Turk J Hip Surg. 2022; 2(1): 138-144 | DOI: 10.5505/TJHS.2022.03522

Effect of Lumbar Variables on Acetabular Version: Analysis with Pelvic-CT Scan

Yüksel Uður Yaradýlmýþ, Alparslan Kýlýç, Ali Teoman Evren, Mehmet Ali Tokgöz, Hakan Þeþen, Murat Altay
Department of Orthopaedics and Traumatology, University of Health Sciences, Keçiören Health Practice and Research Center Ankara, Turkey

ABSTRACT

Objective: The acetabular version is important both for the diagnosis of hip pathologies and in hip replacement surgery. This study aimed to present the acetabular version of the Turkish population and to determine the variation of the acetabular version according to pelvic and lumbar parameters.

Methods: A total of 300 patients with pelvic and spinal CT scans aged 20-80 years without lumbar, pelvic, and hip pathology or fractures were included. Bilateral acetabular version, anterior acetabular sector angle (AASA), and posterior acetabular sector angle (PASA) were measured on axial pelvic CT scans. The pelvic tilt, sacral slope, pelvic incidence, and lumbar lordosis were measured in spinal CT sagittal sections. Sagittal spinal alignment was typed according to Roussouly classification. The variation of the acetabular version according to demographic, pelvic, and lumbar parameters was determined.

Results: Acetabular measurements; mean acetabular version: 18.8±5.9, AASA: 65±8.9, PASA: 99.4±9.9. While there was no statistically significant difference in acetabular version measurements according to age and gender (p=0.766, p=0.087), anteversion was the same on both sides: 18.8±5 on the right and 18.8±6.7 on the left (p=0.841). Mean pelvic tilt was 10.9±5.3, mean sacral slope was 41.1±7.5, mean pelvic incidence was 52±9.5 and all three measurements were significantly correlated with anteversion (respectively: p<0.001, p=0.017, p<0.001). Mean lumbar lordosis was 31.7±11.3 and it was significantly correlated with anteversion (p=0.001). An increase in anteversion was statistically significant according to the Roussouly classification (p=0.05).

Conclusion: The acetabular version is in a wide range, similar to that of the contralateral hip. Lumbar and pelvic parameters have positive correlations with acetabular anteversion.

Keywords: Acetabular version, lumbar lordosis, pelvic tilt, sacral slope, Roussouly classification

---

Lomber deðiþkenlerin asetabular versiyona etkisi: Pelvik-BT ile analiz

Yüksel Uður Yaradýlmýþ, Alparslan Kýlýç, Ali Teoman Evren, Mehmet Ali Tokgöz, Hakan Þeþen, Murat Altay
Saðlýk Bilimleri Üniversitesi, Keçiören Eðitim ve Araþtýrma Hastanesi, Ortopedi ve Travmatoloji Ana Bilim Dalý, Ankara

Amaç: Asetabular versiyon, hem kalça patolojilerinin tanýsýnda hem de kalça protez cerrahisinde doðru komponent oryantasyonu için önemlidir. Çalýþmamýzda hem Türk toplumunun asetabular versiyonunun sunulmasý hem de pelvik ve lomber deðiþkenler karþýsýnda asetabular versiyonun deðiþiminin belirlenmesi amaçlanmýþtýr.

Gereç ve yöntem: Hastanemizde Ocak 2020-Ocak 2021 tarihleri arasýnda travma nedeniyle çekilen pelvik ve spinal BT’ler incelendi. Lomber, pelvik ve kalça patolojisi olmayan 20-80 yaþ aralýðýndaki 300 hasta çalýþmaya dahil edildi. Hastalarýn aksiyel pelvis BT kesitleri üzerinden bilateral asetabular versiyonu, anterior asetabular kýsým açýsý (AASA) ve posterior asetabular kýsým açýsý (PASA) ölçüldü. Hastalarýn spinal BT sagital kesitlerinden; pelvis tilt, sakral slop ve pelvik insidans ölçüldü. Omurga deðerlendirmesi için Roussouly sýnýflandýrmasýna göre tiplendirme yapýldý ve lomber lordoz ölçüldü. Asetabular versiyonun demografik verilere, pelvik ve lomber deðiþkenlere göre deðiþimi belirlendi.

Bulgular: Asetabular ölçümler; ortalama asetabular versiyon: 18.8±5.9, AASA: 65±8.9, PASA: 99.4±9.9 olarak bulundu. Asetabular versiyon ölçümlerinde; yaþ ve cinsiyet deðiþkenine göre istatistiksel olarak fark gözlenmezken (p=0.766, p=0.087), taraf ölçümlerinde sað: 18.8±5, sol: 18.8±6.7 anteversiyon olmak üzere ayný bulundu (p=0.841). Hastalarýn lomber lordozu 31.7±11.3 olup anteversiyon ile korelasyonu anlamlý bulundu (p=0.001). Pelvik tilt: 10.9±5.3, sakral slop: 41.1± 7.5 ve pelvik insidans: 52±9.5 olup anteversion ile korelasyonu anlamlý bulundu (sýrasýyla: p<0.001, p=0.017, p<0.001). Roussouly sýnýflandýrmasýna göre tip arttýkça anteversiyonda artýþ gözlendi ve bu artýþ da istatistiksel olarak anlamlý idi (Tip 1: 14.9±5.1, Tip2: 18.3±5, Tip 3: 18.7±4.7, Tip4: 20.1±5.2, p=0.05).

Sonuç: Asetabular anteversiyon deðeri beklenenden daha geniþ bir aralýkta olup karþý kalça ile benzerdir. Lomber ve pelvik deðiþkenler asetabular anteversiyona doðrudan etkili olup pozitif korelasyon göstermektedir.

Anahtar Kelimeler: Asetabular anteversiyon, lomber lordoz, pelvik tilt, pelvik insidans, sakral slop, Roussouly sýnýflandýrmasý

---

CITE