The Ischial Spine in Developmental Hip Dysplasia: Unraveling the Role of Acetabular Retroversion in Periacetabular Osteotomy
Purpose. Radiological diagnosis of acetabular retroversion (AR) is based on the presence of the crossover sign (COS), the posterior wall sign (PWS), and the prominence of the ischial spine sign (PRISS). The primary purpose of the study is to analyze the clinical significance of the PRISS in a sample...
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Wiley
2020-01-01
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| Series: | Advances in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2020/1826952 |
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| author | Gerard El-Hajj Hicham Abdel-Nour Rami Ayoubi Joseph Maalouly Fouad Jabbour Raja Ashou Alexandre Nehme |
| author_facet | Gerard El-Hajj Hicham Abdel-Nour Rami Ayoubi Joseph Maalouly Fouad Jabbour Raja Ashou Alexandre Nehme |
| author_sort | Gerard El-Hajj |
| collection | DOAJ |
| description | Purpose. Radiological diagnosis of acetabular retroversion (AR) is based on the presence of the crossover sign (COS), the posterior wall sign (PWS), and the prominence of the ischial spine sign (PRISS). The primary purpose of the study is to analyze the clinical significance of the PRISS in a sample of dysplastic hips requiring periacetabular osteotomy (PAO) and evaluate retroversion in symptomatic hip dysplasia. Methods. In a previous paper, we reported the classic coxometric measurements of 178 patients with symptomatic hip dysplasia undergoing PAO where retroversion was noted in 42% of the cases and was not found to be a major factor in the appearance of symptoms. In the current study, we have added the retroversion signs PRISS and PWS to our analysis. Among the retroverted dysplastic hips, we studied the association of the PRISS with the hips requiring PAO. We also defined the ischial spine index (ISI) and studied its relationship to the coxometric measurements and AR. Results. In hips with AR, the operated hips were significantly associated with the PRISS compared to the nonoperated ones (χ2 = 4.847). Additionally, the ISI was able to classify acetabular version (anteverted, neutral, and retroverted acetabula). A direct correlation between the ISI and the retroversion index (RI) was found, and the highest degree of retroversion was found when the 3 signs of acetabular retroversion were concomitantly present (RI = 33.6%). Conclusion. The PRISS, a radiographic sign reflecting AR, was found to be significantly associated with dysplastic hips requiring PAO where AR was previously not considered a factor in the manifestation of symptoms and subsequent requirement for surgery. Moreover, the PRISS can also serve as an adequate radiographic sign for estimating acetabular version on pelvic radiographs. |
| format | Article |
| id | doaj-art-15b85d12e9604a15bc109de9ed5f903d |
| institution | Kabale University |
| issn | 2090-3464 2090-3472 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Orthopedics |
| spelling | doaj-art-15b85d12e9604a15bc109de9ed5f903d2025-02-03T06:43:32ZengWileyAdvances in Orthopedics2090-34642090-34722020-01-01202010.1155/2020/18269521826952The Ischial Spine in Developmental Hip Dysplasia: Unraveling the Role of Acetabular Retroversion in Periacetabular OsteotomyGerard El-Hajj0Hicham Abdel-Nour1Rami Ayoubi2Joseph Maalouly3Fouad Jabbour4Raja Ashou5Alexandre Nehme6Department of Radiology, Saint George Hospital University Medical Center, University of Balamand, P.O. Box 166378, Achrafieh, Beirut 1100 2807, LebanonDepartment of Orthopedic Surgery and Traumatology, Saint George Hospital University Medical Center, University of Balamand, P.O. Box 166378, Achrafieh, Beirut 1100 2807, LebanonDepartment of Orthopedic Surgery and Traumatology, Saint George Hospital University Medical Center, University of Balamand, P.O. Box 166378, Achrafieh, Beirut 1100 2807, LebanonDepartment of Orthopedic Surgery and Traumatology, Saint George Hospital University Medical Center, University of Balamand, P.O. Box 166378, Achrafieh, Beirut 1100 2807, LebanonDepartment of Orthopedic Surgery and Traumatology, Saint George Hospital University Medical Center, University of Balamand, P.O. Box 166378, Achrafieh, Beirut 1100 2807, LebanonDepartment of Radiology, Saint George Hospital University Medical Center, University of Balamand, P.O. Box 166378, Achrafieh, Beirut 1100 2807, LebanonDepartment of Orthopedic Surgery and Traumatology, Saint George Hospital University Medical Center, University of Balamand, P.O. Box 166378, Achrafieh, Beirut 1100 2807, LebanonPurpose. Radiological diagnosis of acetabular retroversion (AR) is based on the presence of the crossover sign (COS), the posterior wall sign (PWS), and the prominence of the ischial spine sign (PRISS). The primary purpose of the study is to analyze the clinical significance of the PRISS in a sample of dysplastic hips requiring periacetabular osteotomy (PAO) and evaluate retroversion in symptomatic hip dysplasia. Methods. In a previous paper, we reported the classic coxometric measurements of 178 patients with symptomatic hip dysplasia undergoing PAO where retroversion was noted in 42% of the cases and was not found to be a major factor in the appearance of symptoms. In the current study, we have added the retroversion signs PRISS and PWS to our analysis. Among the retroverted dysplastic hips, we studied the association of the PRISS with the hips requiring PAO. We also defined the ischial spine index (ISI) and studied its relationship to the coxometric measurements and AR. Results. In hips with AR, the operated hips were significantly associated with the PRISS compared to the nonoperated ones (χ2 = 4.847). Additionally, the ISI was able to classify acetabular version (anteverted, neutral, and retroverted acetabula). A direct correlation between the ISI and the retroversion index (RI) was found, and the highest degree of retroversion was found when the 3 signs of acetabular retroversion were concomitantly present (RI = 33.6%). Conclusion. The PRISS, a radiographic sign reflecting AR, was found to be significantly associated with dysplastic hips requiring PAO where AR was previously not considered a factor in the manifestation of symptoms and subsequent requirement for surgery. Moreover, the PRISS can also serve as an adequate radiographic sign for estimating acetabular version on pelvic radiographs.http://dx.doi.org/10.1155/2020/1826952 |
| spellingShingle | Gerard El-Hajj Hicham Abdel-Nour Rami Ayoubi Joseph Maalouly Fouad Jabbour Raja Ashou Alexandre Nehme The Ischial Spine in Developmental Hip Dysplasia: Unraveling the Role of Acetabular Retroversion in Periacetabular Osteotomy Advances in Orthopedics |
| title | The Ischial Spine in Developmental Hip Dysplasia: Unraveling the Role of Acetabular Retroversion in Periacetabular Osteotomy |
| title_full | The Ischial Spine in Developmental Hip Dysplasia: Unraveling the Role of Acetabular Retroversion in Periacetabular Osteotomy |
| title_fullStr | The Ischial Spine in Developmental Hip Dysplasia: Unraveling the Role of Acetabular Retroversion in Periacetabular Osteotomy |
| title_full_unstemmed | The Ischial Spine in Developmental Hip Dysplasia: Unraveling the Role of Acetabular Retroversion in Periacetabular Osteotomy |
| title_short | The Ischial Spine in Developmental Hip Dysplasia: Unraveling the Role of Acetabular Retroversion in Periacetabular Osteotomy |
| title_sort | ischial spine in developmental hip dysplasia unraveling the role of acetabular retroversion in periacetabular osteotomy |
| url | http://dx.doi.org/10.1155/2020/1826952 |
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