Volume-based dysplasia severity index with the spheric cup method in the evaluation of adult and adolescent acetabular dysplasia

Yıl 2021, Cilt: 4 Sayı: 3, 358 - 365, 21.05.2021

Mehmet Burtaç Eren

https://doi.org/10.32322/jhsm.910775

Öz

Introduction / Aim: Defining and treating adult and adolescent acetabular dysplasia before arthrosis develops is one of the basic principles of hip-preserving surgery. During the evaluation of cases with asymptomatic or mild symptoms, the severity of the acetabular covering deficiency directs the treatment. We attempted to find answers to two questions with our study: 1) Are the values revealed by the described measurement technique sufficient to detect acetabular dysplasia? 2) Do the criteria calculated by the current technique correlate with the well-known radiological criteria for acetabular dysplasia?

Material and Method: Eighteen hips of patients who had undergone periacetabular osteotomy evaluated by computed tomography (CT) between June 2009 and February 2019 were included in the study (Group 1, dysplasia group). Eighteen patients of similar age and sex, who had tomography examination from the pelvic region, except for orthopedic reasons, were identified between the same dates (Group 2, control group). In the tomography examinations of the patients, the entrance area of the acetabulum was determined using the multiplanar reformation (MPR) technique. Acetabulum volume and femoral head volume was calculated according to the spheric cup measurement method. Acetabular index (AI), extrusion index (EI), Sharp angle (SA), lateral center edge angle (LCEA), and anterior center edge angle (ACEA) values were calculated from direct graphy and CT scanograms of the patients.

Findings / Results: In the comparative analysis between the groups, a significant difference was observed in terms of acetabular volume, VBADSI, AI, EI, LCEA, SA, and ACEA values (p < 0.05).

Conclusion: Acetabular volume measured using the spheric cup method and the VBADSI proved to be criteria that could contribute to the diagnosis of acetabular dysplasia. It would be appropriate to measure the described method with a larger series to reveal values peculiar to specific communities.

Anahtar Kelimeler

acetabular dysplasia, acetabular volume, femoral head volume, acetabular dysplasia assessment

