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SUMMARY: The aim of this study was to evaluate the relation between acetabulum morphological measurements and present the reference values of the acetabulum. The study had a retrospective design and was conducted with 234 healthy subjects (108 females; 126 males) aged 18-53 years over a period of 4 years from 2018 to 2022. Eleven measurements including the center- edge angle (CEA), acetabular angle (AA), acetabular depth (AD), acetabular width (AW), dept to width ratio (ADWR), Extrusion A (EA)-B (EB), Extrusion index (EI), the lateral subluxation (LS), peak to edge distance (PED), and roof obliquity (RO) were taken. The p<0.05 value was considered significant. A significant difference was found in CEA, AA, EB, LS, and RO values, while there was no significance in the AD, AW, ADWR, EI, and PED measurements in comparison with acetabular morphometry according to gender. Also, in the evaluation of acetabulum to age-related changes, there was a significant difference in values of the CEA, AA, AD, AW, ADWR, LS, and PED from decades 1 to 5. The knowledge of radiological acetabulum findings is paramount for the diagnosis of hip dysplasia and may be useful for prosthesis, orthopedic and forensic experts. Also, the most interesting finding was that ADWR increased based on age in a directly proportional trend. The most apparent change based on age was seen in CEA (between decades 3-4), LS (decades 1-5), PED (decades 2-4), AD, and AW (decades 2-5).

El objetivo de este estudio fue evaluar la relación entre las medidas morfológicas del acetábulo y presentar sus valores de referencia. El estudio tuvo un diseño retrospectivo y se realizó con 234 sujetos sanos (108 mujeres; 126 hombres) de 18 a 53 años de edad durante un período de 4 años, desde 2018 hasta 2022. Once mediciones que incluyeron el ángulo centro-margen (ACM), ángulo acetabular (AA), profundidad acetabular (PA), ancho acetabular (AC), relación de profundidad y ancho (RPAC), extrusión A (EA)-B (EB), índice de extrusión (IE), subluxación lateral (SL). Se midió la distancia al margen (DAM) y la oblicuidad del techo (OT). Se consideró significativo el valor de p<0,05. Se encontró una diferencia significativa en los valores de ACM, AA, EB, SL y OT, mientras que no hubo significación en las medidas de AA, AC, RPAC, IE y DAM en comparación con la morfometría acetabular según el sexo. Además, en la evaluación del acetábulo respecto a los cambios relacionados con la edad, hubo una diferencia significativa en los valores de ACM, AA, PA, AC, RPAC, SL y DAM de las décadas 1 a 5. El conocimiento de los hallazgos radiológicos del acetábulo es primordial para el diagnóstico de displasia de cadera y puede ser útil para expertos en prótesis, ortopedia y medicina forense. Además, el hallazgo más interesante fue que RPAC aumentó según la edad en una tendencia directamente proporcional. El cambio más aparente según la edad se observó en ACM (entre las décadas 3 y 4), LS (décadas 1 a 5), DAM (décadas 2 a 4), PA y AC (décadas 2 a 5).

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Steel syndrome was initially described by H. H. Steel in 1993 in Puerto Rico, at which time he described the clinical findings required for diagnosis. The responsible gene, COL27A1, was identified in 2015 (Gonzaga-Jauregui et al., European Journal of Human Genetics, 2015;23:342-346). Eleven patients have previously been described with Steel syndrome and homozygous COL27A1 mutations, with eight having an apparent founder mutation, p.Gly697Arg. We describe three more patients identified at Einstein Medical Center Philadelphia and St. Christopher's Hospital for Children (Philadelphia, PA) diagnosed with Steel syndrome. All three are of Puerto Rican ancestry with the previously described founder mutation and had either hip dislocations or hip dysplasia. Radial head dislocation was only identified in one patient while short stature and scoliosis were noted in two of these patients. There are now 51 patients in the literature with Steel syndrome, including the 3 patients in this article, and 14 patients with a genetically confirmed Steel syndrome diagnosis.

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This study aimed to determine whether abnormal apoptosis is present in acetabular cartilage in early developmental dislocations of the hip (DDH), and if so, whether it is correlated with the expression of caspase-3 and Bcl-2. DDH was induced in 24 4-week-old New Zealand white rabbits. Acetabular cartilage specimens from the experimental and control groups were stained with hematoxylin and eosin (H&E). Animals from the experimental group developed acetabular dysplasia. Apoptotic chondrocytes were observed by ultrastructural electron microscopy and H&E. TUNEL assays revealed significantly greater acetabular chondrocyte apoptosis in the treated samples as compared to the control. Significantly higher caspase-3 expression and lower Bcl-2 expression were also measured in the DDH group compared with the control. We conclude that excessive apoptosis does occur in acetabular cartilage with DDH, and is positively correlated with high caspase-3 expression as well as low Bcl-2 expression.

