This study aims to determine the relationship between hip orientation and spinopelvic alignment using 3D renderings of the spine, pelvis, and hip in healthy young adults. The research focuses on femoroacetabular parameters and spinopelvic variables to provide valuable insights for future surgical interventions in patients with degenerative hip and spine pathology.
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Presentation Transcript
Section of Orthopaedic Surgery Establishing normative relationship of spinopelvic alignment to femoroacetabular orientation Taryn Ludwig MD/PhD, PGY3 Jonathan Bourget-Murray - MDCM, FRCSC Sarup Sridharan- MD, PGY5 Ariana Frederick MSc Kelly Johnston - MD, FRCSC Brent Edwards - PhD Fred Nicholls - MD, MA, FRCSC CSS 2021
Objective Determining the native alignment of the acetabulum in patients with both degenerative hip and spine pathology is challenging Postural changes following total hip arthroplasty or spinal fusion can influence the future success of the second surgical intervention Which procedure should be performed first is a subject of debate Normative data describing the relationship between hip orientation and spinopelvic alignment is not described in the literature Our objective is to obtain 3D renderings of the spine, pelvis, and hip to evaluate spinopelvic and femoroacetabular parameters in healthy young adults We hypothesize that femoroacetabular alignment is predictable and can be determined based on measurement of morphologic, non positional parameters
Methods - Patients Cross-sectional study: Healthy volunteers age 20-39 Exclusion criteria: Any previous hip conditions/surgery Any previous spine conditions/surgery Any systemic inflammatory disease Any scoliosis or spondylolisthesis identified on imaging Full body EOS scans are used to obtain measurements of participants acetabulum and proximal femur Preliminary data for a subset of patients are presented here, along with descriptive statistics
Methods - Variables Femoracetabular parameters: obtained from EOS 3D reconstruction - Acetabular version - Acetabular inclination - Femoral version - Femoral neck-shaft angle Spinopelvic parameters: obtained from KEOPS image segmentation software - Pelvic incidence (calculated) - Pelvic tilt - Sacral slope - Lumbar lordosis - Lumbopelvic morphotype Whole body EOS scan
Patient Demographics Number of patients imaged 490 5 4 15 15 2 3 44 446 Scoliosis > 20 Spondylolisthesis Insufficient imaging Previous lower limb surgery/pathology Elevated baseline ODI/NDI Other (C spine condition, inflammatory disease, etc) Total excluded Total included Age (SD) Number female (%) BMI (SD) 28.4 (5.2) 255 (57%) 24.9 (4.3)
Preliminary Results Number of patients Acetabular Version (SD) a 374 14.5 (4.2) 55.7 (3.4) Acetabular inclination (SD) a 15.0 (9.3) Femoral version (SD) a 129.3 (4.5) Femoral neck-shaft angle (SD)a aaverage of bilateral parameters
Preliminary Results Number of patients Pelvic incidence (SD) 446 47.9 (11.6) 38.9 (8.7) Sacral slope (SD) 9.0 (7.6) Pelvic tilt (SD) -53.7 (11.2) Lumbar lordosis L1-S1 (SD) b blordotic angles are negative
Discussion This dataset employs the largest database of full-body EOS images composed entirely of young healthy individuals ever captured in the current literature Exclusion of any previous lower limb or spine pathology will ensure maximum accuracy of femoroacetabular/spinopelvic correlation Future work: Further analysis will include a predictive model of femoroacetabular alignment based on spinopelvic measurements For males and females separately
Conclusions This study will contribute significantly to knowledge of normal spinopelvic and femoroacetabular alignment This will result in improved patient care by: Allowing more informed positioning of hip arthroplasty implants and spinal fusion Decreasing complications and reducing need for revision surgery Questions/feedback? Please get in touch! Taryn Ludwig: teludwig@ucalgary.ca Fred Nicholls: fred.nicholls@ucalgary.ca
