Evaluation of Anterior Coverage in Children With Developmental Dysplasia of the Hip Using Transverse Magnetic Resonance Imaging at 2 Years Is Predictive of Future Radiographic Coverage.
Journal
Journal of pediatric orthopedics
ISSN: 1539-2570
Titre abrégé: J Pediatr Orthop
Pays: United States
ID NLM: 8109053
Informations de publication
Date de publication:
01 09 2022
01 09 2022
Historique:
pubmed:
25
6
2022
medline:
11
8
2022
entrez:
24
6
2022
Statut:
ppublish
Résumé
Although normal anterior acetabular coverage provides stability to the hip, acetabular retroversion leads to femoroacetabular impingement related to hip osteoarthritis. Previous studies have focused on acetabular version and anteroposterior coverage in children with developmental dysplasia of the hip (DDH); however, the correlation between anteroposterior coverage and acetabular development is unclear. We measured anteroposterior acetabular coverage in DDH patients using transverse magnetic resonance imaging (MRI) and subsequent bony acetabular growth, and evaluated the correlation of those findings. We evaluated 37 DDH (dislocations) in 36 patients who underwent MRI at 2 years of age. The mean age was 2.2±0.3 years at the time of MRI (1.6±0.4 y after reduction) and 6.0±0.1 years at the time of plain radiography for the Severin classification. On MRI scans, we measured the cartilaginous center-edge angle (CCEA) and cartilaginous acetabular-head index (CAHI) in the coronal plane and the anterior and posterior cartilaginous center-edge angles (AC-CEA and PC-CEA, respectively) in the transverse plane. Severin I or II was defined as a good outcome and III or IV as a poor outcome. In the evaluations conducted at 2 years of age, the mean CCEA, CAHI, AC-CEA, and PC-CEA were 14±9 degrees, 66%±10%, 39±8 degrees, and 77±7 degrees, respectively; the CEA at 6 years of age was 13±7 degrees. Twelve and 25 hips were classified in the good and poor outcome groups, respectively. Although CCEA, CAHI, and AC-CEA were significantly associated with the outcome in a single regression analysis ( P <0.05), only AC-CEA was significant in the multiple regression analysis with a stepwise selection method ( P =0.018). The cutoff AC-CEA value for a good outcome was 38 degrees (sensitivity, 67%; specificity, 68%) using a receiver operating characteristic curve. Among MRI findings for acetabular cartilaginous morphology, AC-CEA was strongly associated with the outcome. Anteroposterior coverage was correlated with bony acetabular growth in childhood, and anterior coverage was particularly important for subsequent acetabular growth. Level IV-case series.
Sections du résumé
BACKGROUND
Although normal anterior acetabular coverage provides stability to the hip, acetabular retroversion leads to femoroacetabular impingement related to hip osteoarthritis. Previous studies have focused on acetabular version and anteroposterior coverage in children with developmental dysplasia of the hip (DDH); however, the correlation between anteroposterior coverage and acetabular development is unclear. We measured anteroposterior acetabular coverage in DDH patients using transverse magnetic resonance imaging (MRI) and subsequent bony acetabular growth, and evaluated the correlation of those findings.
METHODS
We evaluated 37 DDH (dislocations) in 36 patients who underwent MRI at 2 years of age. The mean age was 2.2±0.3 years at the time of MRI (1.6±0.4 y after reduction) and 6.0±0.1 years at the time of plain radiography for the Severin classification. On MRI scans, we measured the cartilaginous center-edge angle (CCEA) and cartilaginous acetabular-head index (CAHI) in the coronal plane and the anterior and posterior cartilaginous center-edge angles (AC-CEA and PC-CEA, respectively) in the transverse plane. Severin I or II was defined as a good outcome and III or IV as a poor outcome.
RESULTS
In the evaluations conducted at 2 years of age, the mean CCEA, CAHI, AC-CEA, and PC-CEA were 14±9 degrees, 66%±10%, 39±8 degrees, and 77±7 degrees, respectively; the CEA at 6 years of age was 13±7 degrees. Twelve and 25 hips were classified in the good and poor outcome groups, respectively. Although CCEA, CAHI, and AC-CEA were significantly associated with the outcome in a single regression analysis ( P <0.05), only AC-CEA was significant in the multiple regression analysis with a stepwise selection method ( P =0.018). The cutoff AC-CEA value for a good outcome was 38 degrees (sensitivity, 67%; specificity, 68%) using a receiver operating characteristic curve.
CONCLUSIONS
Among MRI findings for acetabular cartilaginous morphology, AC-CEA was strongly associated with the outcome. Anteroposterior coverage was correlated with bony acetabular growth in childhood, and anterior coverage was particularly important for subsequent acetabular growth.
LEVEL OF EVIDENCE
Level IV-case series.
Identifiants
pubmed: 35749759
doi: 10.1097/BPO.0000000000002196
pii: 01241398-202209000-00015
doi:
Substances chimiques
Carcinoembryonic Antigen
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e874-e877Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Chen IH, Kuo KN, Lubicky JP. Prognosticating factors in acetabular development following reduction of developmental dysplasia of the hip. J Pediatr Orthop. 1994;14:3–8.
Albinana J, Dolan LA, Spratt KF, et al. Acetabular dysplasia after treatment for developmental dysplasia of the hip. implications for secondary procedures. J Bone Joint Surg Br. 2004;86:876–886.
Tsukagoshi Y, Kamegaya M, Kamada H, et al. The correlation between Salter’s criteria for avascular necrosis of the femoral head and Kalamchi’s prognostic classification following the treatment of developmental dysplasia of the hip. Bone Joint J. 2017;99B:1115–1120.
