scholarly journals Correlation of tilt of the anterior pelvic plane angle with anatomical pelvic tilt and morphological configuration of the acetabulum in patients with developmental dysplasia of the hip: a cross-sectional study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Norio Imai ◽  
Hayato Suzuki ◽  
Asami Nozaki ◽  
Yuki Hirano ◽  
Naoto Endo
Keyword(s):  
Pelvic Tilt ◽  
Pelvic Incidence ◽  
Developmental Dysplasia ◽  
Morphological Parameters ◽  
Plane Angle ◽  
Acetabular Anteversion ◽  
Anterior Pelvic Plane ◽  
Functional Parameters ◽  
Pelvic Parameters ◽  
Dysplasia Of The Hip

Abstract Background It was previously reported that pelvises with developmental dysplasia of the hip are tilted anteriorly, which increases bony coverage of the femoral head. This study aimed to investigate the correlation between anatomical parameters of the pelvis such as pelvic incidence and anatomical pelvic tilt and functional parameters of the spine and pelvis such as tilt of the anterior pelvic plane. Methods We examined 84 female patients with bilateral developmental dysplasia of the hip who had undergone curved periacetabular osteotomy at author’s institution. Radiographs of the thoracic to lumbar spines and the pelvis were obtained in the standing position to measure spino-pelvic parameters before surgery. Morphological parameters of the acetabulum such as the anterior center-edge (CE) angle, posterior CE angle, lateral CE angle, and acetabular anteversion were measured using a preoperative three-dimensional pelvic model reconstructed from computed tomography images. Pearson’s correlation analysis was conducted to evaluate the relationship of these parameters. Results With regard to correlations between pelvic incidence (PI) and other parameters, the sacral slope (SS) value (r = 0.666) was the highest among functional parameters and the anatomical-SS value (r = 0.789) was the highest among morphological parameters. There were moderate correlations of the anterior pelvic plane angle (APPA) with pelvic tilt (PT) (r = − 0.594) and anatomical-PT (r = 0.646). With regard to correlations between spino-pelvic parameters and bony morphological parameters of the acetabulum, there was a moderate correlation between anatomical-PT and acetabular anteversion (AA) (r = 0.424). There were moderate correlations of APPA with the anterior CE angle (r = − 0.478), posterior CE angle (r = 0.432), and AA (r = 0.565). APPA had a stronger correlation with anatomical-PT (r = 0.646) than with AA. Conclusions The tilt of the pelvis may be more dependent on anatomical-PT, a morphological parameter of the pelvis, than the lateral CE angle, anterior CE angle, posterior CE angle, and acetabular anteversion on bony coverage of the acetabulum. This study is the first to investigate the correlation between functional parameters of the pelvis and spine and morphological parameters of the pelvis and acetabulum besides PI.

Spinopelvic Characteristics in Acetabular Retroversion: Does Pelvic Tilt Change After Periacetabular Osteotomy?

2019 ◽  
Vol 48 (1) ◽  
pp. 181-187 ◽  
Author(s):  
George Grammatopoulos ◽  
Saif Salih ◽  
Paul E. Beaule ◽  
Johan Witt
Keyword(s):  
Pelvic Tilt ◽  
Pelvic Incidence ◽  
Pelvic Ring ◽  
Periacetabular Osteotomy ◽  
Case Series ◽  
Acetabular Retroversion ◽  
Sacral Slope ◽  
Anterior Pelvic Plane ◽  
Level Of Evidence ◽  
Pelvic Position

