The effect of acetabular retroversion on ipsilateral injuries during traumatic hip dislocation

Background

Determine whether native acetabular anteversion angle increased the risk of ipsilateral limb injuries in patients with traumatic hip dislocations.

Methods

Retrospective clinical series completed at a large, tertiary health care system between February 2016-November 2021. Patients with a native traumatic hip dislocation requiring a closed reduction in the operating room or open reduction internal fixation (ORIF) of an associated fracture were included, identified using current provider terminology (CPT) codes 27,250 and 27,252. Standard acetabular version angles were measured on CT images.

Results

121 cases were included in the analysis. The average age of our population was 37.5 years and 72 % were male. The median acetabular version was 14.7° (2–27°). Of the 121 cases of dislocations, 28 experienced a knee injury (23 %, p = 0.89) and 40 had a femoral head injury (33 %, p = 0.88). The most common knee injuries were patellar fractures (29 %, n = 8), tibial plateau fractures (29 %, n = 8), meniscal injuries (25 %, n = 7) and ligamentous knee injuries 21 %, n = 6). Median version angle was not associated with an increase in predisposition to femoral head injury or knee injury for patients with a native hip dislocation (p = 0.13).

Conclusion

These findings demonstrate that native acetabular anteversion does not predispose, nor protect, patients from experiencing an ipsilateral limb injury in the setting of a traumatic hip dislocation. Future studies should investigate other factors that may influence the occurrence of ipsilateral limb injuries in these settings.

Level of evidence

Level IV – Therapeutic (Retrospective Clinical Series).