ePoster #751 - ISHA Annual Scientific Meeting 2016
Characteristics of Patients with Radiographic Borderline Acetabular Dysplasia: Predictors of Clinical Diagnosis
Jacob Haynes, MD, St. Louis, MO UNITED STATES
Jeffrey J. Nepple, MD, St. Louis, MO UNITED STATES
John Clohisy, MD, St. Louis, MO UNITED STATES
Washington University School of Medicine, Saint Louis, MO, UNITED STATES
FDA Status Not Applicable
Summary: Young adult patients with hip pain and radiographic evidence of borderline acetabular dysplasia may have underlying hip instability or femoroacetabular impingement.
Introduction: While the natural history of acetabular dysplasia is well established, less is known regarding the pathophysiology of borderline acetabular dysplasia. Borderline acetabular dysplasia is generally defined by a lateral center edge angle of 20 to 25 degrees. There is a paucity of data on the clinical presentation and treatment of patients presenting with borderline acetabular dysplasia. The purpose of our study was to characterize clinical presentation, underlying clinical diagnosis, and type of surgical treatment in a consecutive cohort of patients with borderline acetabular dysplasia who underwent hip preservation surgery.
Methods: Using our institution’s hip preservation database, we identified a retrospective cohort of all patients with borderline acetabular dysplasia, as defined by a lateral center edge angle (LCEA) of 20-25 degrees, who underwent hip preservation surgery from October 2007 to February 2015. Medical records were reviewed to determine patient demographics, details of clinical presentation and type of operative treatment performed. Preoperative radiographs and advanced imaging were reviewed to identify the underlying hip pathology.
Results: The cohort included 236 consecutive hips with radiographic borderline acetabular dysplasia, including 70.3% (n=166) females and 29.7% (n=70) males. Clinical diagnosis was FAI in 75.8% (n=179) and DDH in 25.0% (n=59). Males were significantly more likely to have FAI (94.3% of males, p<0.001), while females were significantly more likely to have hip dysplasia (32.5% of females, p<0.001). Utilizing multivariate logistic regression, acetabular inclination (p=0.007) and anterior center edge angle (p<0.001) were strongly associated with the underlying diagnosis of FAI or hip dysplasia. Similarly, sex (p<0..001) and age (p=0.002) were also associated with diagnosis.
Conclusions: Patients with radiographic evidence of borderline acetabular dysplasia may have underlying hip dysplasia or FAI. Age, sex, acetabular inclination, and anterior center edge angle are strongly associated with the underlying clinical diagnosis.