Evaluation of the Risk Factors of Avascular Necrosis of the Femoral Head in Developmental Dysplasia of the Hip in Infants Younger Than 18 Months of Age1

2002 ◽  
Vol 11 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Haluk A??u?? ◽  
Hakan ??mero??lu ◽  
Hakan U??ar ◽  
Ali Bi??imo??lu ◽  
Y??cel T??mer
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip

Evaluation of the Risk Factors of Avascular Necrosis of the Femoral Head in Developmental Dysplasia of the Hip in Infants Younger Than 18 Months of Age1

2002 ◽  
Vol 11 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Haluk Ağuş ◽  
Hakan Ömeroğlu ◽  
Hakan Uçar ◽  
Ali Biçimoǧlu ◽  
Yücel Tümer
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip

Is Kalamchi and MacEwen Group I avascular necrosis of the femoral head harmless in developmental dysplasia of the hip?

2010 ◽  
Vol 20 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Haluk Ağuş ◽  
Hakan Ömeroğlu ◽  
Ali Biçimoğlu ◽  
Yücel Tümer
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Developmental Dysplasia ◽  
Group I ◽  
Dysplasia Of The Hip

scholarly journals Contact Pressure Distribution of the Hip Joint During Closed Reduction of Developmental Dysplasia of the Hip

2020 ◽  
Author(s):  
Zhiqiang Zhang ◽  
Hai Li ◽  
Dashan Sui ◽  
Haiyi Qin ◽  
Ziming Zhang
Keyword(s):  
Finite Element ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Contact Pressure ◽  
Closed Reduction ◽  
Treatment Success ◽  
Developmental Dysplasia ◽  
Abduction Angle ◽  
Lateral Part ◽  
Dysplasia Of The Hip

Abstract Background: Developmental dysplasia of the hip (DDH) is the most common deformity of the lower extremity in children, and the etiology remains unclear. The biomechanical change during closed reduction (CR) focused on cartilage contact pressure (CCP) has not been studied. Thereby, we try to provide insight into biomechanical factors potentially responsible for CR treatment success and complications by using finite element analysis (FEA) for the first time.Methods: Finite element models of one patient with DDH were established based on the data of MRI scan on which cartilage contact pressure was measured. During CR, CCP between the femoral head and acetabulum in different abduction and flexion angles were tested to estimate the efficacy and potential risk factors of avascular necrosis (AVN) following CR.Results: A 3D reconstruction by the FEA method was performed on a sixteen-month-old girl with DDH on the right side. The acetabulum of the involved side showed a long, narrow, and "plate-shaped" deformity, whereas the femoral head was smaller and irregular compared with the contralateral side. With increased abduction angle, the stress of the posterior acetabulum increased significantly, and the stress on the lateral part of the femoral head increased as well. The changes of CCP in the superior acetabulum were not apparent during CR. There were no detectable differences in terms of pressure on the femoral head.Conclusions: Severe dislocation (IHDI grade III and IV) in children showed a high mismatch between the femoral head and acetabulum. Increased abduction angle corresponded with high contact pressure, which might relate to avascular necrosis, whereas increased flexion angle was not. Enhanced pressure on the lateral part of the femoral head might increase the risk of AVN.

scholarly journals Efficacy of closed reduction for developmental dysplasia of the hip: midterm outcomes and risk factors associated with treatment failure and avascular necrosis

2020 ◽  
Author(s):  
Ge Zhang ◽  
Ming Li ◽  
Xiangyang Qu ◽  
Yujiang Cao ◽  
Xing Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Avascular Necrosis ◽  
Failure Rate ◽  
Closed Reduction ◽  
Significant Risk ◽  
Developmental Dysplasia ◽  
Secondary Outcome ◽  
Factors Associated ◽  
Related Risk ◽  
Dysplasia Of The Hip

Abstract Background: The purpose of this study was to evaluate the efficacy after closed reduction (CR) in the treatment of developmental dysplasia of the hip (DDH) and investigate risk factors associated with CR failure and avascular necrosis (AVN) occurrence in the follow-ups.Primary and secondary outcome measures: The study retrospectively included 110 patients and 138 hips with DDH diagnosis between February 2012 and November 2015 in our single tertiary medical institution and underwent closed reduction. The failure rate of CR and the underlying risk factors were evaluated. meanwhile, the incidence of AVN and the related risk factors among the successful CR cases were assessed.Results: The overall failure rate of DDH treated by CR in present study was 31.16% (43/138). Risk factors for the CR failure was older age at the time of CR (≥18.35 month), large medical interval before CR (≥35.35 millimeters), and severer dislocation of the affected hip (IDHI grade III and IV). The incidence of AVN was 8.33% (6/72) in the patients with successful CR at last follow-up. No significant risk factors had been established in present study that associated with the AVN occurrence.Conclusions: For the treatment of DDH with CR, patients with younger age might achieve better outcomes, early diagnosis and early treatment might be the key point in the DDH treatment.

scholarly journals Does the vascular development of the femoral head correlate with the incidence of avascular necrosis of the proximal femoral epiphysis in children with developmental dysplasia of the hip treated by closed reduction?