Kaynakça

• Gala L, Clohisy JC, Beaulé PE. Hip dysplasia in the young adult. J Bone Joint Surg Am 2016; 98: 63-73.
• Domb BG, Stake CE, Lindner D, El-Bitar Y, Jackson TJ. Arthroscopic capsular plication and labral preservation in borderline hip dysplasia: two-year clinical outcomes of a surgical approach to a challenging problem. Am J Sports Med 2013; 41: 2591-8.
• Malvitz TA, Weinstein SL. Closed reduction for congenital dysplasia of the hip. Functional and radiographic results after an average of thirty years. J Bone Joint Surg Am 1994; 76: 1777-92.
• Murphy SB, Ganz R, Müller M. The prognosis in untreated dysplasia of the hip. A study of radiographic factors that predict the outcome. J Bone Joint Surg Am 1995; 77: 985-9.
• Lequesne M. Le faux profile de bassin. Nouvelle incidence radiographique pour l’etude de la hanche. Son utilite dans les differentes coxopathies. Rev Rhem Malosteoartic 1961; 28: 643-52.
• Millis MB, Kim YJ. Rationale of osteotomy and related procedures for hip preservation: a review. Clin Orthop Relat Res 2002; 405: 108-21.
• Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis-what the radiologist should know. Am J Roentgenol 2007; 188: 1540-52.
• Wiberg G. Studies on dysplastic acetabula and congenial subluxation of the hip joint. Acta Chir Scand Suppl 1939; 83: 1-130.
• Li PL, Ganz R. Morphologic features of congenital acetabular dysplasia: one in six is retroverted. Clin Orthop Relat Res 2003; 416: 245-53.
• Hilgenreiner H. Zur fuhdiagnose und fruhbehandlung der angeboren huftgelenkverrenkung. Med Klin 1925; 21: 1425-29.
• Sharp IK. Acetabular dysplasia: the acetabular angle J Bone Joint Surg Br 1961; 43: 268-72.
• Umer M, Thambyah A, Tan W, De SD. Acetabular morphometry for determining hip dysplasia in the Singaporean population. J Orthop Surg 2006; 14: 27-31.
• Han CD, Yoo JH, Lee WS, Choe WS. Radiographic parameters of acetabulum for dysplasia in Korean adults. Yonsei Med J 1998; 39: 404-8.
• Aktas S, Pekindil G, Ercan S, Pekindil Y. Acetabular dysplasia in normal Turkish adults. Bull Hosp Jt Dis Orthop Inst 2000; 59: 158-62.
• Yoshimura N, Campbell L, Hashimoto T, et al. Acetabular dysplasia and hip osteoarthritis in Britain and Japan. Rheumatology 1998; 37: 1193-7.
• Kim C-H, Park JI, Shin DJ, Oh SH, Jeong MY, Yoon PW. Prevalence of radiologic acetabular dysplasia in asymptomatic Asian volunteers. J Hip Preserv Surg 2019; 6: 55-9.
• Wyatt MC, Beck M. The management of the painful borderline dysplastic hip. J Hip Preserv Surg 2018; 5: 105-12.
• McClincy MP, Wylie JD, Kim YJ, Millis MB, Novais EN. Periacetabular osteotomy improves pain and function in patients with lateral center-edge angle between 18° and 25°, but are these hips really borderline dysplastic? Clin Orthop Relat Res 2019; 477: 1145.
• Bixby SD, Millis MB. The borderline dysplastic hip: when and how is it abnormal? Pediatr Radiol 2019; 49: 1669-77.
• Azuma H, Taneda H, Igarashi H, Fujioka M. Preoperative and postoperative assessment of rotational acetabular osteotomy for dysplastic hips in children by three-dimensional surface reconstruction computed tomography imaging J Pediatr Orthop 1990; 10: 33-8.
• Haddad FS, Garbuz DS, Duncan CP, Janzen DL, Munk PL. CT evaluation of periacetabular osteotomies. J Bone Joint Surg Br 2000; 82: 526-31.
• Mechlenburg I, Nyengaard J, Rømer L, Søballe K. Changes in load-bearing area after Ganz periacetabular osteotomy evaluated by multislice CT scanning and stereology. Acta Orthop Scand 2004; 75: 147-53.
• Nakamura S, Yorikawa J, Otsuka K, Takeshita K, Harasawa A, Matsushita T. Evaluation of acetabular dysplasia using a top view of the hip on three-dimensional CT. J Orthop Sci 2000; 5: 533-9.
• Humbert L, Carlioz H, Baudoin A, Skalli W, Mitton D. 3D Evaluation of the acetabular coverage assessed by biplanar X-rays or single anteroposterior X-ray compared with CT-scan. Comput Methods Biomech Biomed Engin 2008; 11: 257-62.
• Zhang S, Zhang G, Peng Y, Wang X, Tang P, Zhang L. Radiological measurement of pelvic fractures using a pelvic deformity measurement software program. J Orthop Surg Res 2020; 15: 37.
• Mimura T, Mori K, Kitagawa M, et al. Multiplanar evaluation of radiological findings associated with acetabular dysplasia and investigation of its prevalence in an Asian population: a CT-based study. BMC Musculoskelet Disord 2017; 18: 50.
• Jóźwiak M, Rychlik M, Musielak B, Chen BPJ, Idzior M, Grzegorzewski A. An accurate method of radiological assessment of acetabular volume and orientation in computed tomography spatial reconstruction. BMC Musculoskelet Disord 2015; 16: 42.
• Israel GM, Cicchiello L, Brink J, Huda W. Patient size and radiation exposure in thoracic, pelvic, and abdominal CT examinations performed with automatic exposure control. Am J Roentgenol 2010; 195: 1342-6.
• Griffey RT, Sodickson A. Cumulative radiation exposure and cancer risk estimates in emergency department patients undergoing repeat or multiple CT. Am J Roentgenol 2009; 192: 887-92.
• Arapakis I, Efstathopoulos E, Tsitsia V, et al. Using “iDose4” iterative reconstruction algorithm in adults’ chest–abdomen–pelvis CT examinations: effect on image quality in relation to patient radiation exposure. Br J Radiol 2014; 87: 20130613.
• Ozgur AF, Aksoy MC, Kandemir U, et al. Does Dega osteotomy increase acetabular volume in developmental dysplasia of the hip. J Pediatr Orthop B 2006; 15: 83-6.
• Ito H, Matsuno T, Hirayama T, Tanino H, Yamanaka Y, Minami A. Three-dimensional computed tomography analysis of non-osteoarthritic adult acetabular dysplasia. Skelet Radiol 2009; 38: 131-9.
• Irie T, Orias AAE, Irie TY, et al. Computed tomography-based three-dimensional analyses show similarities in anterosuperior acetabular coverage between acetabular dysplasia and borderline dysplasia. Arthroscopy 2020; S0749-8063(0720)30482-30485.
• van Bosse H, Wedge JH, Babyn P. How are dysplastic hips different? A three-dimensional CT study. Clin Orthop Relat Res 2015; 473: 1712-23.
• Dandachli W, Kannan V, Richards R, Shah Z, Hall-Craggs M, Witt J. Analysis of cover of the femoral head in normal and dysplastic hips: new CT-based technique. J Bone Joint Surg Br 2008; 90: 1428-34.
• Nepple JJ, Wells J, Ross JR, Bedi A, Schoenecker PL, Clohisy JC. Three patterns of acetabular deficiency are common in young adult patients with acetabular dysplasia. Clin Orthop Relat Res 2017; 475: 1037-44.
• Chadayammuri V, Garabekyan T, Jesse MK, et al. Measurement of lateral acetabular coverage: a comparison between CT and plain radiography. J Hip Preserv Surg 2015; 2: 392-400.