Hip dysplasia has traditionally been classified based on the lateral center edge angle (LCEA). A recent meta-analysis demonstrated no definite consensus and a significant heterogeneity in LCEA values used in various studies to define hip dysplasia and borderline dysplasia. To overcome the shortcomings of classifying hip dysplasia based on just LCEA, a comprehensive classification for adult acetabular dysplasia (CCAD) was proposed to classify symptomatic hips into three discrete prototypical patterns of hip instability; lateral/global, anterior, or posterior. The purpose of this study was to assess the reliability of this recently published CCAD. One hundred thirty-four consecutive hips that underwent a PAO were categorized using a validated software (Hip2Norm) into four categories of normal, lateral/global, anterior or posterior. Based on the prevalence of individual dysplasia and using KappaSize R package version 1.1, seventy-four cases were necessary for reliability analysis: 44 dysplastic and 30 normal hips were randomly selected. Five surgeons (3 fellowship trained in hip preservation) did a first reading (Time 1) to classify the hips, followed by four raters for a second reading (Time 2) minimum two weeks apart. Thereafter, a consensus meeting was held where a simplified flow diagram was devised before a third reading by four raters using a separate set of 74 radiographs took place.Background
Methods
What represents clinically significant acetabular undercoverage
in patients with symptomatic cam-type femoroacetabular impingement
(FAI) remains controversial. The aim of this study was to examine
the influence of the degree of acetabular coverage on the functional
outcome of patients treated arthroscopically for cam-type FAI. Between October 2005 and June 2016, 88 patients (97 hips) underwent
arthroscopic cam resection and concomitant labral debridement and/or
refixation. There were 57 male and 31 female patients with a mean
age of 31.0 years (17.0 to 48.5) and a mean body mass index (BMI)
of 25.4 kg/m2 (18.9 to 34.9). We used the Hip2Norm, an
object-oriented-platform program, to perform 3D analysis of hip
joint morphology using 2D anteroposterior pelvic radiographs. The lateral
centre-edge angle, anterior coverage, posterior coverage, total
femoral coverage, and alpha angle were measured for each hip. The
presence or absence of crossover sign, posterior wall sign, and
the value of acetabular retroversion index were identified automatically
by Hip2Norm. Patient-reported outcome scores were collected preoperatively
and at final follow-up with the Hip Disability and Osteoarthritis
Outcome Score (HOOS).Aims
Patients and Methods
