Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia
Aims: The effect of pelvic tilt (PT) and sagittal balance in hips with pincer-type femoroacetabular impingement (FAI) with acetabular retroversion (AR) is controversial. It is unclear if patients with AR have a rotational abnormality of the iliac wing. Therefore, we asked: are parameters for sagitta...
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| Format: | Article |
| Language: | English |
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The British Editorial Society of Bone & Joint Surgery
2021-10-01
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| Series: | Bone & Joint Open |
| Subjects: | |
| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.210.BJO-2021-0069.R1 |
| _version_ | 1818727521186742272 |
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| author | Till Dominic Lerch Adam Boschung Florian Schmaranzer Inga A. S. Todorski Jan Vanlommel Klaus A. Siebenrock Simon D. Steppacher Moritz Tannast |
| author_facet | Till Dominic Lerch Adam Boschung Florian Schmaranzer Inga A. S. Todorski Jan Vanlommel Klaus A. Siebenrock Simon D. Steppacher Moritz Tannast |
| author_sort | Till Dominic Lerch |
| collection | DOAJ |
| description | Aims: The effect of pelvic tilt (PT) and sagittal balance in hips with pincer-type femoroacetabular impingement (FAI) with acetabular retroversion (AR) is controversial. It is unclear if patients with AR have a rotational abnormality of the iliac wing. Therefore, we asked: are parameters for sagittal balance, and is rotation of the iliac wing, different in patients with AR compared to a control group?; and is there a correlation between iliac rotation and acetabular version? Methods: A retrospective, review board-approved, controlled study was performed including 120 hips in 86 consecutive patients with symptomatic FAI or hip dysplasia. Pelvic CT scans were reviewed to calculate parameters for sagittal balance (pelvic incidence (PI), PT, and sacral slope), anterior pelvic plane angle, pelvic inclination, and external rotation of the iliac wing and were compared to a control group (48 hips). The 120 hips were allocated to the following groups: AR (41 hips), hip dysplasia (47 hips) and cam FAI with normal acetabular morphology (32 hips). Subgroups of total AR (15 hips) and high acetabular anteversion (20 hips) were analyzed. Statistical analysis was performed using analysis of variance with Bonferroni correction. Results: PI and PT were significantly decreased comparing AR (PI 42° (SD 10°), PT 4° (SD 5°)) with dysplastic hips (PI 55° (SD 12°), PT 10° (SD 6°)) and with the control group (PI 51° (SD 9°) and PT 13° (SD 7°)) (p < 0.001). External rotation of the iliac wing was significantly increased comparing AR (29° (SD 4°)) with dysplastic hips (20°(SD 5°)) and with the control group (25° (SD 5°)) (p < 0.001). Correlation between external rotation of the iliac wing and acetabular version was significant and strong (r = 0.81; p < 0.001). Correlation between PT and acetabular version was significant and moderate (r = 0.58; p < 0.001). Conclusion: These findings could contribute to a better understanding of hip pain in a sitting position and extra-articular subspine FAI of patients with AR. These patients have increased iliac external rotation, a rotational abnormality of the iliac wing. This has implications for surgical therapy with hip arthroscopy and acetabular rim trimming or anteverting periacetabular osteotomy (PAO). |
| first_indexed | 2024-12-17T22:15:25Z |
| format | Article |
| id | doaj.art-e1155f066ad744f2b64caf5cb9c8b201 |
| institution | Directory Open Access Journal |
| issn | 2633-1462 |
| language | English |
| last_indexed | 2024-12-17T22:15:25Z |
| publishDate | 2021-10-01 |
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| series | Bone & Joint Open |
| spelling | doaj.art-e1155f066ad744f2b64caf5cb9c8b2012022-12-21T21:30:38ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622021-10-0121081382410.1302/2633-1462.210.BJO-2021-0069.R1Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasiaTill Dominic Lerch0Adam Boschung1Florian Schmaranzer2Inga A. S. Todorski3Jan Vanlommel4Klaus A. Siebenrock5Simon D. Steppacher6Moritz Tannast7Department of Orthopedic Surgery and Traumatology, Inselspital Bern, University Hospital of Bern, University of Bern, Bern, SwitzerlandDepartment of Orthopedic Surgery and Traumatology, Inselspital Bern, University Hospital of Bern, University of Bern, Bern, SwitzerlandDepartment of Orthopedic Surgery and Traumatology, Inselspital