Pelvic Bone Deformity and Its Correlation with Acetabular Center-edge Angle

Between August 2014 and April 2015, we prospectively evaluated patients aged between 20 and 60 years old. The exclusion criteria were: metabolic disease, previous hip or spine surgery, radiograph showing hip arthrosis ≥ Tönnis two, severe hip dysplasia, global acetabular overcoverage, acetabular crossover sign, hip deformities from slipped capital femoral epiphysis (SCFE) or Leg-Perthes-Calveé, and bad quality radiographs. At anteroposterior (AP) pelvic radiographs, we have evaluated: the CE angle, the acetabular index (IA), the acetabular crossover sign, the vertical and horizontal superior and inferior pelvic axis (H1: Horizontal line 1, superior pelvic axis; H2: Horizontal line 2, superior pelvic axis; V1: Vertical line, superior pelvic axis; HR: Horizontal line, inferior pelvic axis; VR: Vertical line, inferior pelvic axis). The superior and inferior pelvic axis were considered asymmetric when there was a difference ≥ 5 mm between both sides. Patients were divided into two groups: control and group 1.

Results

A total of 228 patients (456 hips) were evaluated in the period. According to the established criteria, 93 patients were included. The mean age was 39.9 years old (20 to 60 years old, standard deviation [SD] = 10,5), and the mean CE angle in the right hip was 31.5º (20 ^o to 40º), and in the left 32.3º (20 ^o to 40º). The control group had 38 patients, with asymmetric H1 in 4 cases (10.5%), H2 in 5 (13.1%), V1 in 7 (18.4%), HR in 5 (13.1%) and VR in 1 (2.63%). Group 1 had 55 patients, with asymmetric H1 in 24 cases (43.6%), H2 in 50 (90.9%), V1 in 28 (50.9%), HR in 16 (29.09%) and VR in 8 (14.5%). Comparing both groups, there was statistical significance for H1, H2 and V1 asymmetry (p < 0.001).

Conclusion

In the present paper, we observed the correlation between variation in the acetabular CE angle and asymmetry of the superior hemipelvis. The present authors believe that a better understanding of the pelvic morphologic alterations allows a greater facility in the diagnosis of hip articular deformities.

Keywords
hip dislocation; acetabulum; femur head

Exclusion Criteria	Excluded
Previous hip or spine surgery	6
Arthrosis ≥ Tönnis 2	12
Severe DDH	8
Global acetabular overcoverage	14
Sign of intersection of acetabular lines	60
Asymmetry of CE angle 1º or 2º	11
Asymmetry of CE angle + unilateral acetabular retroversion	9
SCFE or Legg-Perthes-Calveé	3
Radiography without adequate quality	12
Total	135

Groups		H1 R	H1 L	H2 R	H2 L	V1 R	V1 L	HR R	HR L	VR R	VR L
Control	1	71	71	94	93	101	102	67	67	67	68
	2	57	65	91	92	92	91	96	92	55	51
	3	55	58	85	87	103	100	90	88	80	79
	4	51	52	86	89	95	98	93	91	58	57
	5	43	43	90	80	115	115	80	88	55	55
	6	49	49	97	98	112	112	90	90	57	57
	7	66	67	88	88	110	110	76	76	68	69
	8	55	61	92	100	126	124	91	100	66	68
	9	50	50	111	113	134	134	83	84	60	60
	10	73	75	108	106	133	131	91	91	65	67
	11	88	88	106	106	131	139	81	90	77	77
	12	64	62	100	99	131	133	85	85	53	53
	13	72	72	102	100	126	121	76	78	88	90
	13	58	60	105	105	137	137	90	88	51	53
	15	57	60	110	115	105	107	87	85	75	73
	16	55	57	85	87	133	134	85	83	52	50
	17	78	78	108	109	132	127	91	90	69	67
	18	62	60	126	124	137	143	88	87	60	61
	19	72	70	100	100	142	142	80	82	80	80
	20	57	55	105	105	151	141	96	97	59	59
	21	60	60	103	102	112	112	84	82	77	76
	22	58	59	94	92	110	110	94	86	67	66
	23	56	56	98	97	97	98	89	89	77	77
	24	51	53	102	101	110	110	98	98	78	78
	25	50	50	98	98	111	112	89	91	57	56
	26	56	57	88	88	110	110	76	76	69	69
	27	65	68	86	88	104	101	89	88	81	80
	28	50	52	87	90	95	97	93	93	58	56
	29	50	50	112	113	134	134	83	83	60	61
	30	64	65	108	108	132	131	90	89	66	67
	31	64	63	99	98	132	133	85	86	54	53
	32	58	60	105	105	137	137	82	84	53	54
	33	55	57	85	86	130	131	85	85	52	51
	34	82	82	100	100	140	138	81	82	77	77
	35	56	55	103	102	112	112	82	80	76	76
	36	55	54	99	100	97	96	90	90	77	77
	37	63	64	102	101	107	109	95	95	75	75
	38	80	80	100	99	140	142	80	80	82	82
	Mean	60.68	61.53	99.05	119.89	119.84	86.34	86.55	66.61	66.45	98.89
	Standard Deviation	10.212	10.01	9.291	16.256	16.045	6.671	6.5	10.612	10.84	9.282

