Developmental dysplasia of the hip associated with aplasia of the pubic bone (hook-pelvis)

Background Measuring the pubofemoral distance (PFD) is important for evaluating the effectiveness of hip reduction in the treatment of developmental dysplasia of the hip (DDH). However, reference PFD values have not been established in normal infants. Purpose To investigate variations in PFD values measured in normal infant medial hips stratified by age, laterality, and gender. Material and Methods A total of 240 infants diagnosed with Graf type Ia and/or Graf type Ib hips by ultrasonography were stratified into eight age groups: 0–1 month; 1–2 months; 2–3 months; 3–4 months; 4–5 months; 5–6 months; 6–7 months; and 7–12 months. The bilateral medial hips were scanned with transinguinal ultrasound. The PFD was defined as the distance between the lateral edge of the superior ramus of pubic bone and the medial edge of the femoral head. Inter-observer reproducibility was assessed. Results Among the 240 infants, there were 371 Graf type Ia hips and 109 Graf type Ib hips. Mean ± SD bilateral PFD values of eight groups were measured separately. There were no significant differences in mean PFD values for left or right hips (t = 0.946, P = 0.345) or mean bilateral PFD values in male and female infants (t = 1.445, P = 0.149). Mean PFD values increased linearly with age (left: r = 0.680, P < 0.0001; right: r = 0.682, P < 0.0001). Inter-observer reproducibility was excellent. Conclusion This study established reference PFD values from the medial hip in infants aged 0–12 months. PFD values increased with age, but were not significantly influenced by laterality or gender. These data provide detailed information that can support follow-up of infants treated for DDH.

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The prevalence and risk factors of pubic bone marrow edema in femoroacetabular impingement and hip dysplasia

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnab081 ◽

2021 ◽

Author(s):

Hiroki Shimodaira ◽

Akihisa Hatakeyama ◽

Hitoshi Suzuki ◽

Shinichiro Takada ◽

Yoichi Murata ◽

...

Keyword(s):

Bone Marrow Edema ◽

Hip Dysplasia ◽

Arthroscopic Surgery ◽

Alpha Angle ◽

Multivariate Logistic Regression Analysis ◽

Developmental Dysplasia ◽

Pubic Bone ◽

Multivariate Logistic Regression ◽

Osteitis Pubis ◽

Dysplasia Of The Hip

ABSTRACT Femoroacetabular impingement syndrome (FAIS) has been associated with osteitis pubis; however, it is still unclear whether hip dysplasia is associated with osteitis pubis. This study aimed to investigate (i) the incidence of pubic bone marrow edema (BME) on magnetic resonance imaging in symptomatic patients with FAIS, borderline developmental dysplasia of the hip (BDDH) and developmental dysplasia of the hip (DDH) undergoing hip arthroscopic surgery with labral preservation and (ii) the demographic and radiographic factors associated with pubic BME. A total of 259 symptomatic patients undergoing hip arthroscopic surgery between July 2016 and April 2019 were retrospectively reviewed and divided into three groups: FAIS (180 patients), BDDH (29 patients) and DDH (50 patients). Diffuse changes in the pubic bone adjacent to the pubic symphysis were labeled pubic BME, and the prevalence of their occurrence was examined. Multivariate logistic regression analysis was performed to identify factors involved in pubic BME, and odds ratios (ORs) for relevant factors were calculated. There was no significant difference in the prevalence of pubic BME among the three groups (20 [11.1%] of 180 FAIS patients, 6 [20.6%] of 29 BDDH patients and 7 [14%] of 50 DDH patients, P = 0.325). Multivariate logistic regression analysis showed that acetabular coverage was not associated with pubic BME, whereas younger age and greater alpha angle were still independent associated factors [age ≤26 years (OR, 65.7) and alpha angle ≥73.5° (OR, 4.79)]. Determining the possible association of osteitis pubis with cam impingement in dysplastic hips may provide insights toward a more accurate understanding of its pathophysiology.

