This study assessed the angle of acetabular anteversion (AA) in 66 children with developmental dysplasia of the hip (132 hips: 24 left, 25 right, 17 bilateral and 49 unaffected hips as controls). The AA was measured by two- and three-dimensional computed tomography (2D-CT and 3D-CT). Measurements were taken by three observers and repeated 2 weeks later by one of these observers. Intra- and inter-observer agreement was analysed using the intra-class correlation coefficient. For all hips, the mean AA (±SD) measured by 2D-CT versus 3D-CT was statistically significantly different (15.76 ± 5.23° versus 16.76 ± 4.43°, respectively). The mean (±SD) AA by 3D-CT in unaffected and affected hips was also statistically significantly different (13.92 ± 3.95° versus 18.44 ± 3.82°, respectively). A significant positive correlation between age at presentation and AA was found in affected, but not unaffected, hips. The 3D-CT showed better intra- and inter-observer agreement than 2D-CT for assessing AA hence is a more reliable measurement of AA. An increased AA is one component of anatomical abnormalities in developmental dysplasia of the hip and the abnormality appears to worsen with age.
SalterRBDubosJP: The first fifteen years personal experience with innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. Clin Orthop1974; 98: 72–103.
2.
BrowningWHRosenkrantzHTarquinoT: Computed tomography in congenital hip dislocation. J Bone Joint Surg Am1982; 64: 27–31.
3.
BuckleySLSponsellerPDMagidD: The acetabulum in congenital and neuromuscular hip instability. J Pediatr Orthop1991; 11: 498–501.
4.
Lloyd-RobertsGCHarrisNHChrispinAR: Anteversion of the acetabulum in congenital dislocation of the hip: A preliminary report. Orthop Clin North Am1978; 9: 89–95.
5.
AndaSTerjesenTKvistadKA: Acetabular angles and femoral anteversion in dysplastic hips in adults: CT investigation. J Comput Assist Tomogr1991; 15: 115–120.
6.
SarbanaSOzturkbATaburaH: Anteversion of the acetabulum and femoral neck in early walking age patients with developmental dysplasia of the hip. J Pediatr Orthop B2005; 14: 410–414.
7.
EdelsonJGHirschMWeinbergH: Congenital dislocation of the hip and computerised axial tomography. J Bone Joint Surg Br1984; 66: 472–478.
8.
GugenheimJJGersonLPTullosHS: Pathologic morphology of the acetabulum in paralytic and congenital hip instability. J Pediatr Orthop1982; 2: 397–400.
9.
MurphySBKijewskiPKMillisMB: Acetabular dysplasia in the adolescent and young adult. Clin Orthop1990; 261: 214–223.
10.
KimSSFrickSLWengerDR: Anteversion of the acetabulum in developmental dysplasia of the hip: Analysis with computed tomography. J Pediatr Orthop1999; 19: 438–442.
11.
LiPLSGanzR: Morphologic features of congenital acetabular dysplasia: One in six is retroverted. Clin Orthop Relat Res2003; 416: 245–253.
12.
MastJWBrunnerRLZebrackJ: Recognizing acetabular version in the radiographic presentation of hip dysplasia. Clin Orthop2004; 418: 48–53.
13.
TönnisDHeineckeA: Decreased acetabular anteversion and femur neck antetorsion cause pain and arthrosis. 1: Statistics and clinical sequelae. Z Orthop Ihre Grenzgeb1999; 137: 153–159.
14.
MandelDMLoderRTHensingerRN: The predictive value of computed tomography in the treatment of developmental dysplasia of the hip. J Pediatr Orthop1998; 18: 794–798.
15.
SmithBGKasserJRHeyLA: Postreduction computed tomography in developmental dislocation of the hip: Part I: Analysis of measurement reliability. J Pediatr Orthop1997; 17: 626–630.
16.
SmithBGMillisMBHeyLA: Postreduction computed tomography in developmental dislocation of the hip: Part II: Predictive value for outcome. J Pediatr Orthop1997; 17: 631–636.
17.
ZilberSLazennecJYGorinM: Variations of caudal, central, and cranial acetabular anteversion according to the tilt of the pelvis. Surg Radiol Anat2004; 26: 462–465.
18.
EddineTAMigaudHChantelotC: Variations of pelvic anteversion in lying and standing positions: Analysis of 24 control subjects and implications for CT measurement of position of prosthetic cup. Surg Radiol Anat2001; 23: 105–110.
19.
AbelMFWengerDRMubarakSJ: Quantitative analysis of hip dysplasia in cerebral palsy: A study of radiographs and 3-D reformatted images. J Pediatr Orthop1994; 14: 283–289.
KimHTWengerDR: The morphology of residual acetabular deficiency in childhood hip dysplasia: Three-dimensional computed tomographic analysis. J Pediatr Orthop1997; 17: 637–647.
22.
NakamuraSYorikawaJOtsukaK: Evaluation of acetabular dysplasia using a top view of the hip on three-dimensional CT. J Orthop Sci2000; 5: 533–539.
23.
TönnisD, (ed): Nomenklatur der angeborenen Hüftluxation. In: Die angeborene Hüftdysplasie und Hüftluxation im Kindes-und Erwachsenenalter. Berlin: Springer, 1984; p 86 [in German].
24.
JacquemierMBolliniGJouveJL: Acetabular anteversion in congenital luxation of the hip. Rev Chir Orthop Reparatrice Appar Mot1995; 80: 22–27 [in French].
25.
PonsetiIV: Growth and development of the acetabulum in the normal child. Anatomical, histological, and roentgenographic studies. J Bone Joint Surg Am1978; 60: 575–585.
26.
PonsetiIV: Morphology of the acetabulum in congenital dislocation of the hip. Gross, histological and roentgenographic studies. J Bone Joint Surg Am1978; 60: 586–599.
27.
WeinerLSKelleyMAUlinRI: Development of the acetabulum and hip: Computed tomographic analysis of the axial plane. J Pediatr Orthop1993; 13: 421–425.
28.
MaruyamaMFeinbergJR: Morphologic features of the acetabulum and femur anteversion angle and implant positioning. Clin Orthop Relat Res2001; 393: 52–65.
29.
LaffertyCMSartorisDJTysonR: Acetabular alterations in untreated congenital dysplasia of the hip: Computed tomography with multiplanar re-formation and three-dimensional analysis. J Comput Assist Tomogr1986; 10: 84–91.
30.
GünalTMuratliHHHapaO: Residual axial plane deformities after hip reconstruction for developmental dysplasia of the hip after walking age. J Pediatr Orthop B2007; 16: 84–89.
31.
BagaturAEZorerGSürelYB: Is sufficient femoral head coverage obtained after Pemberton's pericapsular osteotomy? Evaluation by three-dimensional computed tomographic reconstruction. Acta Orthop Traumatol Turc2002; 36: 203–210 [in Turkish].
32.
DuffyCMTaylorFNColemanL: Magnetic resonance imaging evaluation of surgical management in developmental dysplasia of the hip in childhood. J Pediatr Orthop2002; 22: 92–100.
33.
FrickSLKimSSWengerDR: Pre- and postoperative three-dimensional computed tomography analysis of triple innominate osteotomy for hip dysplasia. J Pediatr Orthop2000; 20: 116–123.
34.
TönnisD: Pelvic operations for dysplasia of the hip. In: Congenital Dysplasia and Dislocation of the Hip (TönnisD, ed). Heidelberg: Springer, 1987; pp 356–385.
35.
GioriNJTrousdaleRT: Acetabular retroversion is associated with osteoarthritis of the hip. Clin Orthop2003; 417: 263–269.
