EVALUATION OF ACETABULUM AND PROXIMAL FEMUR IN THE RADIOLOGICAL EVALUATION OF DEVELOPMENTAL DYSPLASIA OF THE HIP; RELIABILITY OF THE "ACETABULAR ANGLE" AND "TROCHANTERHEAD RELATIONSHIP ASSESSMENT"
Hakan ÖMEROĞLU1, Haluk AĞUŞ2, Ali BİÇİMOĞLU3, Yücel TÜMER4
1Osmangazi Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, Eskişehir
2SSK Tepecik Eğitim Hastanesi 2. Ortopedi ve Travmatoloji Kliniği, İzmir
3Ankara Numune Eğitim ve Araştırma Hastanesi 3. Ortopedi ve Travmatoloji Kliniği, Ankara
4Ortopedi ve Travmatoloji Tedavi Merkezi, Ankara
Keywords: Developmental Dysplasia of the Hip, Acetabulum, Proximal Femur.
Aim: The aim of this study is to analyse two different methods used in the radiographic assessment of developmental dysplasia of the hip (DDH).
Patients and methods: Latest follow-up radiographs of 33patients’ 51 surgically treated and 15 unaffected totally 66 hips were evaluated by 4 raters primarly interested in the field of Pediatric Orthopaedics at two occasions in a period of one month. The most lateral edge of acetabulum was used while measuring acetabular angle (Sharp) by the classic method and the most lateral edge of the bony condensation of the acetabular roof by the modified method. Trochanter-head relatioship was assessed by using the Kalamchi and MacEwen’s criteria.
Results: There was a statistically significant difference between the average acetabular angle measurement values of the classic and modified methods. Intraobserver agreement was somewhat better in the modified method than in the classic method. Interobserver agreement was similar in both methods. Intraobserver and interobserver agreements were considered substantial and moderate respectively in the trochanter-head relationship assessment system.
Conclusion: In order to make accurate comments in the radiographic evaluation of DDH, it is better to use more than one parameter. Acetabular angle and trochanter-head relationship assessment which have adequate level of reliabilities are one of these radiographic parameters. While measuring the acetabular angle, using the most lateral point of the bony condensation as the reference point may lead more accurate comments.