Evaluation of CE angle of Wiberg for the functional outcome in various hip pathologies: an observational study
Keywords:CE angle of Wiberg, Femoroacetabular impingment, Osteoarthritis, Avascular necrosis of femoral head
Background: The objective of the study was to evaluate CE Angle of Wiberg for the functional outcome in various hip pathologies.
Methods: This is a non-randomised prospective, observational study carried out for the period of 15 months. In this study 35 hips of 28 patients with hip pathologies with age more than 5 years of both genders, hip pathologies like CAM and/or Pincer type of femoroacetabular impingement, Acetabular retroversion, Perthes like deformity, osteoarthritis hip, avascular necrosis of femoral head, developmental dysplasia of hip were studed.
Results: In this prospective study out of 28 patients 9 (32.14%) were FAI, 8 (28.57%) were OA hip, 8 (28.57%) were avascular necrosis of femoral head and 3 case (10.71%) is of Perthes' disease. In FAI cases 4(44.44%) patients were of Pincer type, 5 (55.55%) were of combined type with no any case of isolated CAM form. All were unilateral involvement with average CE angle of 32.670±11.670. In Pincer type mean CE angle was 36.250 ±7.50 while in Combined form the mean CE angle was 29.80±14.40. Out of 4 patients of Pincer FAI, 3 patients of Pincer type had CE angle between 250-400 which comes under normal range of CE angle, so all were planned for non operative management.Conclusions: We have found that all the hip pathologies reported to us had spectrum of variations in CE angle depending on the severity of disease. Variation was maximum seen in osteoarthritis and femoroacetabular impingement, in the cases of FAI maximum was of Pincer type.
Fredensborg N. The CE angle of normal hips. Acta Orthop Scand. 1976;47:403-5.
Bruckl R, Hepp WR, Tonnis D. Eine Abgrenzung normaler und dysplastis cherjugendlicher Hiiftgelenke durch den Huftwert. Arch Unfall-Chir. 1972;74:13-3.
Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint. Actachir Scand. 1939;58:1-130.
Severin E. Congenital dislocation of the hip joint. Late results of closed reduction arthrographic studies of recent cases. Acta Chir Scand. 1941;63:1-142.
Wiberg G. Pfannendachplastih bei Dysplasia acetabuli, Subluxatio und Luxatiocoxae unter besonderer Beriicksichtigung der Entwicklung des oberen Pfannenrandes. Arch Orthop Unfall-Chir. 1944;43:314-69.
Wiberg G. Shelf operation in congenital dysplasia of the acetabulum and in subluxation and dislocation of the hip. JBJS. 1953;35(1):65-80.
Davies WR. Acetabular dysplasia and familial joint laxity: two etiological factors in congenital dislocation of the hip. JBJS Br. 1970;52:704-16.
Kutty S, Schneider P, Faris P, Kiefer G, Frizzell B, Park R et al. Powell. Reliability & predictability of center edge angle in the assessment of pincer femoroacetabular impingement. Int Orthop. 2012;36(3):505–10.
Jamali AA, Mladenov K, Meyer DC, Martinez A, Beck M, Ganz R, Leunig M. Anteroposterior pelvic radiographs to assess acetabular retroversion: high validity of the “cross-over-sign”. J Orthop Res. 2007;25(6):758-65.
Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint with special reference to the complication of osteoarthritis. Acta Chir Scandinavica. 1953;83(58):1-135.
Mandal S, Bhan S. The center edge angle of Wiberg in the adult Indian population. JBJS. 1996;78:320-1.
Ito K, Minka MA, Leunig S, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset. JBJS Br. 2001;83:171–6.
Beaulé PE, Zaragoza EJ, Motamedi K, Copelan N, Dorey FJ. Three-dimensional computed tomography of the hip in the assessment of femoroacetabular impingement. J Orthop Res. 2005;23:1286–92.
Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R. Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment. Clin Orthop Relat Res. 2004;418:67–73.
Wagner S, Hofstetter W, Chiquet M, Mainil-Varlet P, Stauffer E, Ganz R, et al. Early osteoarthritic changes of human femoral head cartilage subsequent to femoro-acetabular impingement. Osteoarthritis Cartilage. 2003;11(7):508–18.
Klaue K, Durnin CW, Ganz R. The acetabular rim syndrome. A clinical presentation of dysplasia of the hip. JBJS Br. 1991;73(3):423-9.
Hayes MH, Royer NK. The Relationship of acetabular dysplasia and femoroacetabular impingement to hip osteoarthritis. PMR. 2011;3(11):1055-67.
Chung CY, Park MS, Lee KM. Hip Osteoarthritis and risk factor in elderly Korean population. Osteoarthritis & Cartilage. 2010;18(3):312-6.
Gosvig KK, Jacobsen S, Sonne Holm S, Palm H, Troelsen A. Prevalence of malformation of hip joint and their relationship to sex, groin pain and risk of OA: a population based survey. JBJS Am. 2010:92(5):1162-9.
Boone GR, Pagnotto MR, Walker JA, Trousdale RT, Sierra RJ. Lateral center Edge angle is predictive of acetabular over coverage in Femoroacetabular impingement (2012) AAOS Annual Meeting presentation. Available at http://www.abstractsonline.com/plan/ abstract/b0de. Accessed in 24 May 2014.
Tonnis 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.
Amanatullah DF, Strauss EJ, Di Cesare PE. Current management options for osteonecrosis of femoral head. Am J Orthop. 2011;40(10):217-26.
Nozawa M, Enomoto F, Shitoto K, Matsuda K, Maezawa K, Kurosawa H. Rotational Acetabular Osteotomy for Osteonecrosis with Collapse of the Femoral Head in Young Patients. JBJS Am. 2005;87(3):514-20.
Osman MK, Martin DJ, Sherlock DA. Outcome of late-onset Perthes’ disease using four different treatment modalities. J Child Orthop. 2009;3(3):235–42.