Background: Acetabular retroversion may lead to impingement and pain, which can be treated with an anteverting periacetabular osteotomy (aPAO). Pelvic tilt influences acetabular orientation; as pelvic tilt angle reduces, acetabular version reduces. Thus, acetabular retroversion may be a deformity secondary to abnormal pelvic tilt (functional retroversion) or an anatomic deformity of the acetabulum and the innominate bone (pelvic ring). Purpose: To (1) measure the spinopelvic morphology in patients with acetabular retroversion and (2) assess whether pelvic tilt changes after successful anteverting PAO (aPAO), thus testing whether preoperative pelvic tilt was compensatory. Study Design: Case series; Level of evidence, 4. Methods: A consecutive cohort of 48 hips (42 patients; 30 ± 7 years [mean ± SD]) with acetabular retroversion that underwent successful aPAO was studied. Spinopelvic morphology (pelvic tilt, pelvic incidence, anterior pelvic plane, and sacral slope) was measured from computed tomography scans including the sacral end plate in 21 patients, with adequate images. In addition, the change in pelvic tilt with aPAO was measured via the sacrofemoral-pubic angle with supine pelvic radiographs at an interval of 2.5 ± 2 years. Results: The spinopelvic characteristics included a pelvic tilt of 4° ± 4°, a sacral slope of 39° ± 9°, an anterior pelvic plane angle of 11° ± 5°, and a pelvic incidence of 42° ± 10°. Preoperative pelvic tilt was 4° ± 4° and did not change postoperatively (4° ± 4°) ( P = .676). Conclusion: Pelvic tilt in acetabular retroversion was within normal parameters, illustrating “normal” sagittal pelvic balance and values similar to those reported in the literature in healthy subjects. In addition, it did not change after aPAO. Thus, acetabular retroversion was not secondary to a maladaptive pelvic tilt (functional retroversion). Further work is required to assess whether retroversion is a reflection of a pelvic morphological abnormality rather than an isolated acetabular abnormality. Treatment of acetabular retroversion should focus on correcting the deformity rather than attempting to change the functional pelvic position.

scholarly journals Association of the Anatomical Sacral Slope With Lumbar Lordosis and Pelvic Incidence in Female Patients With Developmental Hip Dysplasia: A Retrospective Cross-sectional Study

2020 ◽  
Author(s):  
Norio Imai ◽  
Hayato Suzuki ◽  
Atsushi Sakagami ◽  
Yuki Hirano ◽  
Naoto Endo
Keyword(s):  
Correlation Coefficient ◽  
Healthy Subjects ◽  
Lumbar Lordosis ◽  
Pelvic Incidence ◽  
Strong Association ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Developmental Dysplasia ◽  
Sacral Slope ◽  
Dysplasia Of The Hip

Abstract Background:The anatomical sacral slope, considered an anatomical pelvic parameter independent of femoral head centers for measurement, was previously described to strongly correlate withpelvic incidenceon two-dimensional examination of normal healthy subjects. However, the associationbetween anatomical sacral slope and pelvic incidence was unclear in patients withdevelopmental dysplasia of the hip. Thecurrent study aimed to examine the association between anatomical sacral slope and other spinopelvic parameters on plain radiographs in female patients with developmental dysplasia of the hip. Methods:Eighty-four women with developmental dysplasia of the hip were examined. Lumbar lordosis, thoracic kyphosis, pelvic incidence, sacral slope, and anatomical sacral slope, which was deemedthe angle formed by the straight line of the S1 superior endplate and a line at a right angle to the anterior pelvic plane, were determined by plain radiographs. The correlations were examined by Pearson correlation coefficients, and intra- and interrater intraclass correlation coefficients were evaluated forreliability.Results:A strong association was observed between pelvic incidence and anatomical sacral slope (r=0.725, p<0.001). In addition, the association between anatomical sacral slope and lumbar lordosis wassimilar to that between pelvic incidence and lumbar lordosis (r=0.661, p<0.001 and r=0.554, p<0.001, respectively). The intraraterintraclass correlation coefficient values were 0.869 for anatomical sacral slope and 0.824 for pelvic incidence. Furthermore, the interraterintraclass correlation coefficient values were 0.83 for anatomical sacral slope and 0.685 for pelvic incidence. Conclusions:We found that the strong association between anatomical sacral slope and pelvic incidence wasequal to that in normal,healthy subjects. The associationbetweenanatomical sacral slope and lumbar lordosis was equal to that between pelvic incidence and lumbar lordosis. Additionally, the intraclass correlation coefficient value foranatomical sacral slope was slightlyhigher than that forpelvic incidence. We thusconclude that anatomical sacral slope can be considered a helpful anatomical pelvic parameter that isasubstitute for pelvic incidence not only in normal subjectsbut also in patients with developmental dysplasia of the hip.

scholarly journals The severity of developmental dysplasia of the hip does not correlate with the abnormality in pelvic incidence

