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CE Angle of Wiberg

(See: Radiographic Features of DDH)

Discussion

  • CE angle provides useful information after the age of 5 years (may be used in adults);
  • angle formed by a line drawn from the center of the femoral head to the outer edge of the acetabular roof, and a verticle line drawn through the center of the femoral head;
  • angle greater than 25 deg are considered normal;
  • less than 20 deg indicates severe dysplasia;
  • Wiberg examined 44 patients with CE angles less than 20 deg (unselected group) that had no radiographic evidence of DHD;
    • in 17 patients (ages 13 to 60 yrs) DJD had developed over a period of 4-28 yrs;
    • DJD in the 4th decade had an average CE of 2 deg;
    • DJD in the 5th decade had an average CE of 5 deg;
    • DJD in the 6th decade had an average CE of 10 deg;
    • DJD in the 7th decade had an average CE of 12 deg;
    • key point of his study was that patients with subluxation were not separated from patients who only had dysplasia;
      • review of these hips showed that most had subluxation;

Cooperman, et al (1983) »

  • followed 20 adult patients (32 hips) for avg 22 years.
  • 15 women and 5 men.
  • all patients had CE angle of less than 20 deg, all had intact Shenton's line, and none had evidence of DJD;
  • average initial age was 43 years (27-57 yrs);
  • average follow up age was 65 years;
  • measurement variables included:
    • CE angle
    • acetabular angle of Sharp
    • percentage of femoral head coverage
    • acetabular depth
    • inclination of lateral lip of acetabulum.
  • none of these variables was predictive for DJD.
  • most patients developed DJD but a linear relationship between DJD and CE (or other variables) could not be developed.
  • males tended to remain free of DJD longer than females.
  • 9 hips remained free of DJD in the 6th decade.
    • 6 of these were male.
  • 7 patients developed severe DJD (during 4th, 5th, 6th, 7th and 8th decades).
    • 4th and 5th decade: 4 hips w/ av CE of 6 deg;
    • 6th decade: 3 hips w/ av CE of 6 deg;
    • 7th decade: 7 hips w/ av CE of 9 deg;
    • 8th decade: 7 hips w/ av CE of 4 deg 
  • Acetabular Dyplasia in the Adult.

  • Studies on Dysplastic Acetabula and Congenital Subluxation of the Hip Joint. Wiberg G. Acta Chir Scand. 1939;(83) Suppl 58:7.