Scholarlink

Introduction <p>The Femoro-Epiphyseal Acetabular Roof (FEAR) index is a proposed radiographic marker of hip instability, particularly in borderline developmental dysplasia of the hip (BDDH). Its diagnostic value in other hip morphologies and its association with patient-reported outcomes (PROMs) remain unclear. This study evaluated the FEAR index for assessing hip instability across different acetabular morphologies by analyzing its associations with radiographic measures obtained from standard anteroposterior pelvic and false-profile radiographs, dynamic ultrasonography, and PROMs.</p> Materials and Methods <p>We retrospectively studied 171 female patients (200 hips) who presented with hip pain and/or symptoms suggestive of hip instability and who underwent radiographs and ultrasonography from April 2020 to March 2024. Hips were classified by lateral center-edge angle (LCEA) as normal (≥ 25°), BDDH (20°–25°), or developmental dysplasia of the hip (DDH; &lt;20°). Radiographic measures included the FEAR index, LCEA, vertical-center anterior angle (VCA), and head lateralization index (HLI). Dynamic instability was assessed by femoral head translation distance (FTD) on ultrasonography. Correlation between FEAR and other parameters were tested with Spearman’s rank. Receiver operating characteristic (ROC) analysis identified the FEAR cut-off for instability (FTD ≥ 2&#xa0;mm). PROMs were compared between groups using the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) and Numerical Rating Scale (NRS).</p> Results <p>The FEAR index correlated significantly with LCEA, VCA, HLI, and FTD across all morphological groups. ROC analysis identified 5.2° as the optimal cut-off (AUC, 0.787). Patients with FEAR ≥ 5.2° had lower JHEQ scores and higher NRS scores than those with FEAR index &lt; 5.2° (<i>p</i> &lt; 0.05).</p> Conclusions <p>The FEAR index is a simple, clinically useful radiographic marker of hip instability across BDDH, DDH, and normal hips. Its strong associations with dynamic ultrasonography and PROMs support its value as a practical tool for comprehensive hip instability assessment.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Evaluation of femoro-epiphyseal acetabular roof index for assessing hip instability in hip disorders in female patients

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月2日

查看全文
  • Yosuke Kozuma,
  • Takeshi Shoji,
  • Shinichi Ueki,
  • Junichi Sumii,
  • Hiroyuki Morita,
  • Nobuo Adachi

摘要

Introduction

The Femoro-Epiphyseal Acetabular Roof (FEAR) index is a proposed radiographic marker of hip instability, particularly in borderline developmental dysplasia of the hip (BDDH). Its diagnostic value in other hip morphologies and its association with patient-reported outcomes (PROMs) remain unclear. This study evaluated the FEAR index for assessing hip instability across different acetabular morphologies by analyzing its associations with radiographic measures obtained from standard anteroposterior pelvic and false-profile radiographs, dynamic ultrasonography, and PROMs.

Materials and Methods

We retrospectively studied 171 female patients (200 hips) who presented with hip pain and/or symptoms suggestive of hip instability and who underwent radiographs and ultrasonography from April 2020 to March 2024. Hips were classified by lateral center-edge angle (LCEA) as normal (≥ 25°), BDDH (20°–25°), or developmental dysplasia of the hip (DDH; <20°). Radiographic measures included the FEAR index, LCEA, vertical-center anterior angle (VCA), and head lateralization index (HLI). Dynamic instability was assessed by femoral head translation distance (FTD) on ultrasonography. Correlation between FEAR and other parameters were tested with Spearman’s rank. Receiver operating characteristic (ROC) analysis identified the FEAR cut-off for instability (FTD ≥ 2 mm). PROMs were compared between groups using the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) and Numerical Rating Scale (NRS).

Results

The FEAR index correlated significantly with LCEA, VCA, HLI, and FTD across all morphological groups. ROC analysis identified 5.2° as the optimal cut-off (AUC, 0.787). Patients with FEAR ≥ 5.2° had lower JHEQ scores and higher NRS scores than those with FEAR index < 5.2° (p < 0.05).

Conclusions

The FEAR index is a simple, clinically useful radiographic marker of hip instability across BDDH, DDH, and normal hips. Its strong associations with dynamic ultrasonography and PROMs support its value as a practical tool for comprehensive hip instability assessment.