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4-year follow-up of ultrasound-based diagnosis and non-surgical treatment of developmental dysplasia of the hip in mongolia: a prospective cohort study

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0036-1587724 ◽

2016 ◽

Vol 37 (S 01) ◽

Cited By ~ 1

Author(s):

T Baumann ◽

B Munkhuu ◽

B Chuluunbaatar ◽

R Schmid ◽

S Essig

Keyword(s):

Cohort Study ◽

Surgical Treatment ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Developmental Dysplasia ◽

Dysplasia Of The Hip ◽

Non Surgical Treatment

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Faculty Opinions recommendation of Avascular necrosis following closed reduction for treatment of developmental dysplasia of the hip: a systematic review.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.729524230.793540307 ◽

2017 ◽

Author(s):

Edilson Forlin

Keyword(s):

Systematic Review ◽

Avascular Necrosis ◽

Closed Reduction ◽

Developmental Dysplasia ◽

Dysplasia Of The Hip

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Screening of Developmental Dysplasia of the Hip in Neonates with Breech Presentation

مجلة دراسات الطفولة ◽

10.21608/jsc.2015.60708 ◽

2015 ◽

Vol 18 (10.2015) ◽

pp. 0-0

Keyword(s):

Breech Presentation ◽

Developmental Dysplasia ◽

Dysplasia Of The Hip

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Prediction of the requirement of open reduction for developmental dysplasia of the hip

Journal of International Medical Research ◽

10.1177/0300060517717357 ◽

2017 ◽

Vol 46 (1) ◽

pp. 54-61 ◽

Cited By ~ 8

Author(s):

Nabil Alassaf

Keyword(s):

Open Reduction ◽

Area Under The Curve ◽

Internal Validity ◽

Developmental Dysplasia ◽

Estimation Model ◽

Cross Sectional ◽

Noninvasive Treatment ◽

Dysplasia Of The Hip ◽

Logistic Regression Equation ◽

Objective Tool

Objective Closed reduction (CR) is a noninvasive treatment for developmental dysplasia of the hip (DDH), and this treatment is confirmed intraoperatively. This study aimed to develop a preoperative estimation model of the probability of requiring open reduction (OR) for DDH. Methods The study design was cross-sectional by screening all patients younger than 2 years who had attempted CR between October 2012 and July 2016 by a single surgeon. Potential diagnostic determinants were sex, age, side, bilaterality, International Hip Dysplasia Institute (IHDI) grade, and acetabular index (AI). An intraoperative arthrogram was the reference standard. A logistic regression equation was built from a reduced model. Bootstrapping was performed for internal validity. Results A total of 164 hips in 104 patients who met the inclusion criteria were analysed. The prevalence of CR was 72.2%. Independent factors for OR were older age, higher IHDI grade, and lower AI. The probability of OR = 1/[1 + exp − (−2.753 + 0.112 × age (months) + 1.965 × IHDI grade III (0 or 1) + 3.515 × IHDI grade IV (0 or 1) − 0.058 × AI (degrees)]. The area under the curve was 0.79. Conclusion This equation is an objective tool that can be used to estimate the requirement for OR.

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Accuracy of New Deep Learning Model-Based Segmentation and Key-Point Multi-Detection Method for Ultrasonographic Developmental Dysplasia of the Hip (DDH) Screening

Diagnostics ◽

10.3390/diagnostics11071174 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1174

Author(s):

Si-Wook Lee ◽

Hee-Uk Ye ◽

Kyung-Jae Lee ◽

Woo-Young Jang ◽

Jong-Ha Lee ◽

...

Keyword(s):

Deep Learning ◽

Intraclass Correlation ◽

Alpha Angle ◽

Learning Model ◽

Developmental Dysplasia ◽

Human Observer ◽

Intraobserver Variability ◽

Cad System ◽

Deep Learning Model ◽

Dysplasia Of The Hip

Hip joint ultrasonographic (US) imaging is the golden standard for developmental dysplasia of the hip (DDH) screening. However, the effectiveness of this technique is subject to interoperator and intraobserver variability. Thus, a multi-detection deep learning artificial intelligence (AI)-based computer-aided diagnosis (CAD) system was developed and evaluated. The deep learning model used a two-stage training process to segment the four key anatomical structures and extract their respective key points. In addition, the check angle of the ilium body balancing level was set to evaluate the system’s cognitive ability. Hence, only images with visible key anatomical points and a check angle within ±5° were used in the analysis. Of the original 921 images, 320 (34.7%) were deemed appropriate for screening by both the system and human observer. Moderate agreement (80.9%) was seen in the check angles of the appropriate group (Cohen’s κ = 0.525). Similarly, there was excellent agreement in the intraclass correlation coefficient (ICC) value between the measurers of the alpha angle (ICC = 0.764) and a good agreement in beta angle (ICC = 0.743). The developed system performed similarly to experienced medical experts; thus, it could further aid the effectiveness and speed of DDH diagnosis.

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