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Protrusio Acetabuli in Marfan Syndrome: History, Diagnosis, and Treatment

Van de Velde, Samuel MD; Fillman, Ramona MHA, PT; Yandow, Suzanne MD

Journal of Bone & Joint Surgery - American Volume: March 2006 - Volume 88 - Issue 3 - p 639–646
doi: 10.2106/JBJS.E.00567
Current Concepts Review
Supplementary Content

Marfan syndrome is an autosomal dominant disorder of connective tissue, with ocular, skeletal, and cardiovascular manifestations.

Protrusio acetabuli is a criterion for the diagnosis of Marfan syndrome.

Prolonged protrusio acetabuli may result in secondary osteoarthritic changes in the hip joint.

Radiographic criteria for protrusio acetabuli include an abnormally positioned acetabular line, a center-edge angle of Wiberg of >40°, and crossing of the teardrop by the ilioischial line.

In a skeletally immature patient with Marfan syndrome in whom the triradiate physis of the acetabulum is still open, closure of the triradiate physis can interrupt and decrease the progression of the deformity. In older patients, valgus intertrochanteric osteotomy and eventually total hip arthroplasty are the only methods available for correction of the protrusio acetabuli.

1 University Hospital Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium. E-mail address:

2 Shriners Hospitals for Children, Honolulu, 1310 Punahou Street, Honolulu, HI 96826-1099

Copyright 2006 by The Journal of Bone and Joint Surgery, Incorporated
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