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Spine align table williams11/14/2022 Tests with LR+ >10 or LR− <0.1 are usually considered suitable for application in routine practice 2 ). The negative likelihood ratio (LR−) was defined as “(1−sensitivity) / specificity” and reflected a decrease in the odds of having windswept hip-spine deformity when the value was negative (LR− of 0-1). The positive likelihood ratio (LR+) was defined as “sensitivity / (1−specificity)” and reflected an increase in the odds of having windswept hip-spine deformity when the value was positive (LR + >1). The sensitivity and likelihood ratios were determined to correspond with windswept hip-spine deformity when limited to either an abduction or adduction of >10° in the AHA. “Windswept hip-spine deformity” was defined when either the abduction position correlated with a downward motion of pelvic obliquity and convex lumbar scoliosis was noted toward the ankylosed side (a) or when the adduction position correlated with these findings on the opposite side (b). “Windswept spine-hip deformity” illustration.Ī) Abduction ankylosed hip case (white arrow ankylosed hip)ī) Adduction ankylosed hip case (white arrow ankylosed hip) This variable was calculated with abduction regarded as a positive angle and adduction regarded as a negative angle. The AHA in the coronal plane was defined as the angle between the perpendicular angle of the line passing through the inferior tip of bilateral pelvic teardrops and the long axis of the femur on the side of the ankylosed hip. PO was marked as positive in calculations when the downward direction was toward the ankylosed hip side and negative when the downward direction was toward the opposite side. The degree of PO was defined as the angle between the horizontal line and the line passing through the inferior tip of the bilateral pelvic teardrops (also known as the U-figure). LS was marked as positive in calculations when the convexity faced the ankylosed hip side and negative when the convexity faced contralaterally. The apical level, defined as the point of the most laterally deviated vertebra in a scoliosis curve, was determined. The degree of LS was measured using the Cobb method in the coronal plane, with LS defined as a curve measuring greater than 10°. The parameters measured were lumbar scoliosis (LS), PO and the ankylosed hip angle (AHA) in the coronal plane ( Fig. During the radiographic examination, all patients were instructed to stand upright in a relaxed, natural posture. The mean duration of ankylosis prior to total hip arthroplasty was 38 years (range, 7-70 years).Īntero-posterior and lateral radiographs of the pelvic and thoracic and lumbar spine were obtained for all patients in the erect posture at our institute. The initial diagnosis was tuberculosis in 13 cases, bacterial infection in 9 cases, post-trauma in 11 cases, developmental hip dysplasia in 20 cases, idiopathic osteonecrosis of the femoral head in 2 cases, and a slipped capital femoral epiphysis in 1 case. The mean age of participants was 65 years (range, 45-80 years), and all had a history of spontaneous (n = 24) or surgical (n = 32) fusion of the hip joint. The affected side was the right in 23 patients and the left in 33 patients, with no significant difference in the side of the ankylosed hip. Therefore, a total of 56 eligible patients (17 males, 39 females) were analyzed. Sixteen patients (19 hips) were deemed ineligible due to a lack of evaluable data resulting from inadequate radiographs (4 hips in 4 patients), the presence of bilateral ankylosed hips (8 hips in 5 patients) or a history of total or bipolar hip arthroplasty on the opposite side (6 hips in 6 patients and 1 hip in 1 patient, respectively). An ankylosed hip was defined as the bony union of the hip joint with trabeculae crossing the resection space and/or transformation of bone architecture, resulting in complete immobility. Seventy-two patients (75 hips) treated with total hip arthroplasty for an ankylosed hip at Saga University Hospital between January 2003 and March 2012 were registered in this study.
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