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Original Article

Is Vertical-center-anterior Angle Equivalent to Anterior Coverage of the Hip?

Takashi Sakai¹, Takashi Nishii², Kazuomi Sugamoto³, Hideki Yoshikawa¹ and Nobuhiko Sugano²

(1)	Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, 565-0871 Suita, Japan

(2)	Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan

(3)	Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Osaka, Japan

Received: 11 September 2008 Accepted: 9 March 2009 Published online: 26 March 2009

Abstract We investigated whether the vertical-center-anterior (VCA) angle measured on the false-profile view of the hip represents true anterior coverage by computer simulation using three-dimensional (3-D) computed tomography (CT) in 100 hips without osteoarthritic changes. True anterior coverage angle on the sagittal plane was measured in the pelvic coordinate system. Two types of VCA angle were measured on the digital reconstructed radiographs: the anterior point of the VCA angle was defined as the foremost aspect of the acetabulum, denoted VCA-1, whereas the anterior edge of the dense shadow of the subchondral bone of the acetabulum was defined as VCA-2. In the normal hips, VCA-1 was consistent with anterior coverage angle (r = 0.88, Spearman rank test), whereas VCA-2 underestimated the anterior coverage (r = 0.72). In the dysplastic hips, VCA-2 did not always indicate true anterior coverage (r = 0.64), whereas VCA-1 overestimated the anterior coverage (r = 0.002). Although VCA-1 in normal hips shows true anterior coverage, the VCA angle does not indicate true anterior coverage in dysplastic hips, and VCA angle measurement in dysplastic hips should be used carefully.

Level of Evidence: Level IV, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

One of the authors (KS) has received funding from the Japanese Science and Technology Agency.

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

Takashi Sakai
Email: tsakai-osk@umin.ac.jp

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