CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(04): 471-477
DOI: 10.1055/s-0043-1769501
Original Article

Birmingham Royal Orthopaedic Hospital (BROH) Femoral Offset—An Ancillary Measure of Adult Dysplasia of the Hip

1   Department of Orthopedics, Southport & Ormskirk NHS Trust, Southport, United Kingdom
,
2   Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, United Kingdom
,
Michail Michalos
3   Department of Young Adult Hip, Royal Orthopedic Hospital, Birmingham, United Kingdom
,
Callum McBryde
3   Department of Young Adult Hip, Royal Orthopedic Hospital, Birmingham, United Kingdom
,
Angelos Politis
3   Department of Young Adult Hip, Royal Orthopedic Hospital, Birmingham, United Kingdom
,
Ed Bache
3   Department of Young Adult Hip, Royal Orthopedic Hospital, Birmingham, United Kingdom
,
Peter Wall
3   Department of Young Adult Hip, Royal Orthopedic Hospital, Birmingham, United Kingdom
,
2   Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, United Kingdom
› Author Affiliations
Funding None.

Abstract

Introduction Adult dysplasia of the hip (ADH) is a disorder of abnormal development of the hip joint resulting in a shallow acetabulum and uncovering of the femoral head. Several radiological measurements such as the Tönnis angle (acetabular index), lateral center edge angle of Wiberg, and cross-sectional imaging parameters exist to calculate hip dysplasia.

Aims The aim of this article was to describe a new ancillary linear measure of ADH on cross-sectional imaging, the Birmingham Royal Orthopaedic Hospital (BROH) Femoral offset.

Patients and Methods Anteroposterior radiographs of the pelvis and computed tomography imaging of 100 consecutive patients with suspected hip dysplasia were reviewed. Demographic details and clinical indications were recorded. Tönnis angle was utilized to measure hip slope on radiographs and the BROH femoral offset was calculated for each patient. Student's t-test and one-way analysis of variance (ANOVA) were performed. Intraclass correlation coefficient analysis was evaluated to assess the reliability between observers.

Results There was a total of 100 patients (128 hips) included in the study (60 with normal Tönnis angle, 53 had dysplasia, and 15 had decreased Tönnis angle). The average BROH femoral offset in the dysplastic cohort was increased in comparison to the normal cohort with a statistically significant p-Value of 0.0001. The p-value was 0.00031 on ANOVA. The BROH femoral offset calculation revealed good intra- and interobserver reliability of 0.9 and 0.9, respectively.

Conclusion The BROH femoral offset can be an additional index for measuring ADH that is easier to calculate, and reproducible with good intra- and inter-observer reliability on cross-sectional imaging.