Groups		H1 R	H1 L	H2 R	H2 L	V1 R	V1 L	HR R	HR L	VR R	VR L
Acetabular inclination	1	45	45	90	80	100	99	105	105	68	66
	2	84	81	90	92	170	170	76	76	72	70
	3	60	50	110	100	100	100	80	80	72	74
	4	50	45	100	94	100	105	96	96	64	63
	5	62	62	107	100	113	115	87	87	72	72
	6	55	50	104	100	102	104	88	88	77	75
	7	53	58	72	89	105	109	75	73	63	70
	8	60	54	92	86	112	110	88	86	67	66
	9	56	57	110	117	110	115	97	107	64	62
	10	50	50	90	98	100	100	70	74	67	65
	11	73	64	107	97	112	112	69	70	65	65
	12	57	51	92	93	107	107	80	79	70	68
	13	50	58	92	97	128	123	90	92	47	47
	13	82	73	114	110	134	139	93	90	77	77
	15	69	69	120	124	138	143	90	80	84	75
	16	55	60	118	128	146	145	88	87	52	50
	17	52	58	76	80	127	124	89	89	59	59
	18	70	70	112	119	135	138	90	90	58	60
	19	55	48	115	100	128	108	85	83	40	42
	20	67	83	116	120	136	136	75	66	55	53
	21	61	62	118	109	135	143	85	75	87	72
	22	51	40	85	92	124	127	83	86	57	57
	23	49	49	148	123	144	146	95	93	60	60
	24	80	82	104	97	119	120	73	75	85	83
	25	47	46	82	88	118	116	86	84	57	55
	26	53	53	101	96	109	132	82	84	75	73
	27	69	69	102	98	138	129	92	90	60	58
	28	62	60	95	94	134	135	95	94	62	61
	29	42	42	94	102	144	149	102	95	72	67
	30	55	55	98	90	145	153	94	92	85	84
	31	60	60	75	81	113	112	82	83	85	73
	32	62	55	104	94	98	104	70	62	66	64
	33	57	61	102	108	108	104	86	88	77	77
	34	60	61	96	102	102	102	68	68	72	72
	35	44	44	83	91	97	97	77	76	65	65
	36	72	72	119	124	137	143	90	82	83	81
	37	55	61	120	128	145	145	87	87	51	45
	38	52	59	75	80	127	123	89	89	72	71
	39	67	67	113	119	135	139	92	90	58	60
	40	56	48	110	100	128	108	85	83	41	42
	41	66	83	116	121	136	136	71	67	54	44
	42	61	63	117	109	136	143	85	76	74	72
	43	51	41	86	92	124	127	82	86	60	60
	44	49	48	140	123	144	144	95	95	58	58
	45	80	82	104	96	119	121	73	74	85	83
	46	48	46	82	89	118	116	87	84	55	58
	47	54	53	101	95	109	132	82	84	74	73
	48	70	69	102	98	138	129	92	91	59	58
	49	44	42	94	101	143	149	98	92	65	66
	50	50	50	98	89	145	153	94	93	70	69
	51	60	61	76	81	113	113	83	83	75	73
	52	62	55	104	93	98	104	70	62	62	61
	53	57	62	101	108	108	104	86	86	72	72
	54	61	61	96	101	103	103	68	66	60	63
	55	45	44	83	92	97	96	77	77	60	59
	Mean	58.49	58.04	100.51	122.44	123.62	84.85	83.45	66.8	64.29	100.93
	Standard Deviation	10.011	11.41	13.179	17.359	18.27	9.093	9.867	11.453	10.544	15.608

	H1		H2		V1		VR		HR
Asymmetry	Yes	No	Yes	No	Yes	No	Yes	No	Yes	No	Total
Inclination	24	31	50	5	28	27	0	0	16	39	55
Acetabular	85.70%	47.70%	90.90%	13.20%	77.80%	47.40%	0.00%	0.00%	76.20%	54.20%	59.10%
Control	4	34	5	33	8	30	0	0	5	33	38
Control	14.30%	52.30%	9.10%	86.80%	12.20%	52.60%	0.00%	0.00%	13.80%	45.80%	40.90%
Total	28	65	55	38	36	57	0	0	21	69	88
Total	100%	100%	100%	100%	100%	100%	100%	100%	100%	100%	100%
Significance	p = 0.001		p < 0.001		p = 0.005		p = 000		p = 0.82

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence Bruno Dutra Roos,MD, Grupo de Quadril do Hospital Ortopédico de Passo Fundo, Faculdade de Medicina da Universidade de Passo Fundo, Av. Sete de Setembro, 817, Centro, Passo Fundo, RS 99010-121, Brasil (e-mail: brunodroos@gmail.com).

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Pelvic Bone Deformity and Its Correlation with Acetabular Center-edge Angle* * Study conducted at the Hip Group of the Hospital Ortopédico de Passo Fundo, Faculdade de Medicina da Universidade de Passo Fundo, Passo Fundo, RS, Brazil.

Abstract

Objective

Methods

Results

Conclusion

Pelvic Bone Deformity and Its Correlation with Acetabular Center-edge Angle^* * Study conducted at the Hip Group of the Hospital Ortopédico de Passo Fundo, Faculdade de Medicina da Universidade de Passo Fundo, Passo Fundo, RS, Brazil.