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- Title
High prevalence of acetabular retroversion in both affected and unaffected hips after Legg-Calvé-Perthes disease.
- Authors
Kawahara, Shinya; Nakashima, Yasuharu; Oketani, Hiroshi; Wada, Akifusa; Fujii, Masanori; Yamamoto, Takuaki; Mawatari, Taro; Motomura, Goro; Sato, Taishi; Akiyama, Mio; Fujii, Toshio; Takamura, Kazuyuki; Iwamoto, Yukihide
- Abstract
Background: Acetabular retroversion is observed in hips after various pediatric hip diseases. This study sought to examine the frequency of acetabular retroversion in both affected and unaffected hips after Legg-Calvé-Perthes disease and its correlation with the prominence of the ischial spine. Methods: We retrospectively investigated the version and morphological features of the acetabulum using pelvic radiographs after Legg-Calvé-Perthes disease (107 affected hips treated non-operatively and 72 unaffected hips from the contralateral side). The diagnosis of acetabular retroversion was made based on the presence of a positive cross-over sign on anteroposterior pelvic radiographs. The correlation between the presence of a positive cross-over sign and modified Stulberg classes, the onset age of Legg-Calvé-Perthes disease, radiographic parameters for acetabular dysplasia and the prominence of the ischial spine were examined. Results: The prevalence of a positive cross-over sign was 49.5 % (45 of 91 hips) in affected hips and 45.8 % (33 of 72 hips) in unaffected hips. Hips with a positive cross-over sign were significantly coexistent bilaterally. The prevalence of prominence of the ischial spine in the positive cross-over sign group was 71.4 % in the affected side and 81.8 % in the unaffected side, indicating a significant correlation between the cross-over sign and the prominence of the ischial spine in both affected and unaffected hips. The positive cross-over sign did not have any correlation with the parameters for acetabular dysplasia and the onset age, however, had a significant correlation with the severity of the femoral head deformity. Conclusions: High prevalence of acetabular retroversion in both affected and unaffected hips after Legg-Calvé-Perthes disease was demonstrated. Symmetric acetabular deformity and the coexistence of prominence of the ischial spine suggested the effects of the Legg-Calvé-Perthes disease lesions on the skeletal development of the whole pelvis. Further follow-up is needed to clarify the pathological significance of acetabular retroversion after Legg-Calvé-Perthes disease.
- Subjects
LEGG-Calve-Perthes disease; HIP joint diseases; OSTEOCHONDROSIS; DYSPLASIA; ORTHOPEDICS
- Publication
Journal of Orthopaedic Science, 2012, Vol 17, Issue 3, p226
- ISSN
0949-2658
- Publication type
Article
- DOI
10.1007/s00776-012-0213-0