Radiographic signs for detection of femoroacetabular impingement and hip dysplasia should be carefully used in patients with osteoarthritis of the hip

BMC Musculoskeletal Disorders

Falk Mittag¹  Roland Syha³  Elisabeth Buck¹  Saskia Sachsenmaier¹  Ina-Christine Rondak⁴  Ingmar Ipach² 

[1] Department of Orthopaedic Surgery, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72074 Tuebingen, Germany;Department of Orthopedic Surgery, Hospital of Ingolstadt, Krumenauerstraße 25, 85021 Ingolstadt, Germany;Department of Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Straße 3, 72074 Tuebingen, Germany;Department of Medical Statistics and Epidemiology, Technische Universität München, Ismaninger Str. 22, Munich 81675, Germany

关键词: Osteoarthritis;    Dysplasia;    Hip;    Impingement;    Radiographic Signs;   

Others  :  1127673
DOI  :  10.1186/1471-2474-15-150

 received in 2014-01-10, accepted in 2014-04-30,  发布年份 2014

【 摘 要 】

Background

During the last years, terms like acetabular retroversion, excessive overcoverage, and abnormal head-neck-junction with the so called “pistol-grip-deformity” has been added to the classical description of hip dysplasia. These anatomical changes could lead to a femoroacetabular impingement (FAI). Both kinds of FAI has been indentified as a main reason for hip pain and progressive degenerative changes leading to early osteoarthritis of the hip. A lot of radiographic criteria on pelvic views have been established to detect classical dysplasia and FAI. The present study was initiated to assess the hypothesis that age and severity of osteoarthritis affect measurements of different radiographic parameters.

Methods

The pelvic radiographs of 1614 patients were measured for head-ratio, CE-angle, roof obliquity, extrusion-index, depth-to-width ratio, CCD-angle, sharp’s angle. To evaluate the severity of osteoarthritis of the hip the classification by Kellgren and Lawrence was used. Associations between age and radiographic parameters or severity of osteoarthritis were assessed by Spearman’s (ρ) or Kendall’s (r) rank correlation coefficient, respectively.

Results

366 (22.7%) patients presented no sign of osteoarthritis, 367 (22.7%) patients presented I° osteoarthritis, 460 (28.5%) patients presented II° osteoarthritis, 307 (19%) III° osteoarthritis and 114 (7.1%) IV° osteoarthritis of the hip. The mean head-ratio of all patients was 1.13 ± 0.26 (0.76 – 2.40), the mean CE-angle 40.05° ± 10.13° (0° - 70°), the mean roof obliquity was 35.27°± 4.96° (10° – 55°), the mean extrusion-index was 12.99 ± 9.21 (6.20 – 95.2), the mean depth-to-width ratio was 59.30 ± 8.90 (6.30 – 100), the mean CCD-angle was 127.68° ± 7.22° (123° – 162°) and the mean sharp’s angle was 9.75° ± 5.40° (1° - 34°) There was a weak association between age and the severity of osteoarthritis of the hips (left: r = 0.291; right: r = 0.275; both P < 0.001) with higher osteoarthritis levels observable for elderly patients).

Conclusion

Severity of osteoarthritis has a negative impact on measurements of different radiographic parameters. Therefore - in our opinion - epidemiological studies on prearthrotic deformities should only be performed in healthy adults with no signs of osteoarthritic changes.

【 授权许可】

   
2014 Ipach et al.; licensee BioMed Central Ltd.

【 图 表 】

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