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Rongshan Cheng ◽  
Muyin Huang ◽  
Willem Alexander Kernkamp ◽  
Huiwu Li ◽  
Zhenan Zhu ◽  
...  
Keyword(s):  
Pelvic Incidence ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Developmental Dysplasia ◽  
Control Group ◽  
Type I ◽  
Type Ii ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
Dysplasia Of The Hip

Abstract Background The purpose of this study was to investigate the association between the severity of Developmental dysplasia of the hip (DDH) and the abnormality in pelvic incidence (PI). Methods This was a retrospective study analyzing 53 DDH patients and 53 non-DDH age-matched controls. Computed tomography images were used to construct three-dimensional pelvic model. The Crowe classification was used to classify the severity of DDH. The midpoint of the femoral head centers and sacral endplates were projected to the sagittal plane of the pelvis. The PI was defined as the angle between a line perpendicular to the sacral plate at its midpoint and a line connecting this point to the axis of the femoral heads. Independent sample t-tests were used to compare the differences between the PI of DDH group and the non-DDH controls group. Kendall’s coefficient of concordance was used to determine the correlation between the severity of DDH and PI. Results Patients with DDH had a significantly (p = 0.041) higher PI than the non-DDH controls (DDH 47.6 ± 8.2°, normal 44.2 ± 8.8°). Crowe type I patients had a significantly (p = 0.038) higher PI (48.2 ± 7.6°) than the non-DDH controls. No significant difference between the PI in Crowe type II or III patients and the PI in non-DDH controls were found (Crowe type II, 50.2 ± 9.6°, p = 0.073; Crowe type III, 43.8 ± 7.2°, p = 0.930). No correlation was found between the severity of DDH and the PI (r = 0.091, p = 0.222). Conclusions No correlation was found between the severity of DDH and the PI. The study confirmed that the PI in DDH (Crowe type I) group was higher than that of the non-DDH control group, while the PI does not correlate with the severity of DDH.

Spinopelvic mobility affects accuracy of acetabular anteversion measurements on cross-table lateral radiographs

2021 ◽  
Vol 103-B (7 Supple B) ◽  
pp. 59-65
Author(s):  
Daniel N. Bracey ◽  
Vishal Hegde ◽  
Andrew J. Shimmin ◽  
Jason M. Jennings ◽  
Jim W. Pierrepont ◽  
...  
Keyword(s):  
Ct Scan ◽  
Acetabular Component ◽  
Pelvic Tilt ◽  
Pelvic Incidence ◽  
Ct Scans ◽  
Acetabular Anteversion ◽  
Spinopelvic Parameters ◽  
Advanced Imaging ◽  
Pelvic Movement ◽  
Tilt Change

Aims Cross-table lateral (CTL) radiographs are commonly used to measure acetabular component anteversion after total hip arthroplasty (THA). The CTL measurements may differ by > 10° from CT scan measurements but the reasons for this discrepancy are poorly understood. Anteversion measurements from CTL radiographs and CT scans are compared to identify spinopelvic parameters predictive of inaccuracy. Methods THA patients (n = 47; 27 males, 20 females; mean age 62.9 years (SD 6.95)) with preoperative spinopelvic mobility, radiological analysis, and postoperative CT scans were retrospectively reviewed. Acetabular component anteversion was measured on postoperative CTL radiographs and CT scans using 3D reconstructions of the pelvis. Two cohorts were identified based on a CTL-CT error of ≥ 10° (n = 11) or < 10° (n = 36). Spinopelvic mobility parameters were compared using independent-samples t-tests. Correlation between error and mobility parameters were assessed with Pearson’s coefficient. Results Patients with CTL error > 10° (10° to 14°) had stiffer lumbar spines with less mean lumbar flexion (38.9°(SD 11.6°) vs 47.4° (SD 13.1°); p = 0.030), different sagittal balance measured by pelvic incidence-lumbar lordosis mismatch (5.9° (SD 18.8°) vs -1.7° (SD 9.8°); p = 0.042), more pelvic extension when seated (pelvic tilt -9.7° (SD 14.1°) vs -2.2° (SD 13.2°); p = 0.050), and greater change in pelvic tilt between supine and seated positions (12.6° (SD 12.1°) vs 4.7° (SD 12.5°); p = 0.036). The CTL measurement error showed a positive correlation with increased CTL anteversion ( r = 0.5; p = 0.001), standing lordosis ( r = 0.23; p = 0.050), seated lordosis ( r = 0.4; p = 0.009), and pelvic tilt change between supine and step-up positions ( r = 0.34; p = 0.010). Conclusion Differences in spinopelvic mobility may explain the variability of acetabular anteversion measurements made on CTL radiographs. Patients with stiff spines and increased compensatory pelvic movement have less accurate measurements on CTL radiographs. Flexion of the contralateral hip is required to obtain clear CTL radiographs. In patients with lumbar stiffness, this movement may extend the pelvis and increase anteversion of the acetabulum on CTL views. Reliable analysis of acetabular component anteversion in this patient population may require advanced imaging with a CT scan. Cite this article: Bone Joint J 2021;103-B(7 Supple B):59–65.