2021 ◽  
pp. 1-7
Author(s):  
JianPing Wu ◽  
Zhe Yuan ◽  
JingChun Li ◽  
MingWei Zhu ◽  
Federico Canavese ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Closed Reduction ◽  
Vascular Development ◽  
Contralateral Side ◽  
Developmental Dysplasia ◽  
Level Of Evidence ◽  
Class B ◽  
Class C ◽  
Dysplasia Of The Hip

Purpose The purpose of this study was to identify the correlation between the vascular development of the femoral head and avascular necrosis (AVN) in patients with developmental dysplasia of the hip (DDH) treated by closed reduction (CR). Methods We retrospectively reviewed 78 patients with DDH treated by CR (83 hips). The vascular maturity, number of vessels and perfusion changes of the femoral head were assessed on perfusion MRI (pMRI) before and after CR. Results The number of vessels (mean 4.2 sd 1.4) of the femoral head and the ratio (36.1%) of mature vessels (type III) on the dislocated side were significantly less than those at contralateral side (mean 6.0 sd 1.2; 82.2%) (p < 0.001). Of the included 83 hips, 39 hips (61.5%) showed decreased perfusion of the femoral head, including partial decreased (Class B, 47.0%) and global decreased (Class C, 14.5%), at the dislocated side, which was significantly more than those at contralateral side (0.0%) (p < 0.001). In total, 32 out of 83 hips (38.5%) developed AVN. The rate of AVN with Class A (18.8%) which perfusion of the femoral head was normal (unchanged or enhanced) was significantly less than those with Class C (66.7%) (p = 0.006). Conclusion The vascular development and perfusion changes of the femoral head on the dislocated side are significantly worse than those at contralateral side. Immature vascularity of the femoral head before CR and poor perfusion of the femoral head after CR may be risk factors for AVN in patients with DDH. Level of evidence III

Traction does not decrease failure of reduction and femoral head avascular necrosis in patients aged 6–24 months with developmental dysplasia of the hip treated by closed reduction

2019 ◽  
Vol 28 (5) ◽  
pp. 436-441 ◽  
Author(s):  
Yi-Qiang Li ◽  
Ming Li ◽  
Yue-Ming Guo ◽  
Xian-Tao Shen ◽  
Hai-Bo Mei ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Closed Reduction ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip

scholarly journals MRI risk factors for development of avascular necrosis after closed reduction of developmental dysplasia of the hip: Predictive value of contrast-enhanced MRI

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248701
Author(s):  
Jung-Eun Cheon ◽  
Ji Young Kim ◽  
Young Hun Choi ◽  
Woo Sun Kim ◽  
Tae-Joon Cho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Contrast Enhancement ◽  
Closed Reduction ◽  
Interobserver Agreement ◽  
Developmental Dysplasia ◽  
Enhancement Pattern ◽  
Contrast Enhanced ◽  
Dysplasia Of The Hip ◽  
Hip Mri

Purpose The purpose of this study was to identify imaging risk factors on contrast-enhanced hip MRI after closed reduction of developmental dysplasia of the hip (DDH) that could predict future development of avascular necrosis (AVN) of the femoral head. Materials and methods Fifty-eight infants (F: M = 53: 5, aged 3–18 months) who underwent immediate postoperative contrast-enhanced hip MRI after closed reduction of DDH were included in this study. Quality of reduction (concentric vs eccentric reduction with or without obstacles), abduction angle of the hip, presence of ossific nucleus, and pattern of contrast enhancement of the femoral head were retrospectively evaluated on MRI. Interobserver agreement of contrast enhancement pattern on MRI were evaluated by two radiologists. Development of AVN was determined through radiographic findings at 1 year after reduction. Results AVN of the femoral head developed in 13 (22%) of 58 patients. Excessive abduction of the hip joint (OR 4.65, [95% CI 1.20, 18.06] and global decreased enhancement of the femoral head (OR 71.66, [95% CI 10.54, 487.31]) exhibited statistically significant differences between the AVN and non-AVN groups (P < 0.05). Eccentric reduction (P = 0.320) did not show statistically significant difference between two groups and invisible ossific nucleus (P = 0.05) showed borderline significance. Multi-variable logistic regression indicated that global decreased enhancement of the femoral head was a significant risk factor of AVN (OR 27.92, 95% CI [4.17, 350.18]) (P = 0.0031). Interobserver agreement of contrast enhancement pattern analysis and diagnosis of AVN were good (0.66, 95% CI [0.52, 0.80]). Conclusion Contrast-enhanced hip MRI provides accurate anatomical assessment of the hip after closed reduction of DDH. Global decreased enhancement of the femoral head could be used as a good predictor for future development of AVN after closed reduction of DDH.

scholarly journals Risk factors for avascular necrosis after closed reduction for developmental dysplasia of the hip

2016 ◽  
Vol 10 (3) ◽  
pp. 185-192 ◽  
Author(s):  
Mathew D. Schur ◽  
Christopher Lee ◽  
Alexandre Arkader ◽  
Anthony Catalano ◽  
Paul D. Choi
Keyword(s):  
Risk Factors ◽  
Avascular Necrosis ◽  
Closed Reduction ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip

The correlation between Salter’s criteria for avascular necrosis of the femoral head and Kalamchi’s prognostic classification following the treatment of developmental dysplasia of the hip

2017 ◽  
Vol 99-B (8) ◽  
pp. 1115-1120 ◽  
Author(s):  
Y. Tsukagoshi ◽  
M. Kamegaya ◽  
H. Kamada ◽  
T. Saisu ◽  
M. Morita ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip
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