Abstract
IntroductionThe prevalence of acetabular retroversion is sparsely investigated. It may be associated with increased anterior pelvic tilt. The purpose of this study was to investigate whether patients with symptomatic and radiographically verified acetabular retroversion demonstrated increased anterior pelvic tilt compared to a control group, and furthermore to evaluate the prevalence of acetabular retroversion in the general population. MethodsAnteroposterior pelvic radiographs in standing position of 111 patients with acetabular retroversion prior to anteverting periacetabular osteotomy (PAO) and 132 matched controls from the general Danish population were assessed. Pelvic tilt was assessed by the sacrococcygeal joint–symphysis distance and pelvic-tilt-ratio. Acetabular retroversion was defined as positive cross-over sign and posterior wall sign. Prior to assessments, interrater reliability analysis was performed. Measurements were agreed by two independent assessors. A nonparametric regression model was used to test between-group differences in median pelvic tilt. The prevalence was calculated as the ratio of subjects and hips with acetabular retroversion, respectively. ResultsThe patient group had significantly larger median anterior pelvic tilt of 14.3 mm in sacrococcygeal joint–symphysis distance and −0.08 in pelvic-tilt-ratio, compared to controls. The prevalence of subjects in the general population with either unilateral or bilateral acetabular retroversion was 24% and 18% for all hips. ConclusionOur data demonstrated that patients with symptomatic acetabular retroversion have increased anterior pelvic tilt compared to the general population. Radiographic sign of acetabular retroversion was highly prevalent in the general population. Implication for practiceIncreased anterior pelvic tilt should be considered when diagnosing and treating patients with hip pain, as symptoms may be related to the functional position of the pelvis and not necessarily solely come from the radiographic verified acetabular retroversion.
Highlights
The prevalence of acetabular retroversion is sparsely investigated
The purpose of this study was to investigate whether patients with symptomatic and radiographically verified acetabular retroversion demonstrated increased anterior pelvic tilt compared to a sample from the general population, and to evaluate the prevalence of acetabular retroversion in the general population
D: difference, n: numbers, F/M: females/males, %: percent, IQR: interquartile range, BMI: body mass index, sacrococcygeal jointesymphysis (SC-S): vertical distance between the sacrococcygeal joint and the upper edge of the symphysis, mm: millimeters, PTR: pelvic tilt ratio. a Median difference. b Chi-square test. c Wilcoxon rank-sum test. d Incomplete matching 2:1, no statistical difference in the distribution of sex (p 1⁄4 0.09). This is the first study to demonstrate that patients with symptomatic acetabular retroversion undergoing periacetabular osteotomy (PAO) had increased anterior pelvic tilt and that the general population had a prevalence of acetabular retroversion of 24% measured as the presence of both COS and PWS
Summary
The prevalence of acetabular retroversion is sparsely investigated. It may be associated with increased anterior pelvic tilt. The purpose of this study was to investigate whether patients with symptomatic and radiographically verified acetabular retroversion demonstrated increased anterior pelvic tilt compared to a control group, and to evaluate the prevalence of acetabular retroversion in the general population. Results: The patient group had significantly larger median anterior pelvic tilt of 14.3 mm in sacrococcygeal jointesymphysis distance and À0.08 in pelvic-tilt-ratio, compared to controls. Conclusion: Our data demonstrated that patients with symptomatic acetabular retroversion have increased anterior pelvic tilt compared to the general population. Implication for practice: Increased anterior pelvic tilt should be considered when diagnosing and treating patients with hip pain, as symptoms may be related to the functional position of the pelvis and not necessarily solely come from the radiographic verified acetabular retroversion.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have