scholarly journals Posterior Pelvic Tilt From Supine to Standing in Patients With Symptomatic Developmental Dysplasia of the Hip

2019 ◽  
Vol 38 (3) ◽  
pp. 578-587 ◽  
Author(s):  
Tetsuro Tani ◽  
Masaki Takao ◽  
Keisuke Uemura ◽  
Yoshito Otake ◽  
Hidetoshi Hamada ◽  
...  
Keyword(s):  
Pelvic Tilt ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip

Pelvic incidence is not associated with the development of hip osteoarthritis

2021 ◽  
Vol 103-B (11) ◽  
pp. 1656-1661
Author(s):  
Makoto Iwasa ◽  
Wataru Ando ◽  
Keisuke Uemura ◽  
Hidetoshi Hamada ◽  
Masaki Takao ◽  
...  
Keyword(s):  
Femoral Head ◽  
Pelvic Incidence ◽  
Hip Osteoarthritis ◽  
Developmental Dysplasia ◽  
Acetabular Anteversion ◽  
Femoral Head Coverage ◽  
Significant Difference ◽  
Hip Disease ◽  
The Difference ◽  
Α Angle

Aims Pelvic incidence (PI) is considered an important anatomical parameter for determining the sagittal balance of the spine. The contribution of an abnormal PI to hip osteoarthritis (OA) remains controversial. In this study, we aimed to investigate the relationship between PI and hip OA, and the difference in PI between hip OA without anatomical abnormalities (primary OA) and hip OA with developmental dysplasia of the hip (DDH-OA). Methods In this study, 100 patients each of primary OA, DDH-OA, and control subjects with no history of hip disease were included. CT images were used to measure PI, sagittal femoral head coverage, α angle, and acetabular anteversion. PI was also subdivided into three categories: high PI (larger than 64.0°), medium PI (42.0° to 64.0°), and low PI (less than 42.0°). The anterior centre edge angles, posterior centre edge angles, and total sagittal femoral head coverage were measured. The correlations between PI and sagittal femoral head coverage, α angle, and acetabular anteversion were examined. Results No significant difference in PI was observed between the three groups. There was no significant difference between the groups in terms of the category distribution of PI. The DDH-OA group had lower mean sagittal femoral head coverage than the other groups. There were no significant correlations between PI and other anatomical factors, including sagittal femoral head coverage, α angle, and acetabular anteversion. Conclusion No associations were found between mean PI values or PI categories and hip OA. Furthermore, there was no difference in PI between patients with primary OA and DDH-OA. From our evaluation, we found no evidence of PI being an independent factor associated with the development of hip OA. Cite this article: Bone Joint J 2021;103-B(11):1656–1661.

scholarly journals Anterior Pelvic Plane: A Potentially Useful Pelvic Anatomical Reference Plane in Assessing the Patients’ Ideal Pelvic Parameters Without the Influence of Spinal Sagittal Deformity

2020 ◽  
pp. 219256822095867
Author(s):  
Chao Liu ◽  
Fanqi Hu ◽  
Zhizhong Li ◽  
Yan Wang ◽  
Xuesong Zhang
Keyword(s):  
Pelvic Incidence ◽  
Full Length ◽  
Reference Plane ◽  
Sacral Slope ◽  
Anterior Pelvic Plane ◽  
Spine Radiography ◽  
Pelvic Parameters ◽  
Equivalent Effect ◽  
Significant Difference ◽  
Sagittal Deformity

