Relationship between Wiberg's lateral center edge angle, Lequesne's acetabular index, and medial acetabular bone stock

Background: Hip arthroscopy has traditionally been performed with a perineal post, resulting in various groin-related complications, including pudendal nerve neurapraxias, vaginal tears, and scrotal necrosis. Purpose: To assess the safety of a technique for hip distraction without the use of a perineal post. Study Design: Case series; Level of evidence, 4. Methods: We prospectively analyzed a consecutive cohort of 1000 hips presenting to a dedicated hip preservation clinic; all patients had hip pain and were subsequently treated with hip arthroscopy. Demographic variables, hip pathology, and lateral center edge angle were recorded for each case. In the operating room, the patient’s feet were placed in traction boots in a specifically designed distraction setup, and the operative table was placed in varying degrees of Trendelenburg. With this technique, enough resistance is created by gravity and friction between the patient’s body and the bed to allow for successful hip distraction without the need for a perineal post. In a subset of 309 hips (n = 281 patients), the degrees of Trendelenburg as well as the distraction force were analyzed. Results: The mean ± SD Trendelenburg angle used among the subset of 309 hips was 11° ± 2°. The mean initial distraction force necessary was 90 ± 28 lb, which decreased to 65 ± 24 lb by 30 minutes after traction initiation ( P < .0001). The most important variables in determining initial force for this cohort of patients were, in order of magnitude, sex ( P < .0001), weight ( P < .0001), and lateral center edge angle ( P < .01). No groin-related complications occurred among the entire cohort of patients, including soft tissue or nerve-related complications. The rate of deep venous thrombosis was 2 in 1000. Conclusion: The use of the Trendelenburg position and a specially designed distraction setup during hip arthroscopy allows for safe hip distraction without a perineal post, thereby eliminating groin-related soft tissue and nerve complications. Certain patient variables can be used to estimate the required distraction force and inclination angle with this method.

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Lateral Center-edge Angle on Conventional Radiography and Computed Tomography

Clinical Orthopaedics and Related Research ◽

10.1007/s11999-012-2651-6 ◽

2012 ◽

Vol 471 (7) ◽

pp. 2233-2237 ◽

Cited By ~ 23

Author(s):

Shafagh Monazzam ◽

James D. Bomar ◽

Krishna Cidambi ◽

Peter Kruk ◽

Harish Hosalkar

Keyword(s):

Computed Tomography ◽

Conventional Radiography ◽

Edge Angle ◽

Center Edge ◽

Lateral Center Edge Angle ◽

Center Edge Angle

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Periacetabular osteotomy with concomitant hip arthroscopy: A case series with 24 months minimum follow-up

Medwave ◽

10.5867/medwave.2020.11.8082 ◽

2020 ◽

Vol 20 (11) ◽

pp. e8082-e8082

Author(s):

Cristian Barrientos ◽

Julián Brañes ◽

Rodrigo Olivares ◽

Rodrigo Wulf ◽

Álvaro Martinez ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Hip Arthroscopy ◽

