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The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis

Lumbo-sacral transitional vertebrae (LSTV) are the most common congenital alteration of the lumbo-sacral junction and known to significantly influence pelvic anatomy. However, the influence of LSTV on dysplasia of the hip (DDH) and the surgical treatment by periacetabular osteotomy (PAO) remains unk...

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Autores principales: Becker, Luis, Hipfl, Christian, Schömig, Friederike, Perka, Carsten, Hardt, Sebastian, Pumberger, Matthias, Leopold, Vincent Justus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10281988/
https://www.ncbi.nlm.nih.gov/pubmed/37340098
http://dx.doi.org/10.1038/s41598-023-37208-8
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author Becker, Luis
Hipfl, Christian
Schömig, Friederike
Perka, Carsten
Hardt, Sebastian
Pumberger, Matthias
Leopold, Vincent Justus
author_facet Becker, Luis
Hipfl, Christian
Schömig, Friederike
Perka, Carsten
Hardt, Sebastian
Pumberger, Matthias
Leopold, Vincent Justus
author_sort Becker, Luis
collection PubMed
description Lumbo-sacral transitional vertebrae (LSTV) are the most common congenital alteration of the lumbo-sacral junction and known to significantly influence pelvic anatomy. However, the influence of LSTV on dysplasia of the hip (DDH) and the surgical treatment by periacetabular osteotomy (PAO) remains unknown. We retrospectively examined standardized standing anterior–posterior pelvic radiographs of 170 patients in 185 PAO procedures. Radiographs were examined for LSTV, lateral-central-edge-angle (LCEA), Tönnis-angle (TA), femoral-head-extrusion index (FHEI), and anterior-wall-index (AWI) and posterior-wall-index (PWI). Patients with LSTV were compared to an age- and sex-matched control group. Patient-reported outcome measurements (PROMs) were evaluated pre- and in the mean 63.0 months (range 47–81 months) postoperatively. 43 patients (25.3%) had LSTV. Patients with LSTV had significantly greater PWI (p = 0.025) compared to the matched control group. No significant differences were seen in AWI (p = 0.374), LCEA (p = 0.664), TA (p = 0.667), and FHEI (p = 0.886). Between the two groups, no significant differences were detected in pre- or postoperative PROMs. Due to the increased dorsal femoral head coverage in patients with LSTV and DDH compared to patients with sole DDH, a more pronounced ventral tilting might be performed in those patients with prominent posterior wall sign to avoid anterior undercoverage, which is a significant predictor for premature conversion to hip arthroplasty after PAO. However, anterior overcoverage or acetabular retroversion must be avoided due to the risk of femoroacetabular impingement. Patients with LSTV reported similar functional outcomes and activity after PAO as the control group. Therefore, even for patients with concomitant LSTV, which are frequent with one-fourth in our cohort, PAO is an efficient treatment option to improve clinical symptoms caused by DDH.
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spelling pubmed-102819882023-06-22 The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis Becker, Luis Hipfl, Christian Schömig, Friederike Perka, Carsten Hardt, Sebastian Pumberger, Matthias Leopold, Vincent Justus Sci Rep Article Lumbo-sacral transitional vertebrae (LSTV) are the most common congenital alteration of the lumbo-sacral junction and known to significantly influence pelvic anatomy. However, the influence of LSTV on dysplasia of the hip (DDH) and the surgical treatment by periacetabular osteotomy (PAO) remains unknown. We retrospectively examined standardized standing anterior–posterior pelvic radiographs of 170 patients in 185 PAO procedures. Radiographs were examined for LSTV, lateral-central-edge-angle (LCEA), Tönnis-angle (TA), femoral-head-extrusion index (FHEI), and anterior-wall-index (AWI) and posterior-wall-index (PWI). Patients with LSTV were compared to an age- and sex-matched control group. Patient-reported outcome measurements (PROMs) were evaluated pre- and in the mean 63.0 months (range 47–81 months) postoperatively. 43 patients (25.3%) had LSTV. Patients with LSTV had significantly greater PWI (p = 0.025) compared to the matched control group. No significant differences were seen in AWI (p = 0.374), LCEA (p = 0.664), TA (p = 0.667), and FHEI (p = 0.886). Between the two groups, no significant differences were detected in pre- or postoperative PROMs. Due to the increased dorsal femoral head coverage in patients with LSTV and DDH compared to patients with sole DDH, a more pronounced ventral tilting might be performed in those patients with prominent posterior wall sign to avoid anterior undercoverage, which is a significant predictor for premature conversion to hip arthroplasty after PAO. However, anterior overcoverage or acetabular retroversion must be avoided due to the risk of femoroacetabular impingement. Patients with LSTV reported similar functional outcomes and activity after PAO as the control group. Therefore, even for patients with concomitant LSTV, which are frequent with one-fourth in our cohort, PAO is an efficient treatment option to improve clinical symptoms caused by DDH. Nature Publishing Group UK 2023-06-20 /pmc/articles/PMC10281988/ /pubmed/37340098 http://dx.doi.org/10.1038/s41598-023-37208-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Becker, Luis
Hipfl, Christian
Schömig, Friederike
Perka, Carsten
Hardt, Sebastian
Pumberger, Matthias
Leopold, Vincent Justus
The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis
title The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis
title_full The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis
title_fullStr The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis
title_full_unstemmed The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis
title_short The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis
title_sort influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10281988/
https://www.ncbi.nlm.nih.gov/pubmed/37340098
http://dx.doi.org/10.1038/s41598-023-37208-8
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