The variation in hip stability measurements between supine and standing radiographs of dysplastic hips

Aims The aims of this study were to compare clinically relevant measurements of hip dysplasia on radiographs taken in the supine and standing position, and to compare Hip2Norm software and Picture Archiving and Communication System (PACS)-derived digital radiological measurements. Methods Preoperative supine and standing radiographs of 36 consecutive patients (43 hips) who underwent periacetabular osteotomy surgery were retrospectively analyzed from a single-centre, two-surgeon cohort. Anterior coverage (AC), posterior coverage (PC), lateral centre-edge angle (LCEA), acetabular inclination (AI), sharp angle (SA), pelvic tilt (PT), retroversion index (RI), femoroepiphyseal acetabular roof (FEAR) index, femoroepiphyseal horizontal angle (FEHA), leg length discrepancy (LLD), and pelvic obliquity (PO) were analyzed using both Hip2Norm software and PACS-derived measurements where applicable. Results Analysis of supine and standing radiographs resulted in significant variation for measurements of PT (p < 0.001) and AC (p = 0.005). The variation in PT correlated with the variation in AC in a limited number of patients (R2 = 0.378; p = 0.012). Conclusion The significant variation in PT and AC between supine and standing radiographs suggests that it may benefit surgeons to have both radiographs when planning surgical correction of hip dysplasia. We also recommend using PACS-derived measurements of AI and SA due to the poor interobserver error on Hip2Norm. Cite this article: Bone Joint J 2021;103-B(11):1662–1668.

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Is the Femoro-Epiphyseal Acetabular Roof (FEAR) index on MRI a relevant predictive factor of instability in a borderline dysplastic hip?

The Bone & Joint Journal ◽

10.1302/0301-620x.101b12.bjj-2019-0502.r1 ◽

2019 ◽

Vol 101-B (12) ◽

pp. 1578-1584 ◽

Cited By ~ 3

Author(s):

Cécile Batailler ◽

Jan Weidner ◽

Michael Wyatt ◽

Dominik Pfluger ◽

Martin Beck

Keyword(s):

Interobserver Reliability ◽

Periacetabular Osteotomy ◽

Femoral Anteversion ◽

Control Group ◽

Acetabular Roof ◽

Plain Radiographs ◽

Radiological Measurement ◽

Hip Stability ◽

Fear Index ◽

Dysplastic Hip

Aims A borderline dysplastic hip can behave as either stable or unstable and this makes surgical decision making challenging. While an unstable hip may be best treated by acetabular reorientation, stable hips can be treated arthroscopically. Several imaging parameters can help to identify the appropriate treatment, including the Femoro-Epiphyseal Acetabular Roof (FEAR) index, measured on plain radiographs. The aim of this study was to assess the reliability and the sensitivity of FEAR index on MRI compared with its radiological measurement. Patients and Methods The technique of measuring the FEAR index on MRI was defined and its reliability validated. A retrospective study assessed three groups of 20 patients: an unstable group of ‘borderline dysplastic hips’ with lateral centre edge angle (LCEA) less than 25° treated successfully by periacetabular osteotomy; a stable group of ‘borderline dysplastic hips’ with LCEA less than 25° treated successfully by impingement surgery; and an asymptomatic control group with LCEA between 25° and 35°. The following measurements were performed on both standardized radiographs and on MRI: LCEA, acetabular index, femoral anteversion, and FEAR index. Results The FEAR index showed excellent intraobserver and interobserver reliability on both MRI and radiographs. The FEAR index was more reliable on radiographs than on MRI. The FEAR index on MRI was lower in the stable borderline group (mean -4.2° (sd 9.1°)) compared with the unstable borderline group (mean 7.9° (sd 6.8°)). With a FEAR index cut-off value of 2°, 90% of patients were correctly identified as stable or unstable using the radiological FEAR index, compared with 82.5% using the FEAR index on MRI. The FEAR index was a better predictor of instability on plain radiographs than on MRI. Conclusion The FEAR index measured on MRI is less reliable and less sensitive than the FEAR index measured on radiographs. The cut-off value of 2° for radiological FEAR index predicted hip stability with 90% probability. Cite this article: Bone Joint J 2019;101-B:1578–1584

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Long-term results of Bernese periacetabular osteotomy using a dual approach in hip dysplasia

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-04090-w ◽

2021 ◽

Author(s):

Hyun Chul Shon ◽

Woo Sung Park ◽

Jae-Suk Chang ◽

Seong-Eun Byun ◽

Dong-Wook Son ◽

...

