Does native combined anteversion influence pain onset in patients with dysplastic hips?

Area of Science:

• Orthopedics
• Radiology
• Biomechanical Engineering

Background:

• Combined anteversion, the sum of femoral and acetabular anteversion, describes axial plane morphology.
• Limited research exists on native combined anteversion in symptomatic dysplastic hips.

Purpose of the Study:

• To determine if dysplastic hips exhibit distinct combined anteversion populations compared to normal hips.
• To investigate clinical differences, specifically the correlation between age of symptom onset and anteversion, in these populations.

Main Methods:

• Computed tomography (CT) scans of 100 dysplastic hips and 50 normal hips were analyzed.
• Dysplastic hips were categorized into anteversion (83) and retroversion (17) groups based on acetabular version.
• Age at pain onset was recorded from medical charts.

Main Results:

• Combined anteversion was significantly greater in the anteversion group (47° ± 12°) compared to retroversion (30° ± 16°) and control (36° ± 9°) groups.
• In the anteversion group, higher combined and femoral anteversion correlated with earlier pain onset.
• Combined anteversion and Sharp angle were independently associated with earlier pain onset in the anteversion group.

Conclusions:

• Axial joint morphology, specifically combined anteversion, plays a role in pain development in dysplastic hips.
• Consideration of optimal combined anteversion is important for surgical planning, such as periacetabular osteotomy.