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中島 康晴, Morphological features of DDHWhat should be corrected?, 日本整形外科学会, 2015.05, Developmental dysplasia of the hip (DDH) is characterized by various morphological abnormalities such as acetabular dysplasia, decreased acetabular coverage of the femoral head, and excessive femoral anteversion.1-3 These features result in abnormal joint stresses, leading to subsequent labral tears, articular cartilage degeneration, and early development of secondary hip osteoarthritis.4-8 Severity of hip dysplasia is determined by the degree of subluxation9 and extent of acetabular dysplasia. Conventional radiographic parameters include the lateral center-edge (CE) angle,10 Sharp angle,11 or acetabular roof obliquity (ARO),12 which are measured in the coronal plane.
Pelvic deformities in the axial plane are also associated with the pathology of DDH. We previously reported that dysplastic hips with acetabular retroversion had earlier pain onset than those without in spite of relatively better acetabular coverage.13 The report would imply the relationship between acetabular version and pathogenesis of osteoarthritis. Additionally, it is reported that as femoral anteversion increased, joint contact area decreased in a three-dimensional computer model using a non-spherical femoral head.14 Femoral version would also affect the dynamic condition of dysplastic hips. Therefore, it is interesting to examine the effect of axial parameters including both acetabular and femoral version on development of osteoarthritis.
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