Reference values and variation of acetabular angles measured by computed tomography in 170 asymptomatic hips

Abstract

Background

We have little knowledge of reference values for acetabular angles.

Purpose

The purpose of this study was to report values and variation for the center-edge (CE), the acetabular-index (AI), the anterior-sector (AASA), the posterior-sector (PASA), and the acetabular-anteversion angle (AcAV) and to investigate gender differences.

Material and Methods

Retrospectively, we recruited 96 individuals, 52 women (mean age = 63 ± 12 years) who had undergone computed tomography (CT) as part of examination for lymphomas in 2013 at Aarhus University Hospital. After CT, the participants completed the Oxford Hip Score. Eight individuals indicated hip problems and three had missing data; those 11 were excluded from the material. The acetabular angles for both hips were measured on CT images by an experienced radiologist. The acetabular angles are reported for right and left hip as mean ± SD degrees and compared women and men with a two-sample t-test.

Results

The CE angle [right;left] averaged [34±6;35±5]. The AI angle averaged [3±6;1±5]. The AASA averaged [58±7;60±9]. The PASA averaged [94±7;95±7]. The AcAV averaged [18±5;18±5]. The AASA was lower whereas the PASA and the ACAV were higher for women compared to men.

Conclusion

We found considerable variation in the values for acetabular angles. There were gender differences in the sector angles and for the AcAV. Knowledge of reference values is important when we attempt to diagnose the pathological hip conditions.

Keywords

Acetabular angles computed tomography hip joint gender differences

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References

Mechlenburg

Evaluation of bernese periacetabular osteotomy: Prospective studies examining projected load-bearing area, bone density, cartilage thickness and migration.

Acta Orthop Suppl 2008; 79:4–43.

Mechlenburg

Nyengaard

Romer

et al . Changes in load-bearing area after ganz periacetabular osteotomy evaluated by multislice CT scanning and stereology. Acta Orthop Scand 2004; 75:147–153.

de Raedt

Mechlenburg

Stilling

et al.

Automated measurement of diagnostic angles for hip dysplasia. Proc SPIE 2013; 8670:867009.

De Raedt

Mechlenburg

Stilling

et al . Reliability of computer-assisted periacetabular osteotomy using a minimally invasive approach. Int J Comput Assist Radiol Surg 2018 Jun 6. doi: 10.1007/s11548-018-1802-y.

Anda

Svenningsen

Dale

et al . The acetabular sector angle of the adult hip determined by computed tomography. Acta Radiol Diagn (Stockh) 1986; 27:443–447.

Tallroth

Lepisto

Computed tomography measurement of acetabular dimensions: Normal values for correction of dysplasia.

Acta Orthop 2006; 77:598–602.

Goto

Mineta

Wada

et al . Correlation between coxa profunda and morphological parameters of acetabular coverage in a Japanese cohort: A CT study. J Orthop Sci 2016; 21:667–672.

Anderson

Kapron

Aoki

et al . Coxa profunda: Is the deep acetabulum overcovered? Clin Orthop Relat Res 2012; 470:3375–3382.

van Klij

Heerey

Waarsing

et al . The prevalence of cam and pincer morphology and its association with development of hip osteoarthritis. J Orthop Sports Phys Ther 2018; 48:230–238.

10.

Jacobsen

Sonne-Holm

Soballe

et al . Hip dysplasia and osteoarthrosis: A survey of 4151 subjects from the osteoarthrosis substudy of the copenhagen city heart study. Acta Orthop 2005; 76:149–158.

11.

Jacobsen

Adult hip dysplasia and osteoarthritis. studies in radiology and clinical epidemiology.

Acta Orthop Suppl 2006; 77:1–37.

12.

Wiberg

Studies on dysplastic acetabula and congenital subluxation of the hip joint. Acta Orthop Scand Suppl 1939; 58:1–132.

13.

Tönnis

Congenital dysplasia and dislocation of the hip in children and adults. Berlin, Heidelberg, New York: Springer, 1987.

14.

Anda

Terjesen

Kvistad

et al . Acetabular angles and femoral anteversion in dysplastic hips in adults: CT investigation. J Comput Assist Tomogr 1991; 15:115–120.

15.

Mast

Impellizzeri

Keller

et al . Reliability and agreement of measures used in radiographic evaluation of the adult hip. Clin Orthop Relat Res 2011; 469:188–199.

16.

Mimura

Mori

Itakura

et al . Prevalence of pincer, cam, and combined deformities in Japanese hip joints evaluated with the Japanese Hip Society diagnostic guideline for femoroacetabular impingement: A CT-based study. J Orthop Sci 2017; 22:105–111.

17.

Mineta

Goto

Wada

et al . CT-based morphological assessment of the hip joint in japanese patients: Association with radiographic predictors of femoroacetabular impingement. Bone Joint J 2016; 98-B:1167–1174.

18.

Fujii

Nakamura

Hara

et al . Does radiographic coxa profunda indicate increased acetabular coverage or depth in hip dysplasia? Clin Orthop Relat Res 2015; 473:2056–2066.

19.

Fujii

Nakashima

Sato

et al . Pelvic deformity influences acetabular version and coverage in hip dysplasia. Clin Orthop Relat Res 2011; 469:1735–1742.

20.

Mimura

Mori

Kitagawa

et al . Multiplanar evaluation of radiological findings associated with acetabular dysplasia and investigation of its prevalence in an Asian population: A CT-based study. BMC Musculoskelet Disord 2017; 18:50.

21.

Valera

Ibanez

Sancho

et al . Acetabular overcoverage in the horizontal plane: An underdiagnosed trigger of early hip arthritis. A CT scan study in young adults. Arch Orthop Trauma Surg 2018; 138:73–82.

22.

Saberi Hosnijeh

Zuiderwijk

Versteeg

et al . Cam deformity and acetabular dysplasia as risk factors for hip osteoarthritis. Arthritis Rheumatol 2017; 69:86–93.

23.

Cooperman

Wallensten

Stulberg

SD.

Acetabular dysplasia in the adult. Clin Orthop 1983; 175:79–85.

24.

Murphy

Millis

Hall

JE.

Surgical correction of acetabular dysplasia in the adult. A Boston experience. Clin Orthop 1999; 363:38–44.

25.

Armiger

Armand

Lepisto

et al . Evaluation of a computerized measurement technique for joint alignment before and during periacetabular osteotomy. Comput Aided Surg 2007; 12:215–224.

26.

Jozwiak

Rychlik

Musielak

et al . An accurate method of radiological assessment of acetabular volume and orientation in computed tomography spatial reconstruction. BMC Musculoskelet Disord 2015; 16:42.

27.

Zingg

Werner

Sukthankar

et al . The anterior center edge angle in Lequesne’s false profile view: Interrater correlation, dependence on pelvic tilt and correlation to anterior acetabular coverage in the sagittal plane. A cadaver study. Arch Orthop Trauma Surg 2009; 129:787–791.