Abstract
BackgroundWe hypothesized that preoperative pelvic morphology may affect postoperative anterior coverage and postoperative clinical range of motion (ROM) leading to postoperative pincer type femoroacetabular impingement (FAI). The aim of this study was to evaluate the relationships between preoperative bone morphology and postoperative ROMs to prevent postoperative FAI after periacetabular osteotomy.MethodsSixty-eight patients (71 hips) with hip dysplasia participated in this study and underwent curved PAO. The acetabular fragment was usually moved only by lateral rotation of the acetabulum, without intraoperative anterior or posterior rotation. The pre- and postoperative three-dimensional center-edge (CE) angles were measured and compared to the postoperative ROM.ResultsPreoperative medial anterior CE angle was significantly associated with postoperative anterior CE angle, and the correlation coefficient of medial anterior CE and postoperative anterior CE was higher than the coefficient of preoperative anterior CE and postoperative anterior CE (preoperative anterior CE, rr = 0.27, p = 0.020; preoperative medial anterior CE, rr = 0.54, p < 0.001). Femoral anteversion correlated with postoperative internal rotation angle at 90° flexion (r = 0.32, p = 0.021). In multiple linear regressions, postoperative internal rotation angle at 90° flexion angle was significantly affected by both medial CE angle through the medial one fourth of femoral head and femoral anteversion.ConclusionsPreoperative medial anterior acetabular coverage was associated with postoperative anterior acetabular coverage. Further, the combination with preoperative medial anterior acetabular coverage and femoral anteversion can predict postoperative internal rotation at 90° flexion. Therefore, the direction of acetabular reorientation should be carefully considered when the patients have high preoperative medial anterior CE angle and small femoral anteversion.
Highlights
We hypothesized that preoperative pelvic morphology may affect postoperative anterior coverage and postoperative clinical range of motion (ROM) leading to postoperative pincer type femoroacetabular impingement (FAI)
Hamada et al reported, in a three-dimensional (3D)-computed tomography (CT) simulation study, that only lateral rotation of the acetabulum to achieve a lateral center-edge (CE) angle of 30° resulted in larger anterior coverage than that of normal hips in half of the Developmental dysplasia of the hip (DDH) cases, and a wide variation of anterior coverage was seen after lateral rotation of the acetabulum [12]
We aimed to evaluate the relationships among preoperative pelvic morphology medial to the femoral head center, postoperative acetabular anterior coverage at the femoral head center, and clinical ROM after periacetabular osteotomy (PAO)
Summary
We hypothesized that preoperative pelvic morphology may affect postoperative anterior coverage and postoperative clinical range of motion (ROM) leading to postoperative pincer type femoroacetabular impingement (FAI). The movement of the acetabulum causes a mismatch between the acetabulum and femoral neck, which reduces flexion and internal rotation of hip range of motion (ROM) and can lead to femoroacetabular impingement (FAI) after periacetabular osteotomy (PAO) [7]. Hamada et al reported, in a three-dimensional (3D)-computed tomography (CT) simulation study, that only lateral rotation of the acetabulum to achieve a lateral center-edge (CE) angle of 30° resulted in larger anterior coverage than that of normal hips in half of the DDH cases, and a wide variation of anterior coverage was seen after lateral rotation of the acetabulum [12]. In a 3D-simulation study, that anterior coverage was increased by only lateral rotation of the acetabulum without anterior or posterior rotation during curved PAO [13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
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 call
