{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T21:07:43Z","timestamp":1780434463032,"version":"3.54.1"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T00:00:00Z","timestamp":1609977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005289","name":"National Institute of Justice","doi-asserted-by":"publisher","award":["2016\u2010DN\u2010BX\u20100144"],"award-info":[{"award-number":["2016\u2010DN\u2010BX\u20100144"]}],"id":[{"id":"10.13039\/100005289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To see if three\u2010dimensional (3D) methods could bring new understanding to acetabular changes in shape and orientation in the spastic hip and in which direction(s) acetabular orientation might change, which is crucial for planning appropriate hip correction surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We performed a retrospective study of pelvic computed tomography (CT) examinations in 20 consecutive patients (10 females, 10 males). The mean age of patients was 12 years 9 months (SD 2y; range: 9\u201316y) at the time of the CT examination. The control group consisted of 18 consecutive pelvic CT examinations (36 acetabula) of deceased individuals (six females, 12 males) aged 4 to 17 years (mean age: 10y 6mo; SD 5y 2mo) whose whole\u2010body CT scans were taken shortly after their death. We compared 3D CT reconstructions of 28 unstable and dislocated hips in children with bilateral cerebral palsy (Gross Motor Function Classification System levels IV and V) with the unaffected side and typically developing controls to assess spatial orientation (inclination, anteversion, and tilt), acetabular volume, and surface area. Additionally, we analysed the multiple factors that may lead to structural and spatial changes of the acetabulum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with dislocated and spastic hips had significantly lower anteversion (\u22123.2\u00b0 and \u22121.4\u00b0 respectively, <jats:italic>p<\/jats:italic>&lt;0.001), increased inclination (85.2\u00b0 and 85.3\u00b0 respectively, <jats:italic>p<\/jats:italic>&lt;0.001), and decreased tilt (24.6\u00b0 [<jats:italic>p<\/jats:italic>=0.014] and 20.7\u00b0 [<jats:italic>p<\/jats:italic>=0.013] respectively) compared with typically developing individuals. Regarding acetabular volume and surface area, dislocated and unstable hips had significantly lower volume (17.6ml vs 31.5ml respectively, <jats:italic>p<\/jats:italic>&lt;0.001) and surface area (28.9cm<jats:sup>2<\/jats:sup> vs 36.2cm<jats:sup>2<\/jats:sup> respectively, <jats:italic>p<\/jats:italic>&lt;0.001) than unaffected hips. Among several factors, only Reimer\u2019s migration index had an influence on acetabular orientation (i.e. anteversion, <jats:italic>p<\/jats:italic>=0.01), volume (<jats:italic>p<\/jats:italic>&lt;0.001), and surface (<jats:italic>p<\/jats:italic>=0.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Acetabula in patients with spastic hip disease were severely retroverted with increased steepness; acetabular orientation was distorted superoposteriorly. In rare cases, acetabular orientation was distorted only superiorly or superoanteriorly.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Acetabular orientation was distorted superoposteriorly in most patients with severe bilateral cerebral palsy.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>More pronounced acetabular changes were found in hips with a higher Reimer\u2019s migration index.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.14793","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T02:31:19Z","timestamp":1610505079000},"page":"608-613","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Acetabular shape and orientation of the spastic hip in children with cerebral palsy"],"prefix":"10.1111","volume":"63","author":[{"given":"Marek","family":"J\u00f3\u017awiak","sequence":"first","affiliation":[{"name":"Department of Paediatric Orthopaedics and Traumatology Poznan University of Medical Sciences Poznan Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142","family":"Rychlik","sequence":"additional","affiliation":[{"name":"Division of Virtual Engineering Poznan University of Technology Poznan Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wies\u0142aw","family":"Szymczak","sequence":"additional","affiliation":[{"name":"Institute of Psychology University of \u0141\u00f3d\u017a \u0141\u00f3d\u017a Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Grzegorzewski","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Paediatric Orthopaedics Medical University of \u0141\u00f3d\u017a \u0141\u00f3d\u017a Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8500-0688","authenticated-orcid":false,"given":"Bartosz","family":"Musielak","sequence":"additional","affiliation":[{"name":"Department of Paediatric Orthopaedics and Traumatology Poznan University of Medical Sciences Poznan Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,7]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"7","article-title":"Which procedure gives best results in reconstructing dislocated hip joints in cerebral palsy?","volume":"64","author":"Brunner R","year":"1998","journal-title":"Acta Orthop Belg"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e318228903d"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B1.19674"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.88B2.16274"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.82B4.0820526"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004694-199703000-00002"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.81B6.9700"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.12169"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B1.15146"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-8-101"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e3181c0e957"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-015-0503-8"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.5604\/15093492.1226275"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199907000-00012"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.20189"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1302\/1863-2548.13.190004"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-014-0589-9"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200001000-00020"}],"container-title":["Developmental Medicine &amp; 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