Femoral deformity may be more predictive of hip range of motion than severity of acetabular disease in patients with acetabular dysplasia: An analysis of the ANCHOR cohort

Peter D. Fabricant, Wudbhav N. Sankar, Mark A. Seeley, Paul E. Beaulé, John C. Clohisy, Young Jo Kim, Michael B. Millis, Christopher L. Peters, David A. Podeszwa, Perry L. Schoenecker, Rafael J. Sierra, Ernest L. Sink, Daniel J. Sucato, Ira Zaltz

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: It is generally believed that acetabular dysplasia (AD) is associated with increased hip range of motion (ROM). The purpose of this study was to investigate the associations between dysplasia severity and hip ROM in a large multicenter cohort. Methods: A prospective registry of patients undergoing periacetabular osteotomy for symptomatic AD by 1 of 13 surgeons was used to analyze 1,051 patients (mean age, 26 ± 10 years). Multivariable linear regression modeling was used to investigate for associations between dysplasia severity (severe, <5°; moderate, 5° to 15°; mild, >15°), α angle, and hip ROM. Results: When controlling for age, sex, body mass index, and α angle, only internal (α 1.94; P 0.005) and external (α -2.63; P < 0.001) rotation in extension were significantly different between groups with increasing dysplasia severity. Alpha angle was greater for those with severe AD compared with subjects with mild disease (60° ± 16° versus 57° ± 15°; P 0.038). Alpha angle was also significantly correlated with rotational ROM parameters (internal and external rotation in flexion and extension) (Pearson r, range: -0.077 to -0.216; P < 0.05 for all), but not with linear motion. Conclusions: Internal rotation in extension was directly associated with dysplasia severity, whereas external rotation in extension was inversely associated. Furthermore, α angle was greater with increasing dysplasia severity and predictive of rotational ROM parameters. Taken together, these data suggest that femoral-sided deformity, including α angle and possibly femoral version, may be responsible for differences in ROM based on dysplasia severity.

Original languageEnglish (US)
Pages (from-to)465-474
Number of pages10
JournalJournal of the American Academy of Orthopaedic Surgeons
Volume24
Issue number7
DOIs
StatePublished - Jul 1 2016

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Articular Range of Motion
Thigh
Hip
Cohort Studies
Hip Dislocation
Osteotomy
Registries
Linear Models
Body Mass Index

Keywords

  • Acetabular dysplasia
  • DDH
  • FAI
  • hip dysplasia
  • periacetabular osteotomy
  • range of motion

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Femoral deformity may be more predictive of hip range of motion than severity of acetabular disease in patients with acetabular dysplasia : An analysis of the ANCHOR cohort. / Fabricant, Peter D.; Sankar, Wudbhav N.; Seeley, Mark A.; Beaulé, Paul E.; Clohisy, John C.; Kim, Young Jo; Millis, Michael B.; Peters, Christopher L.; Podeszwa, David A.; Schoenecker, Perry L.; Sierra, Rafael J.; Sink, Ernest L.; Sucato, Daniel J.; Zaltz, Ira.

In: Journal of the American Academy of Orthopaedic Surgeons, Vol. 24, No. 7, 01.07.2016, p. 465-474.

Research output: Contribution to journalArticle

Fabricant, Peter D. ; Sankar, Wudbhav N. ; Seeley, Mark A. ; Beaulé, Paul E. ; Clohisy, John C. ; Kim, Young Jo ; Millis, Michael B. ; Peters, Christopher L. ; Podeszwa, David A. ; Schoenecker, Perry L. ; Sierra, Rafael J. ; Sink, Ernest L. ; Sucato, Daniel J. ; Zaltz, Ira. / Femoral deformity may be more predictive of hip range of motion than severity of acetabular disease in patients with acetabular dysplasia : An analysis of the ANCHOR cohort. In: Journal of the American Academy of Orthopaedic Surgeons. 2016 ; Vol. 24, No. 7. pp. 465-474.
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abstract = "Background: It is generally believed that acetabular dysplasia (AD) is associated with increased hip range of motion (ROM). The purpose of this study was to investigate the associations between dysplasia severity and hip ROM in a large multicenter cohort. Methods: A prospective registry of patients undergoing periacetabular osteotomy for symptomatic AD by 1 of 13 surgeons was used to analyze 1,051 patients (mean age, 26 ± 10 years). Multivariable linear regression modeling was used to investigate for associations between dysplasia severity (severe, <5°; moderate, 5° to 15°; mild, >15°), α angle, and hip ROM. Results: When controlling for age, sex, body mass index, and α angle, only internal (α 1.94; P 0.005) and external (α -2.63; P < 0.001) rotation in extension were significantly different between groups with increasing dysplasia severity. Alpha angle was greater for those with severe AD compared with subjects with mild disease (60° ± 16° versus 57° ± 15°; P 0.038). Alpha angle was also significantly correlated with rotational ROM parameters (internal and external rotation in flexion and extension) (Pearson r, range: -0.077 to -0.216; P < 0.05 for all), but not with linear motion. Conclusions: Internal rotation in extension was directly associated with dysplasia severity, whereas external rotation in extension was inversely associated. Furthermore, α angle was greater with increasing dysplasia severity and predictive of rotational ROM parameters. Taken together, these data suggest that femoral-sided deformity, including α angle and possibly femoral version, may be responsible for differences in ROM based on dysplasia severity.",
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T1 - Femoral deformity may be more predictive of hip range of motion than severity of acetabular disease in patients with acetabular dysplasia

T2 - An analysis of the ANCHOR cohort

AU - Fabricant, Peter D.

AU - Sankar, Wudbhav N.

AU - Seeley, Mark A.

AU - Beaulé, Paul E.

AU - Clohisy, John C.

AU - Kim, Young Jo

AU - Millis, Michael B.

AU - Peters, Christopher L.

AU - Podeszwa, David A.

AU - Schoenecker, Perry L.

AU - Sierra, Rafael J.

AU - Sink, Ernest L.

AU - Sucato, Daniel J.

AU - Zaltz, Ira

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N2 - Background: It is generally believed that acetabular dysplasia (AD) is associated with increased hip range of motion (ROM). The purpose of this study was to investigate the associations between dysplasia severity and hip ROM in a large multicenter cohort. Methods: A prospective registry of patients undergoing periacetabular osteotomy for symptomatic AD by 1 of 13 surgeons was used to analyze 1,051 patients (mean age, 26 ± 10 years). Multivariable linear regression modeling was used to investigate for associations between dysplasia severity (severe, <5°; moderate, 5° to 15°; mild, >15°), α angle, and hip ROM. Results: When controlling for age, sex, body mass index, and α angle, only internal (α 1.94; P 0.005) and external (α -2.63; P < 0.001) rotation in extension were significantly different between groups with increasing dysplasia severity. Alpha angle was greater for those with severe AD compared with subjects with mild disease (60° ± 16° versus 57° ± 15°; P 0.038). Alpha angle was also significantly correlated with rotational ROM parameters (internal and external rotation in flexion and extension) (Pearson r, range: -0.077 to -0.216; P < 0.05 for all), but not with linear motion. Conclusions: Internal rotation in extension was directly associated with dysplasia severity, whereas external rotation in extension was inversely associated. Furthermore, α angle was greater with increasing dysplasia severity and predictive of rotational ROM parameters. Taken together, these data suggest that femoral-sided deformity, including α angle and possibly femoral version, may be responsible for differences in ROM based on dysplasia severity.

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KW - DDH

KW - FAI

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