Radiographic measures of hip dysplasia correlate only moderately with computationally derived contact mechanics

Holly D Aitken; Jessica E Goetz; Aspen Miller; Dominic J L Rivas; Elle McCormick; Robert W Westermann; Todd O McKinley; Michael C Willey

doi:10.1093/jhps/hnaf047

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Radiographic measures of hip dysplasia correlate only moderately with computationally derived contact mechanics

Journal article

Open access

Peer reviewed

Radiographic measures of hip dysplasia correlate only moderately with computationally derived contact mechanics

Holly D Aitken, Jessica E Goetz, Aspen Miller, Dominic J L Rivas, Elle McCormick, Robert W Westermann, Todd O McKinley and Michael C Willey

Journal of hip preservation surgery

09/05/2025

DOI: 10.1093/jhps/hnaf047

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Abstract

Hip dysplasia is currently diagnosed with two-dimensional radiographic measurements that may not adequately describe the aetiology of pain and dysfunction associated with dysplastic deformity and future osteoarthritis progression. This study aimed to assess how accurately two-dimensional radiographic measurements represent the three-dimensional mechanical joint environment. Spearman ρ correlation was used to determine associations between radiographic measurements of hip dysplasia made on pre-operative and 6-month post-operative standing AP pelvis radiographs, and hip contact stress calculated based on pre- and post-operative pelvis CT scans for a series of 100 patients (125 dysplastic hips) treated with periacetabular osteotomy using discrete element analysis. Only moderate correlations were observed between radiographic measurements and contact mechanics. Pre-operative lateral centre edge angle of Wiberg had the highest, though moderate, correlation with mean cumulative contact stress-time exposure (ρ = −0.5112, P < .0001). Tönnis angle (ρ = 0.4898, P < .0001) and extrusion index (ρ = 0.4579, P < .0001) also had moderate correlations with pre-operative mean cumulative contact stress-time exposure. Only weak correlations were found post-operatively and when comparing change in radiographic measurements to computational contact mechanics metrics before and after surgery. These findings indicate the mechanical environment of the hip joint is more complex than simple radiographic measurements that quantify coverage of the femoral head by the acetabulum. Evaluation of three-dimensional contact mechanics in dysplastic hips should be used in combination with two-dimensional radiographic evaluation for guiding clinical care for patients with hip dysplasia.

Details

Title: Subtitle: Radiographic measures of hip dysplasia correlate only moderately with computationally derived contact mechanics
Creators: Holly D Aitken - University of Iowa
Jessica E Goetz - University of Iowa Health Care
Aspen Miller - University of Iowa, Orthopedics and Rehabilitation
Dominic J L Rivas - University of Iowa
Elle McCormick - University of Iowa
Robert W Westermann - University of Iowa
Todd O McKinley - Indiana University Health
Michael C Willey - University of Iowa Health Care
Resource Type: Journal article
Publication Details: Journal of hip preservation surgery
DOI: 10.1093/jhps/hnaf047
ISSN: 2054-8397
eISSN: 2054-8397
Publisher: OXFORD UNIV PRESS
Grant note: Orthopaedic Research and Education Foundation (OREF): 17-001
This study was funded by the Orthopaedic Research and Education Foundation (OREF) (Career Development Grant 17-001).
Language: English
Electronic publication date: 09/05/2025
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Injury Prevention Research Center; Athletic Training Program
Record Identifier: 9984962645202771

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