How Do Acetabular Version and Femoral Head Coverage Change With Skeletal Maturity?

BACKGROUND: Normal changes in acetabular version over the course of skeletal development have not been well characterized. Knowledge of normal version development is important because acetabular retroversion has been implicated in several pathologic hip processes. QUESTIONS/PURPOSES: The purpose of...

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Publicado no:	Clin Orthop Relat Res
Main Authors:	Hingsammer, Andreas M., Bixby, Sarah, Zurakowski, David, Yen, Yi-Meng, Kim, Young-Jo
Formato:	Artigo
Idioma:	Inglês
Publicado em:	Springer US 2014
Assuntos:	Symposium: 2014 Bernese Hip Symposium
Acesso em linha:	https://ncbi.nlm.nih.gov/pmc/articles/PMC4353546/ https://ncbi.nlm.nih.gov/pubmed/25344405 https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1007/s11999-014-4014-y
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id	pubmed-4353546
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spelling	pubmed-43535462016-04-01 How Do Acetabular Version and Femoral Head Coverage Change With Skeletal Maturity? Hingsammer, Andreas M. Bixby, Sarah Zurakowski, David Yen, Yi-Meng Kim, Young-Jo Clin Orthop Relat Res Symposium: 2014 Bernese Hip Symposium BACKGROUND: Normal changes in acetabular version over the course of skeletal development have not been well characterized. Knowledge of normal version development is important because acetabular retroversion has been implicated in several pathologic hip processes. QUESTIONS/PURPOSES: The purpose of this study was to characterize the orientation of the acetabulum by measuring (1) acetabular version and (2) acetabular sector angles in pediatric patients during development. We also sought to determine whether these parameters vary by sex in the developing child. METHODS: We evaluated CT images of 200 hips in 100 asymptomatic pediatric patients (45 boys, 55 girls; mean age, 13.5 years; range, 9–18 years) stratified by the status of the triradiate physis and sex. We determined the acetabular anteversion angle at various levels in the axial plane as well as acetabular sector angles at five radial planes around the acetabulum. RESULTS: For both genders, anteversion angle was greater for the closed physis group throughout all levels (p < 0.001) and both open and closed physis groups were more anteverted as the cut moved caudally away from the acetabular roof (p < 0.001). At the center of the femoral head, the mean anteversion angle (± SD) in girls was 15° ± 3° in the open group and 19° ± 5° in the closed group (p < 0.001). In boys, the mean anteversion angle increased from 14° ± 4° in the open group to 19° ± 4° in the closed group (p = 0.003). In the superior, posterosuperior, and posterior planes, the acetabular sector angles were greater in the closed compared with the open physis group for both boys and girls with the largest increase occurring in the male posterosuperior plane (approximately 20°) (all p < 0.05). CONCLUSIONS: This study demonstrates that acetabular anteversion and acetabular sector angles in both male and female subjects increase with skeletal maturity as a result of growth of the posterior wall. This suggests that radiographic appearance of acetabular retroversion may not be attributable to overgrowth of the anterior wall but rather insufficient growth of the posterior wall, which has clinical treatment implications for pincer-type impingement. LEVEL OF EVIDENCE: Level IV diagnostic study. Springer US 2014-10-25 2015-04 /pmc/articles/PMC4353546/ /pubmed/25344405 http://dx.doi.org/10.1007/s11999-014-4014-y Text en © The Association of Bone and Joint Surgeons® 2014
institution	US NLM
collection	PubMed Central
language	Inglês
format	Artigo
topic	Symposium: 2014 Bernese Hip Symposium
spellingShingle	Symposium: 2014 Bernese Hip Symposium Hingsammer, Andreas M. Bixby, Sarah Zurakowski, David Yen, Yi-Meng Kim, Young-Jo How Do Acetabular Version and Femoral Head Coverage Change With Skeletal Maturity?
description	BACKGROUND: Normal changes in acetabular version over the course of skeletal development have not been well characterized. Knowledge of normal version development is important because acetabular retroversion has been implicated in several pathologic hip processes. QUESTIONS/PURPOSES: The purpose of this study was to characterize the orientation of the acetabulum by measuring (1) acetabular version and (2) acetabular sector angles in pediatric patients during development. We also sought to determine whether these parameters vary by sex in the developing child. METHODS: We evaluated CT images of 200 hips in 100 asymptomatic pediatric patients (45 boys, 55 girls; mean age, 13.5 years; range, 9–18 years) stratified by the status of the triradiate physis and sex. We determined the acetabular anteversion angle at various levels in the axial plane as well as acetabular sector angles at five radial planes around the acetabulum. RESULTS: For both genders, anteversion angle was greater for the closed physis group throughout all levels (p < 0.001) and both open and closed physis groups were more anteverted as the cut moved caudally away from the acetabular roof (p < 0.001). At the center of the femoral head, the mean anteversion angle (± SD) in girls was 15° ± 3° in the open group and 19° ± 5° in the closed group (p < 0.001). In boys, the mean anteversion angle increased from 14° ± 4° in the open group to 19° ± 4° in the closed group (p = 0.003). In the superior, posterosuperior, and posterior planes, the acetabular sector angles were greater in the closed compared with the open physis group for both boys and girls with the largest increase occurring in the male posterosuperior plane (approximately 20°) (all p < 0.05). CONCLUSIONS: This study demonstrates that acetabular anteversion and acetabular sector angles in both male and female subjects increase with skeletal maturity as a result of growth of the posterior wall. This suggests that radiographic appearance of acetabular retroversion may not be attributable to overgrowth of the anterior wall but rather insufficient growth of the posterior wall, which has clinical treatment implications for pincer-type impingement. LEVEL OF EVIDENCE: Level IV diagnostic study.
author	Hingsammer, Andreas M. Bixby, Sarah Zurakowski, David Yen, Yi-Meng Kim, Young-Jo
author_facet	Hingsammer, Andreas M. Bixby, Sarah Zurakowski, David Yen, Yi-Meng Kim, Young-Jo
author_sort	Hingsammer, Andreas M.
title	How Do Acetabular Version and Femoral Head Coverage Change With Skeletal Maturity?
title_short	How Do Acetabular Version and Femoral Head Coverage Change With Skeletal Maturity?
title_full	How Do Acetabular Version and Femoral Head Coverage Change With Skeletal Maturity?
title_fullStr	How Do Acetabular Version and Femoral Head Coverage Change With Skeletal Maturity?
title_full_unstemmed	How Do Acetabular Version and Femoral Head Coverage Change With Skeletal Maturity?
title_sort	how do acetabular version and femoral head coverage change with skeletal maturity?
publisher	Springer US
container_title	Clin Orthop Relat Res
publishDate	2014
url	https://ncbi.nlm.nih.gov/pmc/articles/PMC4353546/ https://ncbi.nlm.nih.gov/pubmed/25344405 https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1007/s11999-014-4014-y
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How Do Acetabular Version and Femoral Head Coverage Change With Skeletal Maturity?

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