Keyword(s):

Hip Dysplasia ◽

Periacetabular Osteotomy ◽

Long Term Results ◽

Dual Approach

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Pain and quality of life are impaired in adults with hip dysplasia undergoing periacetabular osteotomy: a systematic review and meta-analysis

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2021.05.049 ◽

2021 ◽

Vol 29 ◽

pp. S31

Author(s):

M.J. O'Brien ◽

A. Semciw ◽

L. Reimer ◽

C. Stewart ◽

P. Mechlenburg ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Hip Dysplasia ◽

Meta Analysis ◽

Periacetabular Osteotomy

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Comparison of stirrup lengths chosen for flatwork by novice and experienced riders

Comparative Exercise Physiology ◽

10.3920/cep170033 ◽

2018 ◽

Vol 14 (4) ◽

pp. 223-230 ◽

Cited By ~ 1

Author(s):

M. Andrews-Rudd ◽

C. Farmer-Day ◽

H.M. Clayton ◽

J.M. Williams ◽

D.J. Marlin

Keyword(s):

Standing Position ◽

Knee Angle ◽

Leg Length ◽

Greater Trochanter ◽

Significant Difference ◽

And Function ◽

Leg Position ◽

Combined Data

Although stirrups may be considered an essential part of equestrian equipment, there is little research describing their use and function. The aim of the present study was to compare stirrup lengths chosen for flatwork by novice and experienced riders, and to measure the associated leg position and knee angles. Ten novice and ten experienced riders, with kinematic markers attached to their greater trochanter, lateral femoral epicondyle, and lateral fibular malleolus, mounted three horses and a mechanical horse. The riders selected an appropriate stirrup length for flatwork by adjusting the unnumbered stirrup leathers. Stirrup length was measured and expressed as a percentage of the rider’s leg length measured from the greater trochanter to the floor when standing. Lateral photographs were taken from both sides with the riders mounted on each horse in a standing position. The kinematic markers were digitised to measure knee angle and ankle position relative to the hip in the anteroposterior direction. Within riders, there was no significant difference in stirrup length between the three live horses or between the mechanical horse and live horse. Experienced riders consistently selected a significantly longer stirrup length as a percentage of their leg length compared with novice riders (combined data for live horses and mechanical horse; P=0.005). Experienced riders demonstrated a significantly larger knee angle (combined data for live horses and mechanical horse) compared with novice riders (118±8° and 109±7°, respectively; P=0.016). Novice riders had a significantly larger knee angle on the mechanical horse compared with the live horse (115±9° versus 107±9°, respectively; P=0.003). The relatively longer stirrup length selected by experienced riders is thought to reflect the development of an independent seat, which implies the ability to move the legs independently of the pelvis. The chair seat adopted by novice riders on the mechanical horse could be considered counter to improving their equitation skills.

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Concomitant Arthroscopy With Labral Reconstruction and Periacetabular Osteotomy for Hip Dysplasia

Arthroscopy Techniques ◽

10.1016/j.eats.2018.07.012 ◽

2018 ◽

Vol 7 (11) ◽

pp. e1141-e1147 ◽

Cited By ~ 4

Author(s):

David R. Maldonado ◽

Justin M. LaReau ◽

Ajay C. Lall ◽

Muriel R. Battaglia ◽

Mitchell R. Mohr ◽

...

Keyword(s):

Hip Dysplasia ◽

Periacetabular Osteotomy

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Patient-specific template and electromagnetic navigation assisted bilateral periacetabular osteotomy for staged correction of bilateral injury-induced hip dysplasia: a case report

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnab054 ◽

2021 ◽

Author(s):

Peter Brumat ◽

Rene Mihalič ◽

Črt Benulič ◽

Anže Kristan ◽

Rihard Trebše

Keyword(s):

Case Report ◽

Hip Dysplasia ◽

Periacetabular Osteotomy ◽

Patient Specific ◽

Computer Assisted ◽

Electromagnetic Navigation ◽

Assisted Navigation ◽

High Surgical Risk ◽

Unique Method ◽

Post Traumatic

ABSTRACT Periacetabular osteotomy (PAO) for pelvic fracture sequelae presents a challenge in hip preservation surgery due to a combination of complex conditions involving post-traumatic altered anatomy and technically demanding procedure, with high surgical risk involved. To address these challenging conditions and evade potential devastating complications, a combination of patient-specific template (PST) and electromagnetic navigation (EMN) guidance can be used to increase the safety of the procedure and the accuracy of the acetabular reorientation. Herein we report our experience utilizing a combined PST- and EMN-assisted bilateral PAO for staged correction of bilateral severe, injury-induced hip dysplasia. The presented case report describes a unique method of successful surgical treatment of severe, bilateral injury-induced hip dysplasia with combined 3-D printing technology (PST) and intra-operative electromagnetic computer-assisted navigation (EMN) aided technically demanding surgical procedure (PAO), which emphasizes the benefits of PST and EMN use in hip preservation surgery in patients with complex pathoanatomic circumstances.

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