Key result
Preoperative medial anterior center-edge angle strongly correlates with postoperative anterior coverage and range of motion.
Why the study?
Preoperative pelvic morphology's effect on postoperative anterior coverage and range of motion after curved periacetabular osteotomy was unclear.
Does preoperative pelvic morphology predict postoperative anterior coverage and range of motion after curved periacetabular osteotomy in patients with developmental hip dysplasia?
Observational (n=30)
No
Does preoperative pelvic morphology predict postoperative anterior coverage and range of motion after curved periacetabular osteotomy in patients with developmental hip dysplasia?
Effect estimate: r = 0.92
p-value: p=<.0001
Measuring preoperative parameters reflecting pelvic morphology enables surgeons to predict postoperative anterior coverage and range of motion in curved periacetabular osteotomy cases.
Preoperative medial anterior center-edge angles may predict post-osteotomy coverage in hip dysplasia; hypothesis-generating for surgical planning, pending clinical validation.
This study observed anterior coverage extent after lateral rotation of the acetabulum, without anterior or posterior rotation, during curved periacetabular osteotomy by three-dimensional simulation, and determined if preoperative pelvic morphology affects postoperative anterior coverage and range of motion. Thirty patients scheduled for consecutive primary curved periacetabular osteotomy for developmental hip dysplasia at our hospital between 2016 and 2017 were included. Virtual acetabular osteotomies were performed to achieve a postoperative lateral center-edge angle of 30°. We measured anterior center-edge angles before curved periacetabular osteotomy through the medial one-third and one-quarter of the femoral head as an index reflecting the pelvic morphology medial to the femoral head center. The range of motion simulation was performed after virtual curved periacetabular osteotomy. Single linear regression analysis was performed to examine correlations between preoperative pelvic morphology parameters and anterior center-edge angles after virtual osteotomy. Furthermore, linear regression analysis was used to assess correlations between center-edge angles and simulated range of motions (P < .05). Anterior center-edge angle after virtual osteotomy was more strongly correlated with the anterior center-edge angle through the medial one-third (r = .92, P < .0001) and one-quarter (r = .84, P < .0001) of the femoral head. Flexion angle and internal rotation at 90° flexion showed significant correlations with anterior center-edge angle through the medial one-third (r = -.62, P = .0003; r = -.57, P = .001) and one-quarter (r = -.60, P = .0005; r = -.55, P = .002) of the femoral head and anterior center-edge angle after virtual osteotomy (r = -.67, P = .0005; r = -.62, P = .0003). Measuring preoperative parameters reflecting pelvic morphology enables surgeons to predict postoperative anterior coverage and range of motion in curved periacetabular osteotomy cases.
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Kamenaga et al. (2020) conducted an observational in Developmental hip dysplasia (n=30). Preoperative pelvic morphology (anterior center-edge angles) was evaluated on Anterior center-edge angle after virtual osteotomy and simulated range of motion (r = 0.92, p=<.0001). Preoperative anterior center-edge angle through the medial one-third of the femoral head strongly correlated with postoperative anterior coverage (r = 0.92, P < 0.0001) and range of motion.
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