TY - JOUR
T1 - Prediction of 3-Dimensional Coverage Surface Area of the Femoral Head in Hip Dysplasia Through Conventional Computed Tomography
AU - Kamenaga, Tomoyuki
AU - Ritacco, Lucas
AU - Slullitel, Pablo A.
AU - Nahal, Chadi
AU - Nepple, Jeffrey J.
AU - Clohisy, John C.
AU - Pascual-Garrido, Cecilia
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/3
Y1 - 2024/3
N2 - Background: Assessment of 3-dimensional (3D) femoral head coverage is critical in evaluating, preoperative planning, and treating hip dysplasia. Purpose: To (1) propose a mathematical model to establish 3D femoral head coverage using conventional computed tomography (CT), (2) determine the correlation of 2D parameters with 3D coverage, and (3) characterize the patterns of dysplasia based on 3D morphology. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We identified 30 patients (n = hips) with symptomatic dysplasia and 30 patients (n = hips) without dysplasia. Patients with dysplastic hips were matched with regard to sex, age, and body mass index to those with nondysplastic hips. Preoperative CTs were analyzed using 3D software, and 3D femoral head surface area coverage (FHSAC; in %) was assessed in 4 quadrant zones: anteromedial, anterolateral, posteromedial, and posterolateral. To assess lateral coverage of the femoral head, we introduced the anterolateral femoral head coverage angle (ALFC) and the posterolateral femoral head coverage angle (PLFC). Results: Reduced femoral head coverage was more pronounced in dysplastic versus nondysplastic hips in the anterolateral quadrant (18% vs 40.7%, respectively) and posterolateral quadrant (35.8% vs 56.9%, respectively) (P <.0001 for both). Dysplastic hips had smaller ALFC and PLFC (18.4° vs 38.7°; P <.0001; 47.2° vs 72.3°; P =.0002). Anterolateral and posterolateral FHSAC were strongly correlated with the ALFC (r = 0.88; P <.0001) and the PLFC (r = 0.82; P <.0001) along with the lateral center-edge angle (anterolateral, r = 0.75; P <.0001; posterolateral, r = 0.73; P <.0001). Prediction models established for FHSAC had strong agreement with explanatory CT variables (anterolateral: r = 0.91; P <.0001; posterolateral: r = 0.90; P <.0001). The cutoff values for anterolateral and posterolateral FHSAC were 25% and 41%, respectively. In dysplastic hips, global deficiency was most common (15/30 hips), 9 hips showed an anterolateral deficiency, and 4 hips had a posterolateral deficiency pattern. Conclusion: The ALFC and The PLFC were strongly correlated with 3D lateral FHSAC and were able to predict 3D coverage accurately.
AB - Background: Assessment of 3-dimensional (3D) femoral head coverage is critical in evaluating, preoperative planning, and treating hip dysplasia. Purpose: To (1) propose a mathematical model to establish 3D femoral head coverage using conventional computed tomography (CT), (2) determine the correlation of 2D parameters with 3D coverage, and (3) characterize the patterns of dysplasia based on 3D morphology. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We identified 30 patients (n = hips) with symptomatic dysplasia and 30 patients (n = hips) without dysplasia. Patients with dysplastic hips were matched with regard to sex, age, and body mass index to those with nondysplastic hips. Preoperative CTs were analyzed using 3D software, and 3D femoral head surface area coverage (FHSAC; in %) was assessed in 4 quadrant zones: anteromedial, anterolateral, posteromedial, and posterolateral. To assess lateral coverage of the femoral head, we introduced the anterolateral femoral head coverage angle (ALFC) and the posterolateral femoral head coverage angle (PLFC). Results: Reduced femoral head coverage was more pronounced in dysplastic versus nondysplastic hips in the anterolateral quadrant (18% vs 40.7%, respectively) and posterolateral quadrant (35.8% vs 56.9%, respectively) (P <.0001 for both). Dysplastic hips had smaller ALFC and PLFC (18.4° vs 38.7°; P <.0001; 47.2° vs 72.3°; P =.0002). Anterolateral and posterolateral FHSAC were strongly correlated with the ALFC (r = 0.88; P <.0001) and the PLFC (r = 0.82; P <.0001) along with the lateral center-edge angle (anterolateral, r = 0.75; P <.0001; posterolateral, r = 0.73; P <.0001). Prediction models established for FHSAC had strong agreement with explanatory CT variables (anterolateral: r = 0.91; P <.0001; posterolateral: r = 0.90; P <.0001). The cutoff values for anterolateral and posterolateral FHSAC were 25% and 41%, respectively. In dysplastic hips, global deficiency was most common (15/30 hips), 9 hips showed an anterolateral deficiency, and 4 hips had a posterolateral deficiency pattern. Conclusion: The ALFC and The PLFC were strongly correlated with 3D lateral FHSAC and were able to predict 3D coverage accurately.
KW - 3-dimensional
KW - femoral head coverage
KW - hip dysplasia
KW - periacetabular osteotomy
UR - http://www.scopus.com/inward/record.url?scp=85188294638&partnerID=8YFLogxK
U2 - 10.1177/23259671241234684
DO - 10.1177/23259671241234684
M3 - Article
C2 - 38510321
AN - SCOPUS:85188294638
SN - 2325-9671
VL - 12
JO - Orthopaedic Journal of Sports Medicine
JF - Orthopaedic Journal of Sports Medicine
IS - 3
ER -