Key result
Borderline hip dysplasia is characterized by significant tridimensional anatomical alterations, most notably a diminished anterior acetabular surface, which patients are 11.2 times more likely to have compared to healthy controls.
Case-Control (n=54)
No
Computerized tomography reveals that borderline hip dysplasia is characterized by insufficient acetabular coverage along the superior, anterior, and inferior axes, providing tridimensional anatomical insights beyond the lateral center edge angle.
CT may refine borderline hip dysplasia assessment beyond lateral center-edge angle; leaves open impact on outcomes or surgical thresholds.
Background Borderline hip dysplasia (BhD) might be associated with insufficient acetabular coverage. Thus, we investigated potential differences in acetabular anatomical measurements derived from computerized tomography (CT) that characterize BhD compared with healthy controls. Methods BhD patients (LCEA between 18º and 25º) and healthy controls (LCEA between 25º and 40º) underwent anteroposterior pelvic X-ray and CT to study Wiberg and Tönnis angle, extrusion and Fear index, notch width and depth, anterior and posterior wall height, anterior and posterior articular surfaces, articular circumference, the ratio between the anterior articular surface and the articular circumference, the ratio between the posterior articular surface and the articular circumference, and the ratio between the notch width and the articular circumference. An independent two-tailed t-test, U of Mann-Whitney test, and odds ratios were obtained (α = 5%). Results Twenty-three BhD patients aged 31.5 ± 8.3 years and LCEA 21.6° ± 4.0° and thirty-one healthy controls aged 34.1 ± 8.0 years and LCEA 33.7° ± 5.5° were included. The sensitive CT features for BhD were anterior ( p < 0.001) acetabular surface, anterior ( p = 0.009), anteroposterior ( p = 0.008) and posterior ( p < 0.008) acetabular surface ratios, and acetabular notch width ( p = 0.002). Conclusions BhD CT characterization provides tridimensional anatomical insights beyond the LCEA. BhD insufficient acetabular coverage can be found along the superior (lower Wiberg angle, and increased Tönnis angle and extrusion index), anterior (lower anterior acetabular surface and anteroposterior acetabular surface ratio, and increased posterior acetabular ratio), and inferior (increased acetabular notch width) axis.
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Lara et al. (2024) conducted a case-control in Borderline hip dysplasia (n=54). Borderline hip dysplasia vs. Healthy controls was evaluated on Diminished anterior acetabular surface (OR 11.2, 95% CI 2.23-56.17, p=0.001). Borderline hip dysplasia is characterized by significant tridimensional anatomical alterations, most notably a diminished anterior acetabular surface, which patients are 11.2 times more likely to have compared to healthy controls.
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