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Femoroacetabular Variations Are Predisposing Factors for Traumatic Posterior Hip Dislocation.

Stephan Regenbogen1,2, Sven Shafizadeh3, Sven Märdian4

  • 1Department of Traumatology and General Surgery, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau am Staffelsee, Germany.

The Journal of Bone and Joint Surgery. American Volume
|April 1, 2024
PubMed
Summary

High-energy trauma can cause posterior hip dislocations, with acetabular retroversion and posterior undercoverage being significant risk factors. Cam-type femoroacetabular impingement (FAI) morphology also increases dislocation risk.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Radiology

Background:

  • High-energy trauma is typically linked to posterior hip dislocations.
  • Femoroacetabular variations may predispose individuals to low-impact dislocations.
  • This study investigates morphologic risk factors for posterior hip dislocations in high-energy trauma.

Purpose of the Study:

  • To identify specific femoral and acetabular morphologic risk factors for posterior hip dislocations in high-energy trauma.
  • To quantify the association between femoroacetabular impingement (FAI) morphology and traumatic posterior hip dislocations.

Main Methods:

  • Computed tomography (CT) scans of 83 hips with traumatic posterior dislocation were analyzed.
  • Morphologic parameters including acetabular version, coverage, and FAI deformities were measured.
  • A control group of 83 trauma patients without hip injury was used for comparison.

Main Results:

  • Patients with posterior hip dislocations showed significantly increased acetabular retroversion and posterior acetabular undercoverage (p < 0.001).
  • Cam-type FAI deformity and coxa valga were also significantly more prevalent in the dislocation group (p < 0.001).
  • Specific thresholds for acetabular version (≤9°) and alpha angle (≥47°) indicated increased dislocation risk.

Conclusions:

  • Acetabular retroversion and posterior acetabular undercoverage are significant risk factors for traumatic posterior hip dislocation.
  • Cam-type FAI morphology may also contribute to the risk of posterior hip dislocations in high-energy trauma settings.