pelvic Deformity Influences Acetabular Version and Coverage in Hip Dysplasia. Clin Orthop Relat Res 469, 1735–1742 (2011). https://doi.org/10.1007/s11999-010-1746-1

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  • DOI: https://doi.org/10.1007/s11999-010-1746-1

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