Periacetabular Osteotomy ◽

Case Series ◽

Resonance Imaging ◽

Edge Angle ◽

Center Edge ◽

Lateral Center Edge Angle ◽

Center Edge Angle

Purpose To describe patient-reported outcomes, radiological results, and revision to total hip replacement in patients with hip dysplasia that underwent periacetabular osteotomy as isolated treatment or concomitant with hip arthroscopy. Methods Case series study. Between 2014 and 2017, patients were included if they complained of hip pain and had a lateral center-edge angle ≤ of 20°. Exclusion criteria included an in-maturate skeleton, age of 40 or older, previous hip surgery, concomitant connective tissue related disease, and Tönnis osteoarthritis grade ≥ 1. All patients were studied before surgery with an anteroposterior pelvis radiograph, false-profile radiograph, and magnetic resonance imaging. Magnetic resonance imaging was used to assess intraarticular lesions, and if a labral or chondral injury was found, concomitant hip arthroscopy was performed. The non-parametric median test for paired data was used to compare radiological measures (anterior and lateral center-edge angle, Tönnis angle, and extrusion index) after and before surgery. Survival analysis was performed using revision to total hip arthroplasty as a failure. Kaplan Meier curve was estimated. The data were processed using Stata. Results A total of 15 consecutive patients were included; 14 (93%) were female patients. The median follow-up was 3.5 years (range, 2 to 8 years). The median age was 20 (range 13 to 32). Lateral center-edge angle, Tönnis angle, and extrusion index correction achieved statistical significance. Seven patients (47%) underwent concomitant hip arthroscopy; three of them (47%) were bilateral (10 hips). The labrum was repaired in six cases (60%). Three patients (15%) required revision with hip arthroplasty, and no hip arthroscopy-related complications are reported in this series. Conclusion To perform a hip arthroscopy concomitant with periacetabular osteotomy did not affect the acetabular correction. Nowadays, due to a lack of conclusive evidence, a case by case decision seems more appropriate to design a comprehensive treatment.

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Value of susceptibility-weighted imaging for the assessment of angle measurements reflecting hip morphology

Scientific Reports ◽

10.1038/s41598-020-77671-1 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Sarah M. Böker ◽

Lisa C. Adams ◽

Ute Lina Fahlenkamp ◽

Gerd Diederichs ◽

Bernd Hamm ◽

...

Keyword(s):

Imaging Modality ◽

Linear Regression Analysis ◽

Maximum Intensity Projection ◽

Additional Information ◽

Edge Angle ◽

Center Edge ◽

Hip Morphology ◽

Line Imaging ◽

Lateral Center Edge Angle ◽

Center Edge Angle

AbstractRadiographs are the clinical first line imaging modality for evaluating hip morphology and pathology. MRI offers additional information and is the method of choice to evaluate soft tissue, bone marrow and preradiographic signs of osteoarthritis. Radiographs are used to measure the most morphometric parameters. The aim of this study was to compare susceptibility weighted MRI (SWMR) with radiographs to evaluate hip morphology. 40 Patients were examined with standard MR-sequences, coronal SWMR and radiographs in anteroposterior pelvic view. Coronal maximum intensity projection (MIP) images of both hips were automatically reconstructed on SWMR and T1weighted images. Sharp´s angle, Tönnis angle, lateral center–edge angle of Wiberg and caput-collum-diaphyseal angle were measured on coronal SWMR MIP-images, T1weighted MIP-images and radiographs. Measurements were compared by linear regression analysis and Bland-Altmann Plots, using radiographs as reference standard. Additionally, a ratio between the signal intensity of muscles and bone on SWMR and T1weighted MIP-images was calculated and compared between these two sequences. SWMR enables the reliable assessment of Sharp´s angle (SWMR: R2 = 0.80; T1weighted: R2 = 0.37), Tönnis angle (SWMR: R2 = 0.86; T1weighted: not measurable), lateral center–edge angle of Wiberg (SWMR: R2 = 0.88; T1weighted: R2 = 0.40) and caput-collum-diaphyseal angle (SWMR: R2 = 0.38; T1weighted: R2 = 0.18) compared to radiographs with a higher accuracy than conventional MR imaging. The ratio between the intensity of muscles and bone was significant higher on SWMR (2.00 and 2.02) than on T1weighted MIP-images (1.6 and 1.42; p < 0.001).

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Reduction by Pelvic External Fixator Followed by Innominate and Derotational Femoral Osteotomies for Late Presenting Bilateral Developmental Dysplasia of the Hip

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1016/j.jotr.2018.01.001 ◽

2018 ◽

Vol 25 (1) ◽

pp. 76-81

Author(s):

Teplenky Mikhail ◽

Mekki Waleed

Keyword(s):

