Related Experiment Video
Updated: Jun 25, 2026
In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
Published on: July 2, 2021
Factors associated with symptom development in bilateral hip dysplasia with comparable acetabular coverage
Hiroto Funahashi1, Yusuke Osawa2, Hiroaki Ido2
1Department of Orthopedic Surgery, Nagoya University, Nagoya, Japan. jajamalu61916@gmail.com.
Insights
In bilateral hip dysplasia (HD), increased femoral neck anteversion (FNA) and femoral head lateralization are key indicators of hip pain, even when lateral centre-edge angles (CEA) are similar. These factors may be more significant than acetabular parameters in identifying symptomatic hips.
Area of Science:
- Orthopedic surgery
- Radiology
- Biomechanical analysis
Background:
- Bilateral hip dysplasia (HD) presents complex diagnostic challenges.
- Identifying morphological predictors of symptomatic hip joints is crucial for targeted treatment.
- Understanding the interplay between acetabular and femoral morphology in HD is essential.
Purpose of the Study:
- To investigate morphological distinctions between symptomatic and asymptomatic hips in patients with bilateral hip dysplasia (HD).
- To determine if specific femoral or acetabular parameters correlate with hip pain in bilateral HD.
- To compare the diagnostic value of acetabular sector angles (ASAs) versus femoral parameters in symptomatic hips.
Main Methods:
- Comparative analysis of 33 patients with bilateral HD undergoing eccentric rotational acetabular osteotomy (ERAO).
- Three-dimensional measurement of acetabular sector angles (ASAs), femoral neck anteversion (FNA), and femoral head lateralization.
- Statistical comparison between symptomatic and asymptomatic hips using paired t-tests and conditional logistic regression.
Main Results:
- The First Cohort showed lower ASAs on the symptomatic side, but this was not significant in the Second Cohort (matched for lateral centre-edge angle - CEA).
- Both cohorts demonstrated significantly greater FNA and femoral head lateralization on the symptomatic side.
- Increased FNA (OR: 1.3) and lateralization (OR: 4.6) were identified as significant predictors of hip pain in bilateral HD patients.
Conclusions:
- When CEA is comparable in bilateral HD, increased FNA and femoral head lateralization are stronger indicators of symptomatic hips.
- Acetabular parameters may be less critical than femoral morphology in predicting pain when CEA is similar.
- This finding aids in better identifying the primary source of pain in bilateral hip dysplasia.
Purpose:
This study aimed to identify morphological differences between the symptomatic and asymptomatic hips in patients with bilateral hip dysplasia (HD).
Methods:
From 109 patients who underwent eccentric rotational acetabular osteotomy (ERAO) between 2017 and 2022, 33 patients were selected as the First Cohort. These patients had undergone ERAO on the symptomatic side, while the contralateral side remained completely asymptomatic for ≥ three years postoperatively. Among them, 18 patients with matching lateral centre-edge angles (CEA) on both sides were selected as the Second Cohort. The acetabular sector angles (ASAs) were measured three-dimensionally. Femoral neck anteversion (FNA) and femoral head lateralization were also assessed. Morphological comparisons between the symptomatic and asymptomatic sides were conducted using paired t-tests in both cohorts. In the Second Cohort, conditional logistic regression analysis was used to identify factors associated with the onset of hip pain.
Results:
In the First Cohort, the symptomatic side exhibited lower ASAs across the superior-to-anterior acetabulum than the asymptomatic side, whereas no significant differences in ASAs were observed in the Second Cohort. By contrast, both cohorts exhibited greater FNA and lateralization on the symptomatic side. Conditional logistic regression analysis in the Second Cohort identified increased FNA (odds ratio: 1.3) and lateralization (odds ratio: 4.6) as factors associated with hip pain (all p < 0.05).
Conclusion:
When the CEA is comparable on both sides in patients with bilateral HD, morphological features, such as increased FNA and femoral head lateralization, may be more indicative of the symptomatic hip than acetabular parameters.
More Related Videos
09:51The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
08:40Surgical Technique of the 3-Dimensional-printed Personalized Hip Implant for the Treatment of Canine Hip Dysplasia
Published on: April 19, 2024
