Acetabular Dysplasia (original) (raw)
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ROLE OF ACETABULOPLASTY IN MANAGEMENT OF DEVELOPMENTAL DYSPLASIA OF THE HIP
Background: Developmental dysplasia of the hip is a spectrum of disorder ranging from mild dysplasia up to frank dislocation. Objectives: Evaluation of the results of Dega acetabuloplasty in cases of developmental dysplasia of the hip below 8 years. Patients and Methods: This prospective study was conducted on thirty five hips in thirty patients of developmental dysplasia of the hip in Zagazig University hospitals, Sharqia between 2013 and 2015. Results: Results of treatment were evaluated using clinical and radiological parameters based on modified McKay criteria and Severin classification respectively. Satisfactory results were present in thirty two hips (91.4%), compared with unsatisfactory results in three hips (8.6%). Conclusion Adding Dega osteotomy in indicated cases of DDH, greatly helps to improve femoral head coverage and stability of the hip without adding significant complications.
3D Characterization of Acetabular Deficiency in Children with Developmental Dysplasia of the Hip
Indian Journal of Orthopaedics, 2021
Background The purpose of this study is to determine if a quantitative method can be used to identify differences in 3D morphology between normal and developmentally dysplastic hips and to identify specific areas of undercoverage in children with DDH compared to age- and sex-matched controls. Methods Subjects were included if they were typically developing children with no other underlying conditions affecting their musculoskeletal system and had an available pelvic CT scan (67 hips). Custom software was used to measure standard variables defining acetabular morphology (version, tilt, surface area). Acetabuli were divided into equal octants; coverage angles were measured for each octant of interest. Variables were compared with age- and sex-matched controls (128 hips) using analysis of variance or the Mann–Whitney test. Results Hips with DDH were more anteverted compared to normal hips (DDH: 22.6˚, Control: 16.4˚, p
Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in total hip replacement
The Archives of Bone & Joint Surgery, 2014
Developmental dysplasia of the hip (DDH) or congenital hip dysplasia (CDH) is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is challenging. Interpretation of published data is difficult and should ...
Arthrographic Evaluation of Developmental Dysplasia of the Hip
Clinical Orthopaedics and Related Research, 1996
Arthrograms of 35 hips in 33 children less than 2 years of age with typical developmental dysplasia of the hip were reviewed. After arthrograms were repeated for 11 hips 6 weeks following the initial test, results were classified into 6 types based on medial pooling ratio and morphology of the acetabular limbus. Using modified Severin's criteria for outcome evaluation, 7 of the 11 hips had been upgraded in type. All hips that were classified as Type I by arthrogram had Severin I results. The relation of arthrographic type and radiographic results was statistically significant. Immediate open reduction is recommended in hips classified as Type VI at first arthrogram or Type I11 and above at reneat arthrozram. The extent of femoral head displacement and the shape of the acetabular limbus are important both in making management decisions and in evaluating outcome of developmental
Clinics in Orthopedic Surgery, 2022
Developmental dysplasia of the hip (DDH) is a common pediatric orthopedic disorder with an incidence of 1.5-2.5 per 1,000 live births. 1) In early infancy, the physical examination cannot diagnose all cases of DDH; therefore, imaging either by ultrasound or radiography became popular worldwide for screening, confirming clinical suspicion, and classifying the severity of the condition. 2-4) Ultrasound is the preferred modality for diagnosing DDH in infants less than 6 months old, but the skills to perform a valuable ultrasound may not be available everywhere. 5) A majority of orthopedic surgeons use pelvic radiographic films to diagnose DDH in children over 3 months of age. 6) The International Hip Dysplasia Institute (IHDI) classification, which uses the midpoint of the proximal femoral metaphysis as a reference landmark to determine the location of the hip, can be applied to children of all ages and is considered more reliable than the Tönnis method, which depends on the relative position of the ossified capital femoral nucleus to Perkin's line and Hilgenreiner's line, even when the capital femoral epiphysis is ossified. 2,7,8) However, this classification depends mainly on the lateralization and displacement of the proximal femur and neglects the acetabulum. Moreover, grade 1 is a little bit confusing and it may be difficult to decide whether the hip with this grade is normal or abnormal as acetabular dysplasia alone without displacement of the proximal femur is also considered as a type of DDH. This study aimed to upgrade the IHDI classification by including the state of the acetabulum (normal or dysplastic) to classify the hips. The authors hypothesized that the inclusion of the acetabular state will resolve confusion about the grade 1 hips (whether normal or abnormal).
Developmental dysplasia of the hip: Is acetabular retroversion a crucial factor?
Orthopaedics & Traumatology-surgery & Research, 2009
The objective of this study was to investigate a possible relation between congenital hip dysplasia and acetabular retroversion and to explore the eventual influence of the latter in the surgical decision for periacetabular osteotomy. Materials and methods: We assessed the classical morphological characteristics of both hips, with an additional newly described retroversion index. The study was conducted in 174 patients with uni-or bilateral congenital hip dysplasia having undergone unilateral (153 patients) or bilateral (21 patients) periacetabular osteotomy when respectively one or both dysplastic hips remained symptomatic. Results: In the group of operated hips (195 hips in total), 53% of the acetabuli were anteverted, 42% retroverted, and 5% neutral orientations. The group of nonoperated hips (153 hips) included 24% normal hips, 22% hips with normal coverage but retroverted, 35% dysplastic hips with anteverted or neutral orientation, and 19% dysplastic retroverted hips. Comparing the two hips in the subgroup of patients in whom the operated and nonoperated sides were both dysplastic failed to demonstrate statistically significant difference in the mean retroversion index. However, all the other variables measured were significantly different; with the operated side more dysplastic. Comparing the two hips in the other subgroups showed that acetabular retroversion was nearly always bilateral and symmetrical, even in presence of unilateral congenital dysplasia. Discussion: Our data suggest that the presence of acetabular retroversion is probably independent of the congenital hip dysplasia and that this abnormality seems at best a secondary factor in the appearance of dysplastic hip symptoms.
Developmental Dysplasia of the Hip in Young Children
2019
Developmental dysplasia of the hip (DDH) in the newborn describes a wide spectrum of pathologic disorders of the hip, ranging from subtle dysplasia of the acetabulum to irreducible hip dislocation. At all ages of treatment, the primary goal is to obtain a concentric reduction of the femoral head within the acetabulum while minimizing the risk for avascular necrosis or other complications. When recognized in the first 6 months of life, DDH is typically successfully treated with simple outpatient based harness therapy (Pavlik) and routinely results in excellent outcomes. After 6 months of age, closed reduction, open reduction, and femoral and pelvic osteotomies are more often required as treatment modalities. Each treatment decision should be considered thoughtfully in each unique patient encounter, with the overriding goal of obtaining a concentrically reduced hip joint while minimizing complications always at the forefront.
Acetabular dysplasia at the age of 1 year in children with neonatal instability of the hip
Acta Orthopaedica, 2013
Background and purpose As much as one-third of all total hip arthroplasties in patients younger than 60 years may be a consequence of developmental dysplasia of the hip (DDH). Screening and early treatment of neonatal instability of the hip (NIH) reduces the incidence of DDH. We examined the radiographic outcome at 1 year in children undergoing early treatment for NIH.