Abstract
BackgroundIt was previously reported that pelvises with developmental dysplasia of the hip are tilted anteriorly, which increases bony coverage of the femoral head. This study aimed to investigate the correlation between anatomical parameters of the pelvis such as pelvic incidence and anatomical pelvic tilt and functional parameters of the spine and pelvis such as tilt of the anterior pelvic plane.MethodsWe examined 84 female patients with bilateral developmental dysplasia of the hip who had undergone curved periacetabular osteotomy at author’s institution. Radiographs of the thoracic to lumbar spines and the pelvis were obtained in the standing position to measure spino-pelvic parameters before surgery. Morphological parameters of the acetabulum such as the anterior center-edge (CE) angle, posterior CE angle, lateral CE angle, and acetabular anteversion were measured using a preoperative three-dimensional pelvic model reconstructed from computed tomography images. Pearson’s correlation analysis was conducted to evaluate the relationship of these parameters.ResultsWith regard to correlations between pelvic incidence (PI) and other parameters, the sacral slope (SS) value (r = 0.666) was the highest among functional parameters and the anatomical-SS value (r = 0.789) was the highest among morphological parameters. There were moderate correlations of the anterior pelvic plane angle (APPA) with pelvic tilt (PT) (r = − 0.594) and anatomical-PT (r = 0.646). With regard to correlations between spino-pelvic parameters and bony morphological parameters of the acetabulum, there was a moderate correlation between anatomical-PT and acetabular anteversion (AA) (r = 0.424). There were moderate correlations of APPA with the anterior CE angle (r = − 0.478), posterior CE angle (r = 0.432), and AA (r = 0.565). APPA had a stronger correlation with anatomical-PT (r = 0.646) than with AA.ConclusionsThe tilt of the pelvis may be more dependent on anatomical-PT, a morphological parameter of the pelvis, than the lateral CE angle, anterior CE angle, posterior CE angle, and acetabular anteversion on bony coverage of the acetabulum. This study is the first to investigate the correlation between functional parameters of the pelvis and spine and morphological parameters of the pelvis and acetabulum besides PI.
Highlights
It was previously reported that pelvises with developmental dysplasia of the hip are tilted anteriorly, which increases bony coverage of the femoral head
The purpose of this study was to investigate the correlation between anatomical parameters of the pelvis, Pelvic incidence (PI), anatomical-sacral slope (SS), anatomical-PT, Anterior centeredge angle (ACE), posterior CE angle (PCE), lateral CE angle (LCE), and acetabular anteversion (AA), and functional parameters of the spine and pelvis, SS, pelvic tilt (PT), TK, lumbar lordosis (LL), and anterior pelvic plane angle (APPA)
There was no strong correlation of APPA with PI (r = 0.159) and SS (r = 0.317) (Table 2)
Summary
It was previously reported that pelvises with developmental dysplasia of the hip are tilted anteriorly, which increases bony coverage of the femoral head. Developmental dysplasia of the hip (DDH) is considered one of the more frequent causes of secondary osteoarthritis of the hip, especially in Japan [1]. A higher degree of tilt of the anterior pelvic plane angle (APPA) has been reported in patients with DDH than in normal subjects [2, 3], and it has been considered to increase bony coverage of the femoral head [4]. Gebhart et al [6] described that a higher PI value may affect the development of osteoarthritis of the hip. PI is well known to affect sagittal spinal balance such as lumbar lordosis (LL) and posture in standing position [8, 9]
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