External Fixator ◽

Developmental Dysplasia ◽

Femoral Osteotomy ◽

Acetabular Index ◽

Edge Angle ◽

Center Edge ◽

Challenging Situation ◽

Dysplasia Of The Hip ◽

Center Edge Angle

Introduction Bilateral developmental dysplasia of the hip is a challenging situation, closed and open reduction with or without pelvic and femoral osteotomies are all proposed. Methods We investigated the feasibility of closed ilizarov reduction combined with Salter and femoral osteotomy to provide stable concentric hips. Results We retrospectively reviewed 19 patients (38 hips). Tonnis Criteria, acetabular index and Center-edge angle were measured preoperatively and postoperatively. Acetabular index changed significantly (P<0,001), 80% were excellent or good according to Mckay, 25% were Ia and 69% were IIa Severin's criteria with at least three years follow-up. Conclusion The midterm overall results are favorable for application of this technique.

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No Correlation Between Depth of Acetabuloplasty or Postoperative Lateral Center-Edge Angle on Midterm Outcomes of Hip Arthroscopy With Acetabuloplasty and Labral Repair: Response

The American Journal of Sports Medicine ◽

10.1177/03635465211030227 ◽

2021 ◽

Vol 49 (11) ◽

pp. NP57-NP58

Author(s):

Marc J. Philippon ◽

Joseph J. Ruzbarsky ◽

Adam W. Johannsen ◽

Rui Soares ◽

Lauren A. Pierpont ◽

...

Keyword(s):

Hip Arthroscopy ◽

Labral Repair ◽

Edge Angle ◽

Center Edge ◽

Lateral Center Edge Angle ◽

Center Edge Angle

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Superior Clinical Outcomes with Capsular Closure versus Non-Closure in Patients Undergoing Arthroscopic Hip Labral Repair

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118s00009 ◽

2018 ◽

Vol 6 (3_suppl) ◽

pp. 2325967118S0000 ◽

Cited By ~ 7

Author(s):

Ioanna Bolia ◽

Karen K. Briggs ◽

Marc J. Philippon

Keyword(s):

Clinical Outcomes ◽

Hip Arthroscopy ◽

Labral Repair ◽

Secondary Outcome ◽

Edge Angle ◽

Center Edge ◽

Lateral Center Edge Angle ◽

Closure Group ◽

Center Edge Angle

Objectives: Controversy still exists on closing the capsule following hip arthroscopy. It is unclear if capsular closure at the end of hip arthroscopy results in better clinical outcomes compared to non-closure. The purpose of this study was to compare the clinical outcomes in patients who had a closed capsule to those without a closed capsule following hip arthroscopic labral repair by a single surgeon. Methods: Patients who did not have capsular closure were identified by reviewing arthroscopy video (non-closure group). Fifty consecutive patients without capsular closure were matched with fifty patients who had capsular closure. All patients underwent primary hip arthroscopy and labral repair. The primary patient-reported outcome measure was Hip Outcome Score(HOS)-ADL. Secondary outcome measures included the modified Harris hip score(MHHS), HOS-Sport, WOMAC, general health, and patient satisfaction with outcome. Patients with lateral center edge angle less than 25º were excluded. Results: There were 23 females and 27 males with an average age of 36 years (range:14 to 77) in each group. The average lateral center edge angle was 34º (range, 27 to 48) in both groups. The alpha angle was 68º (range, 40 to 134) in the non-closure group and 70º (range, 41 to 98) in the closure group. No patient had microfractures at the time of surgery. The average follow-up time was 5 years (non-closure group range: 3-10; closure group range 3-9). Eight patients (16%) in the non-closure group required total hip arthroplasty(THA), while 4 patients (8%) in the closure group required THA. Six patients in the non-closure group and 3 patients in the closure group required revision hip arthroscopy. Of those patients who did not require revision or THA, there was a significant difference in the HOS ADL score and the secondary outcome measures (see table). Capsular closure resulted in superior clinical outcomes compared to non-closure. Conclusion: There were twice as many conversion to THA and twice as many hip arthroscopy revisions in patients undergoing hip arthroscopic labral repair without capsular closure compared to those with closure. In addition, the closure group showed significantly higher outcomes scores compared to the non-closure at 5-year follow-up time. [Table: see text]

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