Role of magnetic resonance imaging in assessment of acetabular and femoral version in developmental dysplasia of the hip

Abstract Objective: To evaluate the role of magnetic resonance imaging (MRI) in the assessment of femoral and acetabular version in developmental dysplasia of the hip (DDH). Materials and Methods: This was a cross-sectional study of 20 consecutive patients with DDH (27 dysplastic hips) who were examined with MRI. In dysplastic and normal hips (DDH and comparison groups, respectively), we evaluated the following parameters: osseous acetabular anteversion (OAA); cartilaginous acetabular anteversion (CAA); femoral anteversion; osseous Mckibbin index (OMI); cartilaginous Mckibbin index (CMI); and the thickness of the anterior and posterior acetabular cartilage. Results: The OAA was significantly greater in the dysplastic hips. The CAA, femoral anteversion, OMI, and CMI did not differ significantly between the normal and dysplastic hips. In the DDH and comparison groups, the OAA was significantly lower than the CAA, the OMI was significantly lower than the CMI, and the posterior acetabular cartilage was significantly thicker than the anterior cartilage. Conclusion: Our findings confirm that MRI is a valuable tool for the assessment of femoral and acetabular version in DDH. Preoperative MRI evaluation has great potential to improve the planning of pelvic and femoral osteotomies.

摘要
研究目的：评估磁共振成像（Magnetic Resonance Imaging, MRI）在髋关节发育不良（Developmental Dysplasia of the Hip, DDH）患者股骨与髋臼前倾角度评估中的应用价值。
材料与方法：本研究为横断面研究，纳入20例连续收治的DDH患者（共计27个发育不良髋关节），所有患者均接受MRI检查。分别对发育不良髋关节与正常髋关节（对应DDH组与对照组）的以下参数进行评估：骨性髋臼前倾角（osseous acetabular anteversion, OAA）、软骨性髋臼前倾角（cartilaginous acetabular anteversion, CAA）、股骨前倾角、骨性Mckibbin指数（osseous Mckibbin index, OMI）、软骨性Mckibbin指数（cartilaginous Mckibbin index, CMI），以及髋臼前后侧软骨厚度。
结果：发育不良髋关节的骨性髋臼前倾角显著升高。软骨性髋臼前倾角、股骨前倾角、骨性Mckibbin指数与软骨性Mckibbin指数在正常髋关节与发育不良髋关节间无显著统计学差异。在DDH组与对照组中，骨性髋臼前倾角均显著低于软骨性髋臼前倾角，骨性Mckibbin指数显著低于软骨性Mckibbin指数，且髋臼后侧软骨厚度显著高于前侧软骨厚度。
结论：本研究结果证实，MRI是评估DDH患者股骨与髋臼前倾角度的可靠工具。术前MRI评估对优化骨盆与股骨截骨手术规划具有重要应用潜力。