Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia.

Lerch, Till Dominic; Boschung, Adam; Schmaranzer, Florian; Todorski, Inga A. S.; Vanlommel, Jan; Siebenrock, Klaus A.; Steppacher, Simon D.; Tannast, Moritz (2021). Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia. Bone & joint open, 2(10), pp. 813-824. The British Editorial Society of Bone & Joint Surgery 10.1302/2633-1462.210.BJO-2021-0069.R1

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AIMS

The effect of pelvic tilt (PT) and sagittal balance in hips with pincer-type femoroacetabular impingement (FAI) with acetabular retroversion (AR) is controversial. It is unclear if patients with AR have a rotational abnormality of the iliac wing. Therefore, we asked: are parameters for sagittal balance, and is rotation of the iliac wing, different in patients with AR compared to a control group?; and is there a correlation between iliac rotation and acetabular version?

METHODS

A retrospective, review board-approved, controlled study was performed including 120 hips in 86 consecutive patients with symptomatic FAI or hip dysplasia. Pelvic CT scans were reviewed to calculate parameters for sagittal balance (pelvic incidence (PI), PT, and sacral slope), anterior pelvic plane angle, pelvic inclination, and external rotation of the iliac wing and were compared to a control group (48 hips). The 120 hips were allocated to the following groups: AR (41 hips), hip dysplasia (47 hips) and cam FAI with normal acetabular morphology (32 hips). Subgroups of total AR (15 hips) and high acetabular anteversion (20 hips) were analyzed. Statistical analysis was performed using analysis of variance with Bonferroni correction.

RESULTS

PI and PT were significantly decreased comparing AR (PI 42° (SD 10°), PT 4° (SD 5°)) with dysplastic hips (PI 55° (SD 12°), PT 10° (SD 6°)) and with the control group (PI 51° (SD 9°) and PT 13° (SD 7°)) (p < 0.001). External rotation of the iliac wing was significantly increased comparing AR (29° (SD 4°)) with dysplastic hips (20°(SD 5°)) and with the control group (25° (SD 5°)) (p < 0.001). Correlation between external rotation of the iliac wing and acetabular version was significant and strong (r = 0.81; p < 0.001). Correlation between PT and acetabular version was significant and moderate (r = 0.58; p < 0.001).

CONCLUSION

These findings could contribute to a better understanding of hip pain in a sitting position and extra-articular subspine FAI of patients with AR. These patients have increased iliac external rotation, a rotational abnormality of the iliac wing. This has implications for surgical therapy with hip arthroscopy and acetabular rim trimming or anteverting periacetabular osteotomy (PAO). Cite this article: Bone Jt Open 2021;2(10):813-824.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Lerch, Till; Boschung, Adam; Schmaranzer, Florian; Todorski, Inga Almut Senta; Siebenrock, Klaus-Arno; Steppacher, Simon Damian and Tannast, Moritz

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2633-1462

Publisher:

The British Editorial Society of Bone & Joint Surgery

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

03 Nov 2021 13:18

Last Modified:

03 Nov 2021 13:18

Publisher DOI:

10.1302/2633-1462.210.BJO-2021-0069.R1

PubMed ID:

34619033

Uncontrolled Keywords:

Acetabular retroversion CT scans FAI Femoroacetabular impingement Hip Hip dysplasia Pelvic incidence Pelvic tilt acetabular rim cam-type FAI dysplastic hips femoroacetabular impingement hip pain hips pelvic incidence pelvic tilting

BORIS DOI:

10.48350/160046

URI:

https://boris.unibe.ch/id/eprint/160046

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