論文

最終著者 国際誌
2021年4月8日

Evaluation of the labrum on postoperative magnetic resonance images: a predictor of acetabular development in developmental dysplasia of the hip.

Hip international : the journal of clinical and experimental research on hip pathology and therapy
  • Tomonori Tetsunaga
  • ,
  • Tomoko Tetsunaga
  • ,
  • Hirofumi Akazawa
  • ,
  • Kazuki Yamada
  • ,
  • Takayuki Furumatsu
  • ,
  • Toshifumi Ozaki

開始ページ
11207000211004917
終了ページ
11207000211004917
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1177/11207000211004917

INTRODUCTION: Residual acetabular dysplasia of the hip after open reduction can complicate the treatment of developmental dysplasia of the hip (DDH) due to the potential need for corrective surgery. This retrospective study aimed to determine the predictive factors for acetabular development using postoperative radiographs and magnetic resonance imaging (MRI). METHODS: We retrospectively investigated 74 hips of patients with DDH who underwent open reduction after reaching walking age and were followed up radiologically until skeletal maturity. We evaluated the cartilaginous acetabulum and labrum using a new method that measures the cartilaginous and labral landmarks on coronal and axial MR T2*-weighted images in patients aged 5 years. The mean age at the time of surgery was 22 months and that at the final survey was 20 years. Severin classification was determined at the final follow-up. Groups with good (53 hips) and poor (21 hips) outcomes were compared using the postoperative radiographic and MRI parameters recorded at 5 years of age. Factors predicting acetabular development were identified using univariate and multiple logistic analyses. RESULTS: There were no significant differences in the bony-acetabular index (AI) and centre-edge (CE) angle between the good and poor outcome groups. However, the poor outcome group had significantly larger cartilaginous- and labral-AIs but significantly smaller cartilaginous- and labral-CE angles than the good outcome group (both p < 0.05). Multiple logistic regression analysis showed that labral-AI and labral-CE angle were predictors of acetabular development after open reduction for DDH, and their optimal cut-offs were 4° (77% sensitivity, 76% specificity) and 37° (68% sensitivity, 85% specificity), respectively. DISCUSSION: Normal cartilaginous acetabulum development occurs in childhood, and evaluation using only radiographs is difficult. However, labral-AI ⩾4° and labral-CE angle <37° on MRI at 5 years of age offer useful indications for corrective surgery in patients with DDH.

リンク情報
DOI
https://doi.org/10.1177/11207000211004917
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33829902
ID情報
  • DOI : 10.1177/11207000211004917
  • PubMed ID : 33829902

エクスポート
BibTeX RIS