Publication History

Article published online:
16 June 2023

© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Wyles CC, Heidenreich MJ, Jeng J, Larson DR, Trousdale RT, Sierra RJ. The John Charnley award: redefining the natural history of osteoarthritis in patients with hip dysplasia and impingement. Clin Orthop Relat Res 2017; 475 (02) 336-350
  • 2 Engesæter IØ, Laborie LB, Lehmann TG. et al. Prevalence of radiographic findings associated with hip dysplasia in a population-based cohort of 2081 19-year-old Norwegians. Bone Joint J 2013; 95-B (02) 279-285
  • 3 Gala L, Clohisy JC, Beaulé PE. Hip dysplasia in the young adult. J Bone Joint Surg Am 2016; 98 (01) 63-73
  • 4 Jacobsen S, Sonne-Holm S. Hip dysplasia: a significant risk factor for the development of hip osteoarthritis. A cross-sectional survey. Rheumatology (Oxford) 2005; 44 (02) 211-218
  • 5 Garbuz DS, Masri BA, Haddad F, Duncan CP. Clinical and radiographic assessment of the young adult with symptomatic hip dysplasia. Clin Orthop Relat Res 2004; (418) 18-22
  • 6 Beltran LS, Rosenberg ZS, Mayo JD. et al. Imaging evaluation of developmental hip dysplasia in the young adult. AJR Am J Roentgenol 2013; 200 (05) 1077-1088
  • 7 Kim HT, Kim IB, Lee JS. MR-based parameters as a supplement to radiographs in managing developmental hip dysplasia. Clin Orthop Surg 2011; 3 (03) 202-210
  • 8 Starr V, Ha BY. Imaging update on developmental dysplasia of the hip with the role of MRI. Am J Roentgenol 2014; 203 (06) 1324-1335
  • 9 Delaunay S, Dussault RG, Kaplan PA, Alford BA. Radiographic measurements of dysplastic adult hips. Skeletal Radiol 1997; 26 (02) 75-81
  • 10 Popat R, Lee S, George DA, Amiras D, Sarraf KM. Assessment of the young adult hip joint using plain radiographs. Musculoskelet Surg 2020; 104 (03) 245-255
  • 11 Kraeutler MJ, Safran MR, Scillia AJ, Ayeni OR, Garabekyan T, Mei-Dan O. A contemporary look at the evaluation and treatment of adult borderline and frank hip dysplasia. Am J Sports Med 2020; 48 (09) 2314-2323
  • 12 Fa L, Wang Q, Ma X. Superiority of the modified Tönnis angle over the Tönnis angle in the radiographic diagnosis of acetabular dysplasia. Exp Ther Med 2014; 8 (06) 1934-1938
  • 13 van Bosse H, Wedge JH, Babyn P. How are dysplastic hips different? A three-dimensional CT study. Clin Orthop Relat Res 2015; 473 (05) 1712-1723
  • 14 Tönnis D. Normal values of the hip joint for the evaluation of X-rays in children and adults. Clin Orthop Relat Res 1976; (119) 39-47
  • 15 Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016; 15 (02) 155-163 DOI: 10.1016/j.jcm.2016.02.012. Erratum in: J Chiropr Med 2017 Dec;16(4):346
  • 16 Schmitz MR, Murtha AS, Clohisy JC. ANCHOR Study Group. Developmental dysplasia of the hip in adolescents and young adults. J Am Acad Orthop Surg 2020; 28 (03) 91-101
  • 17 Leide R, Bohman A, Wenger D, Overgaard S, Tiderius CJ, Rogmark C. Hip dysplasia is not uncommon but frequently overlooked: a cross-sectional study based on radiographic examination of 1,870 adults. Acta Orthop 2021; 92 (05) 575-580
  • 18 Kosuge D, Yamada N, Azegami S, Achan P, Ramachandran M. Management of developmental dysplasia of the hip in young adults: current concepts. Bone Joint J 2013; 95-B (06) 732-737
  • 19 Werner CM, Ramseier LE, Ruckstuhl T. et al. Normal values of Wiberg's lateral center-edge angle and Lequesne's acetabular index–a coxometric update. Skeletal Radiol 2012; 41 (10) 1273-1278
  • 20 Ogata S, Moriya H, Tsuchiya K, Akita T, Kamegaya M, Someya M. Acetabular cover in congenital dislocation of the hip. J Bone Joint Surg Br 1990; 72 (02) 190-196
  • 21 McClincy MP, Wylie JD, Yen YM, Novais EN. Mild or borderline hip dysplasia: are we characterizing hips with a lateral center-edge angle between 18° and 25° appropriately?. Am J Sports Med 2019; 47 (01) 112-122
  • 22 Puloski SK, Leunig M, Ganz R. Acetabular centre-edge angles revisited: applications and limitations in patients with acetabular dysplasia undergoing periacetabular osteotomy. Hip Int 2006; 16 (01) 1-7
  • 23 Haddad FS, Garbuz DS, Duncan CP, Janzen DL, Munk PL. CT evaluation of periacetabular osteotomies. J Bone Joint Surg Br 2000; 82 (04) 526-531
  • 24 Mimura T, Mori K, Kitagawa M. et al. Multiplanar evaluation of radiological findings associated with acetabular dysplasia and investigation of its prevalence in an Asian population: a CT-based study. BMC Musculoskelet Disord 2017; 18 (01) 50
  • 25 Tallroth K, Lepistö J. Computed tomography measurement of acetabular dimensions: normal values for correction of dysplasia. Acta Orthop 2006; 77 (04) 598-602
  • 26 Subramanian A, Hegde G, Azzopardi C. et al. TI VIBE inversion MRI - an alternative to CT for imaging of hip pain. J Clin Orthop Trauma 2021; 19: 196-199