Goronzy J, Blum S, Hartmann A, et al. Is MRI an adequate replacement for CT scans in the three-dimensional assessment of acetabular morphology? Acta Radiol. 2018;60:726.
Tsukagoshi Y, Kamada H, Kamegaya M, et al. Three-dimensional MRI analysis of femoral head remodeling after reduction in patients with developmental dysplasia of the hip. J Pediatr Orthop. 2018;38:e377–e381.
Tsukagoshi Y, Kamada H, Takeuchi R, et al. Three-dimensional MRI analyses of prereduced femoral head sphericity in patients with developmental dysplasia of the hip after pavlik harness failure. J Pediatr Orthop B. 2018;27:394–398.
Tomaru Y, Kamada H, Tsukagoshi Y, et al. The relationship between gluteus medius and minimus muscle volumes and hip development in developmental dysplasia of the hip. J Orthop Sci. 2021. doi: 10.1016/j.jos.2021.06.020.
doi: 10.1016/j.jos.2021.06.020
Takeuchi R, Kamada H, Mishima H, et al. Evaluation of the cartilaginous acetabulum by magnetic resonance imaging in developmental dysplasia of the hip. J Pediatr Orthop B. 2014;23:237–243.
Walbron P, Müller F, Mainard-Simard L, et al. Bone maturation of MRI residual developmental dysplasia of the hip with discrepancy between osseous and cartilaginous acetabular index. J Pediatr Orthop B. 2019;28:419–423.
Shirai Y, Wakabayashi K, Wada I, et al. Magnetic resonance imaging evaluation of the labrum to predict acetabular development in developmental dysplasia of the hip. Medicine (Baltimore). 2017;96:e7013.
Tetsunaga T, Tetsunaga T, Akazawa H, et al. Evaluation of the labrum on postoperative magnetic resonance images: a predictor of acetabular development in developmental dysplasia of the hip. Hip Int. 2021. doi: 10.1177/11207000211004917.
doi: 10.1177/11207000211004917
Ganz R, Parvizi J, Beck M, et al. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120.
Imai H, Kamada T, Takeba J, et al. Anterior coverage after eccentric rotational acetabular osteotomy for the treatment of developmental dysplasia of the hip. J Orthop Sci. 2014;19:762–769.
Peterson JB, Doan Meng J, Bomar JD, et al. Sex differences in cartilage topography and orientation of the developing acetabulum: Implications for hip preservation Surgery. Clin Orthop Relat Res. 2015;473:2489–2494.
Hingsammer AM, Bixby S, Zurakowski D, et al. How do acetabular version and femoral head coverage change with skeletal maturity? Clin Orthop Relat Res. 2015;473:1224–1233.
Lu W, Li L, Zhang L, et al. Development of acetabular anteversion in children with normal hips and those with developmental dysplasia of the hip: a cross-sectional study using magnetic resonance imaging. Acta Orthop. 2021;92:341–346.
Wang C, Wu K, Wang T, et al. Comparison of acetabular anterior coverage after salter osteotomy and pemberton acetabuloplasty: a long-term followup. Clin Orthop Relat Res. 2014;472:1001–1009.
Kawamura Y, Tetsunaga T, Akazawa H, et al. Acetabular depth, an early predictive factor of acetabular development: MRI in patients with developmental dysplasia of the hip after open reduction. J Pediatr Orthop B. 2021;30:509–514.
Kobayashi D, Satsuma S, Kinugasa M, et al. Does salter innominate osteotomy predispose the patient to acetabular retroversion in adulthood? Clin Orthop Relat Res. 2015;473:1755–1762.
Anda S, Svenningsen S, Dale LG, et al. The acetabular sector angle of the adult hip determined by computed tomography. Acta Radiol Diagn. 1986;27:443–447.
Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint: with special reference to the complication of osteoarthritis. Acta Chir Scand. 1939;83:53–68.
Severin E. Congenital dislocation of the hip joint. Acta Chir Scand. 1941;84:32–54.
Douira-Khomsi W, Smida M, Louati H, et al. Magnetic resonance evaluation of acetabular residual dysplasia in developmental dysplasia of the hip: a preliminary study of 27 patients. J Pediatr Orthop. 2010;30:37–43.
Nepple J, Wells J, Ross J, et al. Three patterns of acetabular deficiency are common in young adult patients with acetabular dysplasia. Clin Orthop Relat Res. 2017;475:1037–1044.
Cai Z, Zhao Q, Li L, et al. Can computed tomography accurately measure acetabular anterversion in developmental dysplasia of the hip? Verification and characterization using 3D printing technology. J Pediatr Orthop. 2018;38:e180–e185.
Clohisy J, Carlisle J, Beaulé P, et al. A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am. 2008;90:47–66.
Herman M, Krivoniak A, Ruh E, et al. Acetabular coverage decreases at the end of skeletal growth: a 3DCT study of healthy hips. J Pediatr Orthop. 2021;41:e232–e239.
Grammatopoulos G, Jamieson P, Dobransky J, et al. Acetabular version increases during adolescence secondary to reduced anterior femoral head coverage. Clin Orthop Relat Res. 2019;477:2470–2478.
Kleinberg S, Lieberman HS. The acetabular index in infants in relation to congenital dislocation of the hip. Arch Surg. 1936;32:1049–1054.
Lalonde FD, Frick SL, Wenger DR. Surgical correction of residual hip dysplasia in two pediatric age-groups. J Bone Joint Surg Am. 2002;84:1148–1156.
Barrett WP, Staheli LT, Chew DE. The effectiveness of the salter innominate osteotomy in the treatment of congenital dislocation of the hip. J Bone Joint Surg Am. 1986;68:79–87.