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Visualization of acetabular coverage with radar chart before and after curved periacetabular osteotomy in dysplastic hips

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Abstract

Background

Curved periacetabular osteotomy (CPO) is indicated for patients with developmental dysplasia of hip (DDH) to prevent progressive osteoarthritis. Patients with DDH have not only lateral acetabulum dysplasia but also anterior and posterior dysplasia. The full circumference acetabular coverage angle (ACA) of the femoral head should be evaluated preoperatively. This study aimed to determine the full circumference ACA in the patients with DDH before and after CPO compared with the coverage in normal patients.

Methods

Twenty-three patients (a total of 24 hips) with DDH undergoing CPO between February 2006 and March 2014 were included in this study. The normal group was defined as the normal side in patients with unilateral osteonecrosis of the femoral head (ONFH) and the non-collapsed femoral head side in patients with bilateral ONFH. Pre- and postoperative hip functions were evaluated using the Japanese Orthopedic Association (JOA) hip score. ACA was measured using pre- and postoperative three-dimensional computed tomography (3DCT) and described as a clock using a radar chart. The ACA of the normal group was evaluated in the same manner as that for patients who underwent CPO. The ACA before CPO was compared with the ACA after CPO, the ACA before CPO was compared with that of the normal group and the ACA after CPO was compared with that of the normal group at each location.

Results

The mean JOA hip scores improved significantly from 69 preoperatively to 88 postoperatively. The superior, posterior, and anterior ACA after CPO significantly increased and the inferior ACA decreased compared with ACA before CPO. The superior, posterior, and anterior ACA before CPO were significantly smaller than ACA in the normal group. The ACA after CPO were similar to the normal group.

Conclusions

CPO improved the anterosuperior coverage of the femoral head but reduced its inferior coverage. The radar chart could visualize acetabulum full circumference and was useful for three-dimensional pre-postoperative evaluation.

1. Introduction

Patients with developmental dysplasia of the hip (DDH) have dysplasia of the acetabulum. The acetabular coverage of the femoral head is insufficient, resulting in concentrated stress on the hip joint during loading. This concentrated stress causes cartilage degeneration, resulting in progressive osteoarthritis (OA) of the hip [

[1]

  • Beltran L.S.
  • Rosenberg Z.S.
  • Mayo J.D.
  • De Tuesta M.D.
  • Martin O.
  • Neto L.P.
  • Bencardino J.T.
Imaging evaluation of developmental hip dysplasia in the young adult.