Abstract
The purpose of this study was to correlate measures of sagittal spinopelvic alignment [lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT) and pelvic incidence (PI)] and measures of acetabular coverage [lateral center edge angle (LCEA) and Tonnis angle] in asymptomatic adolescents on standing biplanar radiographs. We hypothesized that subjects with increased pelvic incidence and LL would have increased anterior PT and increased measures of acetabular coverage. Upright anteroposterior and lateral spinopelvic radiographs were obtained using EOS imaging technique. LCEA and Tonnis angle were calculated on the anteroposterior images and the lateral images were analyzed for LL, PI, PT and SS. LL was found to have a strong correlation with SS (rs = 0.786, P < 0.001), moderate correlation with PI (rs = 0.529, P < 0.001), and a poor inverse correlation with PT (rs = −0.167, P = 0.018). However, LCEA was not found to be significantly correlated with PT (rs = 0.084, P = 0.238) and Tonnis angle was not found to be correlated with any of the sagittal spinopelvic measures. Healthy, asymptomatic adolescents with increased pelvic incidence and lumbar lordosis did not have increased anterior PT or increased measures of acetabular coverage. The correlations identified in previous cadaveric studies or clinical studies evaluating changes between supine and standing radiographs are not supported in this healthy adolescent population. Our findings may suggest that an individual’s acetabulum develops as a dynamic adaptation to one's particular sagittal spinopelvic alignment to optimize femoral head coverage. Level III. Diagnostic – Investigating a diagnostic test.
Highlights
Prior cadaveric studies have shown that pelvic tilt (PT) influences radiographic measures of acetabular retroversion and dysplasia for a given pelvis [1, 2], and that PT varies when someone is standing or supine [3]
lateral center edge angle (LCEA) and Tonnis angle were calculated on the anteroposterior images and the lateral images were analyzed for lumbar lordosis (LL), pelvic incidence (PI), PT and sacral slope (SS)
LCEA was not found to be significantly correlated with PT and Tonnis angle was not found to be correlated with any of the sagittal spinopelvic measures
Summary
Prior cadaveric studies have shown that pelvic tilt (PT) influences radiographic measures of acetabular retroversion and dysplasia for a given pelvis [1, 2], and that PT varies when someone is standing or supine [3] This has led some authors to recommend obtaining a standardized supine anteroposterior (AP) pelvis radiograph to accurately assess hip pathology [1]. Significant variations in pelvic morphologic parameters [PT, pelvic incidence, sacral slope (SS), lumbar lordosis] have been demonstrated in healthy young adult populations [1, 4, 5] Taken together, this makes accurate assessment of acetabular version, coverage and dysplasia for a given individual challenging on a supine anteroposterior radiograph. With hip flexion and internal rotation, the femoral neck has been shown to abut the labrum
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