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OBJECTIVE:To evaluate the progression of the contralateral hip after unilateral reconstruction of hip dislocation in patients classified as GMFCS IV-V; and to identify potential prognostic factors for their evolution.METHODS:This was a retrospective study on 17 patients with spastic cerebral palsy, who were classified on the GMFCS scale (Gross Motor Functional Classification System) as degrees IV and V, and who underwent unilateral reconstruction surgery to treat hip dislocation (adductor release, femoral varus osteotomy and acetabuloplasty). The minimum postoperative follow-up was 30 months. The clinical parameters evaluated were sex, age at time of surgery, length of follow-up after surgery and range of abduction. The treatment parameters were use/nonuse of femoral shortening, application of botulinum toxin and any previous muscle releases. The radiographic parameters were Reimer's extrusion index (REI), acetabular angle (AA) and the continuity of Shenton's line...

OBJETIVO:Avaliar a evolução do quadril contralateral após a reconstrução unilateral de luxação de quadril em pacientes classificados como GMFCS IV-V e identificar possíveis fatores prognósticos da evolução.MÉTODOS:Estudo retrospectivo de 17 pacientes portadores de paralisia cerebral espástica, classificados pela escala GMFCS (Gross Motor Functional Classification System) em graus IV e V, submetidos a cirurgia de reconstrução unilateral de luxação de quadril (liberação de adutores, osteotomia varizante femoral e acetabuloplastia). O seguimento pós-operatório mínimo foi de 30 meses. Foram avaliados parâmetros clínicos (sexo, idade na ocasião do procedimento cirúrgico, tempo de seguimento após a cirurgia e amplitude de abdução), de tratamento (a feitura ou não de encurtamento femoral, aplicação de toxina botulínica e se houve procedimentos musculares prévios) e radiográficos (índice de extrusão de Reimers [IR], ângulo acetabular [AC] e continuidade do arco de Shenton [AS])...

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BACKGROUND: Primary or idiopathic osteoarthritis (OA) of the hip has increasingly been attributed to the presence of presumably minor femoral or acetabular deformities that are not routinely identified. The alpha angle reflects one such deformity of the femoral neck and reflects a risk for femoroacetabular impingement, which in turn reportedly is associated with OA. If impingement is in fact associated with OA, then one might expect the mean alpha angle to be greater in patients with presumed idiopathic hip OA. QUESTIONS/PURPOSES: We therefore compared the alpha angle among a group of elderly patients with idiopathic OA with that in a control group of elderly individuals without OA. PATIENTS AND METHODS: We measured the alpha angles in 50 individuals (72 hips) with a mean age of 70 years (range, 60-84 years) with apparently idiopathic OA and compared their angles with those from a control group of 56 individuals without OA. The alpha angle was measured by means of radiographs of their hips using the Dunn view at 45 degrees flexion. RESULTS: The patients with OA had a greater percentage with abnormal alpha angles than did the normal subjects: 82% versus 30%, respectively. The mean alpha angle in the group with OA was larger than in the control subjects: 66.4 masculine (range, 28 degrees -108 degrees ) versus 48.1 masculine (range, 34 degrees -68 degrees ). CONCLUSIONS: Hips with presumably idiopathic OA had more abnormalities at the femoral head-neck junction than did the control hips without OA and may relate to the risk of OA developing. LEVEL OF EVIDENCE: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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En este trabajo se presentan resultados del estudio de 23 pacientes con luxación traumática de la cadera, atendidos en el Hospital Baca Ortiz de Quito, en el período de 1980 a 1989; 11 pacientes fueron descartados por falta de seguimiento; la relación hombres-mujeres fue de 3 a 1 y el grupo de edad más afectado fue de 5 a 10 años (58,32 por ciento) de los casos. Todos los casos fueron luxaciónes posteriores sin lesiones asociadas aparentes y el tiempo transcurrido entre la lesión y el tratamiento fue alto en el 83,3 por ciento de los casos con una medida de 2,3 meses, lo que derivó en un alto índice de complicaciones, 83,3 por ciento de los casos. La complicación más frecuente fue la necrosis aséptica 50 por ciento (6 casos), seguido de subluxación, 16,6 por ciento (2 casos) y la recidiva y rigidez 1 caso cada una 8,35 por ciento, respectivamente. El tipo de tratamiento no influyó en el pronóstico de estas caderas, sino que tuvo más importancia el tiempo transcurrido entre lesión y tratamiento, y las lesiones asociadas subdiagnosticadas con radiología simple.

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