Does Acetabular Coverage Vary Between the Supine and Standing Positions in Patients with Hip Dysplasia?

• DOI: 10.1097/corr.0000000000000898
• Publication Date: 2019-08-06T12:10:48Z
• Authors: Tetsuya Tachibana; Masanori Fujii; Kenji Kitamura; Tetsuro Nakamura; Yasuharu Nakashima
• Keywords: Pelvic tilt; Supine position; Hip Dysplasia

Although variation in physiologic pelvic tilt may affect acetabular version and coverage, postural change patients with hip dysplasia who are candidates for preservation surgery has not been well characterized, its clinical importance is unknown.The aim of this study was to determine (1) changes sagittal between the supine standing positions; (2) orientation coverage femoral head (3) patient demographic morphologic factors associated tilt.Between 2009 2016, 102 underwent osteotomy treat dysplasia. All had AP radiographs CT images taken during their preoperative examination. Ninety-five (lateral center-edge angle < 20°) younger than 60 years old were included. Patients advanced osteoarthritis, other disease, prior or spine surgery, deformity, inadequate imaging excluded. Sixty-five (64%) eligible participation retrospective study. Two board-certified orthopaedic surgeons (TT MF) investigated tilt, spinopelvic parameters, using images. Intra- interobserver reliabilities, evaluated intraclass correlation coefficient (0.90 0.98, 0.93 0.99, 0.87 0.96, respectively), excellent. Demographic data (age, gender, BMI) collected by medical record review. Sagittal quantified as formed anterior plane a z-axis (anterior angle). Using 2D-3D matching technique, we measured version, three-dimensional positions. We correlated measurement parameters Pearson's Spearman's coefficients.Although functional varied widely among individuals, pelvis tilted posteriorly from position (mean APP 8° ± 6° versus 2° 7°; mean difference -6°; 95% CI, -7° -5°; range -17° 4.1°; p 0.001; paired t-test).The more 5° 39 (60%), greater 10° 12 (18%). In latter subgroup patients, anteversion increased (22° 27° ±5°; 5°; 4°-6°; 0.001) anterosuperior sector notably deceased (91° 11° 77° 14°; -14°; -11°; t-test). Postural any studied including age, BMI, coverage.On average, dysplasia, resulting decreased position. Thus, assessment radiograph overlook weightbearing recommend assessing when diagnosing planning surgery. Further studies needed how biomechanical environment results reorientation osteotomy.Level IV, diagnostic