Acetabular morphology in bladder exstrophy complex.

Little information is available concerning the acetabular morphology in adults with a history of bladder exstrophy. We documented the pelvic anatomy in adult patients with bladder exstrophy who never had prior surgery. We retrospectively reviewed 31 patients (62 hips) seen from 1976 to 2003 for urologic problems related to bladder exstrophy without adjunctive pelvic osteotomy. There were 18 males and 13 females with an average age of 30 years at last followup. Radiographs at final followup were analyzed for lateral center-edge angle, acetabular index, head extrusion, hip center of rotation, acetabular version, retroversion index, sacral width, and interteardrop distance. Most hips (60 hips) had no arthritis. The average lateral center-edge angle, ace-tabular index, and head extrusion index were 32 degrees, 5.7 degrees, and 0.266%, respectively. Fifty-eight percent of hips had a retroverted acetabulum and 42% were neutral or anteverted. The interteardrop distance averaged 154 mm. Most patients will not have early arthritis develop, and the majority of patients (58%) have retroverted orientation of the acetabulum.