Bern, University Hospital of Bern, University of Bern, Bern, SwitzerlandDepartment of Orthopedic Surgery and Traumatology, Inselspital Bern, University Hospital of Bern, University of Bern, Bern, SwitzerlandDepartment of Orthopaedic Surgery and Traumatology, Orthoclinic, Bruges, BelgiumDepartment of Orthopedic Surgery and Traumatology, Inselspital Bern, University Hospital of Bern, University of Bern, Bern, SwitzerlandDepartment of Orthopedic Surgery and Traumatology, Inselspital Bern, University Hospital of Bern, University of Bern, Bern, SwitzerlandDepartment of Orthopedic Surgery and Traumatology, Inselspital Bern, University Hospital of Bern, University of Bern, Bern, SwitzerlandAims: The effect of pelvic tilt (PT) and sagittal balance in hips with pincer-type femoroacetabular impingement (FAI) with acetabular retroversion (AR) is controversial. It is unclear if patients with AR have a rotational abnormality of the iliac wing. Therefore, we asked: are parameters for sagittal balance, and is rotation of the iliac wing, different in patients with AR compared to a control group?; and is there a correlation between iliac rotation and acetabular version? Methods: A retrospective, review board-approved, controlled study was performed including 120 hips in 86 consecutive patients with symptomatic FAI or hip dysplasia. Pelvic CT scans were reviewed to calculate parameters for sagittal balance (pelvic incidence (PI), PT, and sacral slope), anterior pelvic plane angle, pelvic inclination, and external rotation of the iliac wing and were compared to a control group (48 hips). The 120 hips were allocated to the following groups: AR (41 hips), hip dysplasia (47 hips) and cam FAI with normal acetabular morphology (32 hips). Subgroups of total AR (15 hips) and high acetabular anteversion (20 hips) were analyzed. Statistical analysis was performed using analysis of variance with Bonferroni correction. Results: PI and PT were significantly decreased comparing AR (PI 42° (SD 10°), PT 4° (SD 5°)) with dysplastic hips (PI 55° (SD 12°), PT 10° (SD 6°)) and with the control group (PI 51° (SD 9°) and PT 13° (SD 7°)) (p < 0.001). External rotation of the iliac wing was significantly increased comparing AR (29° (SD 4°)) with dysplastic hips (20°(SD 5°)) and with the control group (25° (SD 5°)) (p < 0.001). Correlation between external rotation of the iliac wing and acetabular version was significant and strong (r = 0.81; p < 0.001). Correlation between PT and acetabular version was significant and moderate (r = 0.58; p < 0.001). Conclusion: These findings could contribute to a better understanding of hip pain in a sitting position and extra-articular subspine FAI of patients with AR. These patients have increased iliac external rotation, a rotational abnormality of the iliac wing. This has implications for surgical therapy with hip arthroscopy and acetabular rim trimming or anteverting periacetabular osteotomy (PAO).https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.210.BJO-2021-0069.R1hiphip dysplasiafemoroacetabular impingementfaiacetabular retroversionpelvic incidencepelvic tiltpelvic incidencedysplastic hipspelvic tiltingfemoroacetabular impingementhipsct scanship painacetabular rimcam-type fai |
| spellingShingle | Till Dominic Lerch Adam Boschung Florian Schmaranzer Inga A. S. Todorski Jan Vanlommel Klaus A. Siebenrock Simon D. Steppacher Moritz Tannast Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia Bone & Joint Open hip hip dysplasia femoroacetabular impingement fai acetabular retroversion pelvic incidence pelvic tilt pelvic incidence dysplastic hips pelvic tilting femoroacetabular impingement hips ct scans hip pain acetabular rim cam-type fai |
| title | Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia |
| title_full | Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia |
| title_fullStr | Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia |
| title_full_unstemmed | Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia |
| title_short | Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia |
| title_sort | lower pelvic tilt lower pelvic incidence and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia |
| topic | hip hip dysplasia femoroacetabular impingement fai acetabular retroversion pelvic incidence pelvic tilt pelvic incidence dysplastic hips pelvic tilting femoroacetabular impingement hips ct scans hip pain acetabular rim cam-type fai |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.210.BJO-2021-0069.R1 |
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