Department of Orthopedic Surgery and Traumatology, Saint Georges Hospital, PO Box 166378, 11002807 Achrafieh, Beyrouth, Lebanon.
Orthop Traumatol Surg Res. 2009 Nov;95(7):511-9. doi: 10.1016/j.otsr.2009.06.006.
The objective of this study was to investigate a possible relation between congenital hip dysplasia and acetabular retroversion and to explore the eventual influence of the latter in the surgical decision for periacetabular osteotomy.
We assessed the classical morphological characteristics of both hips, with an additional newly described retroversion index. The study was conducted in 174 patients with uni- or bilateral congenital hip dysplasia having undergone unilateral (153 patients) or bilateral (21 patients) periacetabular osteotomy when respectively one or both dysplastic hips remained symptomatic.
In the group of operated hips (195 hips in total), 53% of the acetabuli were anteverted, 42% retroverted, and 5% neutral orientations. The group of nonoperated hips (153 hips) included 24% normal hips, 22% hips with normal coverage but retroverted, 35% dysplastic hips with anteverted or neutral orientation, and 19% dysplastic retroverted hips. Comparing the two hips in the subgroup of patients in whom the operated and nonoperated sides were both dysplastic failed to demonstrate statistically significant difference in the mean retroversion index. However, all the other variables measured were significantly different; with the operated side more dysplastic. Comparing the two hips in the other subgroups showed that acetabular retroversion was nearly always bilateral and symmetrical, even in presence of unilateral congenital dysplasia.
Our data suggest that the presence of acetabular retroversion is probably independent of the congenital hip dysplasia and that this abnormality seems at best a secondary factor in the appearance of dysplastic hip symptoms.
Level IV, retrospective diagnostic study.
本研究旨在探讨先天性髋关节发育不良与髋臼后倾之间可能存在的关系，并探讨后者对髋臼周围截骨术手术决策的潜在影响。
我们评估了双侧髋关节的经典形态特征，并增加了一个新描述的后倾指数。本研究共纳入 174 例单侧（153 例）或双侧（21 例）髋臼周围截骨术患者，这些患者均为单侧或双侧先天性髋关节发育不良，且仍有症状。
在手术组（共 195 髋）中，53%的髋臼前倾，42%的髋臼后倾，5%的髋臼中立位。在非手术组（153 髋）中，24%的髋关节正常，22%的髋关节覆盖正常但髋臼后倾，35%的髋臼发育不良髋关节前倾或中立位，19%的髋臼发育不良后倾。在手术组和非手术组均为发育不良的患者亚组中，比较两侧髋关节的后倾指数平均值无统计学差异。然而，所有其他测量的变量均有显著差异；手术侧髋关节发育不良更严重。在其他亚组中比较两侧髋关节，发现髋臼后倾几乎总是双侧对称的，即使存在单侧先天性发育不良。
我们的数据表明，髋臼后倾的存在可能与先天性髋关节发育不良无关，并且这种异常充其量只是髋关节发育不良症状出现的次要因素。
IV 级，回顾性诊断研究。