Study Design: Observational study. Objective: This study was aimed at investigating the reliability of anterior pelvic plane (APP) as an anatomical reference plane for assessing the patients’ pelvic incidence in patients with ankylosing spondylitis kyphosis deformity. Methods: The globe kyphosis (GK), lumber lordosis (LL), thoracolumbar kyphosis (TLK), thoracic kyphosis (TK), anatomical cervical 7 sacrum angle (aC7SA), and cervical 7 sacrum angle (C7SA) were measured on full-length spine radiography imagines. The pelvic incidence (PI), anatomical pelvic tilt (aPT), and anatomical sacral slope (aSS) were measured on the pelvic synthesized 2D lateral radiography imagines. Because the angle between APP and vertical line was about 4°, Angle1 and tPT were calculated using the following formulas: Angle1 = aC7SA − 4; PT = aPT + 4. According to the study conducted by Vialle, traditional PT (tPT) was calculated using the following widely accepted formula: tPT = PI * 0.37 − 7. Measured PT (mPT) was also measured on the full-length spine radiography imagines. Results: The data analysis showed that PI, mPT, aSS, aPT, and APPA were 50.83 ± 13.44°, 32.52 ± 4.64°, 41.36 ± 9.46°, 8.56 ± 6.80°, and 23.95 ± 5.17°, respectively. There was no significant difference between the PT and tPT (12.56 ± 6.80, 11.49 ± 4.73; P = .152). So, the results demonstrated that the PT could play the equivalent effect as tPT did for making surgical plans in patients with kyphosis deformity. Conclusion: The pelvic anatomical reference plane had potential to be used in assessing the patients’ ideal pelvic incident without the influence of spinal sagittal deformity. The aPT+4 may represent patients’ postoperative ideal PT.

scholarly journals Relationship between pelvic morphology and functional parameters in standing position for patient-specific cup planning in THA

10.29007/41f9 ◽  
2018 ◽  
Author(s):  
Maximilian Fischer ◽  
Stephanie Schörner ◽  
Stefan Rohde ◽  
Christian Lüring ◽  
Klaus Radermacher
Keyword(s):  
Pelvic Tilt ◽  
Planning Process ◽  
Pelvic Incidence ◽  
Pubic Symphysis ◽  
Standing Position ◽  
Patient Specific ◽  
Automatic Process ◽  
Sacral Slope ◽  
Functional Parameters ◽  
Eos Imaging

The sagittal orientation of the pelvis commonly called pelvic tilt has an effect on the orientation of the cup in total hip arthroplasty (THA). Pelvic tilt is different between individuals and changes during activities of daily living. In particular, the pelvic tilt in standing position should be considered during the planning of THA to adapt the target angles of the cup patient-specifically to minimize wear and the risk of dislocation. Methods to measure pelvic tilt require an additional step in the planning process, may be time consuming and additional devices or x-ray imaging are necessary.In this study, the relationship between three functional parameters describing the sagittal pelvic orientation in standing position and seven morphological parameters of the pelvis was investigated. Correlations might be used to estimate the pelvic tilt in standing position by the morphology of the pelvis in order to avoid additional measuring techniques of pelvic tilt in the planning process of THA. For 18 subjects a semi-automatic process was established to match a 3D-reconstruction of the pelvis from CT scans to orthogonal EOS imaging in standing position and to calculate the morphological and functional parameters of the pelvis subsequently.The two strongest correlations of the linear correlation analysis were observed between morphological pelvic incidence and functional sacral slope (r = 0.78; p = 0.0001) and between morphological pubic symphysis-posterior superior iliac spines- ratio and functional tilt of anterior pelvic plane (r = -0.59; p = 0.0098). The results of this study suggest that patient-specific adjustments to the orientation of the cup in planning of THA without additional measurement of the sagittal pelvic orientation in standing position should be based on the correlation between morphological pelvic incidence and functional sacral slope.

Sign in / Sign up

Export Citation Format

Share Document