Preoperative assessment of acetabular sectoral deficiency during developmental dysplasia of the hip.

Authors

  • A. E. Loskutov SI “Dnipropetrovsk State Medical Academy of Health Ministry of Ukraine”, Dnipro, Ukraine, Ukraine
  • E. A. Kovbasa SI “Dnipropetrovsk State Medical Academy of Health Ministry of Ukraine”, Dnipro, Ukraine, Ukraine
  • A. E. Oleynik SI “Dnipropetrovsk State Medical Academy of Health Ministry of Ukraine”, Dnipro, Ukraine, Ukraine
  • V. G. Strijeniy SE “Regional Clinic Hospital named after I.I. Mechnikov”, Dnipro, Ukraine, Ukraine
  • A. V. Gubarik SE “Regional Clinic Hospital named after I.I. Mechnikov”, Dnipro, Ukraine, Ukraine

DOI:

https://doi.org/10.26641/1997-9665.2019.1.21-31

Keywords:

total hip replacement, developmental dysplasia of the hip, acetabulum, sectoral deficiency, frontal inclination

Abstract

Backgroud. Variability and combination of acetabular morphological abnormalities make a wide spectrum of deformity patterns that requires reliable visualization. Acetabular deficiency localization and severity, as well as frontal inclination angle are pivotal for implantation technique, however inaccessible through a routine radiography. Objective. To assess acetabular sectoral deficiency during DDH and to define its correlation with head’s cranial migration and indeces of acetabular sphericity. Methods. there were revealed a complex comparative MSCT-mophometric investigation of 32 normal hips and 65 hips with DDH. Results. Normal values of acetabular coverage were defined as AASA - 63,5º [57; 68], PASA – 105º [97; 115], HASA - 166º [163; 178], Wiberg angle – 40º [39; 43], Sharp angle – 37º [35; 38]; acetabular frontal inclination - 22◦ [17; 26]. There were revealed strong correlation between HASA and femoral head’s cranial migration (r=-0,65, p<0,00001) and acetabular sphericity index (r=0,89, p<0,00001) that confirms progressive deepening of acetabular deficiency accordingly to severity of dysplasia. The analogue tendency is defined for anterior ASA: Crowe I – 45◦ [40; 50], Crowe II – 35◦ [28; 38], Crowe III – 25,5◦ [27; 31] (p<0,001). Posterior wall deficiency isn’t accompanied neigher with anterior (r=0,17) nor superior (r=0,43) one. No statistical markable difference (p>0,05) was defined between acetabular inclination angles neither during between-group nor intra-group comparison. There were carried out that acetabular inclination is defined as relation of anterior and posterior sector angles (½ х (PASA-ASA)). Conclusion. Acetabular sectoral deficiency remains to be multidirectional and is realized in multiple deformity patterns. MSCT-morphomerty during preplanning is of outstanding value due to verification and quantification of acetabular sectoral deficiency that is an issue for implantation technique selection.

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Loskutov, A. E., Kovbasa, E. A., Oleynik, A. E., Strijeniy, V. G., & Gubarik, A. V. (2019). Preoperative assessment of acetabular sectoral deficiency during developmental dysplasia of the hip. Морфологія / Morphologia / Morfologìâ, 13(1), 21–31. https://doi.org/10.26641/1997-9665.2019.1.21-31

Issue

Vol. 13 No. 1 (2019)

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Copyright (c) 2019 Loskutov A.E., Kovbasa E.A., Oleynik A.E., Strijeniy V.G., Gubarik A.V., Morphologia

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