Comprehensive deformity analysis using LCEA, AI, AWI and PWI showed, that 40% of these hips were deficient either antero-laterally or postero-laterally. The rather high proportion of symptomatic hips labelled borderline dysplastic suggested, that there might be substantial acetabular deficiency not recognizable by LCEA. ![]() ![]() ICC confirmed highly accurate and reproducible readings of all parameters. Gender stratification revealed that male acetabula seemed to be slightly more postero-laterally deficient than female (mean PWI 0.80 vs 0.89 p = 0.017). Based on AWI and PWI, the categorization resulted in 116 laterally dysplastic (60.4%), 33 antero-laterally (17.2%) and 43 postero-laterally dysplastic hips (22.4%). ResultsĪccording to LCEA, 192 hips were identified as “borderline dysplastic”. Intra- and interobserver correlation of the parameters was analyzed by intraclass correlation coefficient (ICC). With these values, the hips were categorized into laterally, antero-laterally and postero-laterally dysplastic and stratified by gender. On all preoperative pelvic radiographs with a LCEA of 18–25°, acetabular index (AI), AWI and PWI were measured. Material and methodsĪ retrospective review of 397 consecutive hips was performed, all treated with triple pelvic osteotomy (TPO) due to symptomatic hip dysplasia. This allowed an increasingly comprehensive understanding of acetabular morphology and a questioning of the borderline definition. In recent years, several radiographic parameters have been described to assess the antero posterior coverage of the femoral head, for example, the anterior and posterior wall index (AWI and PWI). In hip preservation surgery, the term “borderline hip dysplasia” was used when the lateral center edge angle (LCEA), historically described by Wiberg, measured 18–25°.
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