scholarly journals Greater presence of receptors for relaxin in the ligamentum teres of female infants who undergo open reduction for developmental dysplasia of the hip

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Semih Ayanoğlu ◽  
Haluk Çabuk ◽  
Fatmagül Kuşku Çabuk ◽  
Kubilay Beng ◽  
Timur Yildirim ◽  
...  
Keyword(s):  
Open Reduction ◽  
Ligamentum Teres ◽  
Developmental Dysplasia ◽  
Control Group ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Prospective Comparative Study ◽  
Relaxin 2 ◽  
Dysplasia Of The Hip

Abstract Background While many factors involved in the etiology of developmental dysplasia of the hip (DDH), one of which is the hormone relaxin. Relaxin concentrations in patients with DDH may lead to pathodynamic changes during hip development by altering the physiological nature of the ligament, as well as by long-term exposure to relaxin during pregnancy. Our objective in this study was to determine the number of relaxin receptors in the ligamentum teres and their role in causing DDH. Methods We identified 26 infants between birth and 3 years of age who had undergone open reduction for DDH between 2010 and 2012. 12 hips of 12 miss abortus fetus between 20 to 35 weeks of gestation were used as control group. Specimens obtained from two groups were stained with Relaxin-2 antibody, and the amount of staining for relaxin receptors was determined using an ordinal H score. Results The mean (SD) H scores of infants with DDH were significantly higher than those of controls: 215 (59) versus 52 (48); P = 0.00; 95% CI. Statistically significant difference between the two groups in terms of gender was not found. Conclusion As a result, increased number of relaxin receptors in the ligamentum teres could be a risk factor for DDH. Level of evidence Level 2, Prospective comparative study.

scholarly journals Are Hips Too Relaxed to Develop Healthy ?

2021 ◽  
Author(s):  
Semih Ayanoglu ◽  
Haluk Çabuk ◽  
Fatmagül Kuşku Çabuk ◽  
Kubilay Beng ◽  
Timur Yıldırım ◽  
...  
Keyword(s):  
Ligamentum Teres ◽  
Developmental Dysplasia ◽  
Control Group ◽  
Level Of Evidence ◽  
Clinical Prognosis ◽  
Developmental Dysplasia Of Hip ◽  
Prospective Comparative Study ◽  
The Mean ◽  
Relaxin 2

Abstract Background: Developmental dysplasia of hip (DDH) etiology is still a controversial issue. While many factors involved in the etiology, one of which is the hormone relaxin. Relaxin concentrations in patients with DDH may lead to pathodynamic changes during hip development by altering the physiological nature of the ligament, as well as by long-term exposure to relaxin during pregnancy. Our objective in this study was to determine the quantity of relaxin receptors in the ligamentum teres and their part in causing DDH.Methods: We identified infants between birth and 3 years of age who had undergone open reduction for DDH between 2010 and 2012. 12 hips of 12 miss abortus fetus between 20 to 35 weeks of gestation were used as control group. Specimens obtained from two groups were stained with Relaxin-2 antibody and the amount of staining for relaxin receptors was determined using an ordinal H score. Results: The mean H scores of infants with DDH were significantly higher than those of controls (p=0.00). Conclusion: As a result, increased number of relaxin receptors in the ligamentum teres could be a risk factor for DDH and the number of relaxin receptors is an important clue in explaining the female:male ratio and clinical prognosis of early dysplastic hips.Level of Evidence: Level 2, Prospective comparative study

scholarly journals Dega pelvic osteotomy: indications, results and complications

2018 ◽  
Vol 12 (4) ◽  
pp. 342-348 ◽  
Author(s):  
J. Czubak ◽  
K. Kowalik ◽  
A. Kawalec ◽  
M. Kwiatkowska
Keyword(s):  
Femoral Head ◽  
Open Reduction ◽  
Age Groups ◽  
Pelvic Osteotomy ◽  
Developmental Dysplasia ◽  
Femoral Osteotomy ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Dysplasia Of The Hip

Purpose Developmental dysplasia of the hip (DDH) after walking age is difficult to treat. Dega pelvic osteotomy is combined with open reduction and femoral osteotomy to obtain concentric stable reduction with good coverage of the femoral head. The purpose of this study is to evaluate the use of the Dega osteotomy in the treatment of DDH in two different age groups. Methods A total of 45 patients (52 hips) with a mean age of 3.9 years (1.2 to 12.8) were treated with open reduction, Dega osteotomy and femoral osteotomy. There were 38 dislocated and 14 subluxated hips. Bilateral DDH was observed in seven female patients. Radiographic parameters included acetabular index, centre-edge angle of Wiberg and migration percentage. The final radiographic outcome was evaluated according to the Severin classification. Results The mean follow-up period was four years (3 to 9). According to the Severin criteria 78.8% were types I or II whereas 21.2% showed types III or IV. There was no statistically significant difference in final outcome between children less than three years of age and older children at the time of surgery. One hip in children with unilateral involvement had developed coxa magna, that interfered with hip concentricity. Three hips (5.8%) showed avascular necrosis of the femoral head. Conclusion Dega osteotomy is a safe and adequate procedure for the management of developmental dysplasia of the hip in walking patients with low complication rates. Restoring the acetabulum to normal or nearly normal can result in good medium-term results. Level of Evidence III

scholarly journals Quantity of Relaxin Receptors in the Ligament of Head of Femur in Infants with Developmental Hip Dysplasia

2021 ◽  
Author(s):  
Semih Ayanoglu ◽  
Haluk Çabuk ◽  
Fatmagül Kuşku Çabuk ◽  
Kubilay Beng ◽  
Timur Yıldırım ◽  
...  
Keyword(s):  
Risk Factor ◽  
Hip Dysplasia ◽  
Ligamentum Teres ◽  
Control Group ◽  
Developmental Hip Dysplasia ◽  
Clinical Prognosis ◽  
Prospective Comparative Study ◽  
Relaxin 2 ◽  
Level 2

Abstract BackgroundDevelopmental dysplasia of hip (DDH) etiology is still a controversial issue. While many factors involved in the etiology, one of which is the hormone relaxin. Relaxin concentrations in patients with DDH may lead to pathodynamic changes during hip development by altering the physiological nature of the ligament, as well as by long-term exposure to relaxin during pregnancy. Our objective in this study was to determine the quantity of relaxin receptors in the ligamentum teres and their part in causing DDH.MethodsWe identified infants between birth and 3 years of age who had undergone open reduction for DDH between 2010 and 2012. 12 hips of 12 miss abortus fetus between 20 to 35 weeks of gestation were used as control group. Specimens obtained from two groups were stained with Relaxin-2 antibody and the amount of staining for relaxin receptors was determined using an ordinal H score. ResultsThe mean H scores of infants with DDH were significantly higher than those of controls (p=0.00). ConclusionAs a result, increased number of relaxin receptors in the ligamentum teres could be a risk factor for DDH and the number of relaxin receptors is an important clue in explaining the female:male ratio and clinical prognosis of early dysplastic hips.Level of Evidence: Level 2, Prospective comparative study

scholarly journals Enhanced recovery care versus traditional non- ERAS  care following osteotomies in developmental dysplasia of the hip in children : a retrospective case-cohort study

2020 ◽  
Author(s):  
Jin Li ◽  
Saroj Rai ◽  
Renhao Ze ◽  
Xin Tang ◽  
Ruikang Liu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Enhanced Recovery ◽  
Perioperative Complications ◽  
Length Of Hospital Stay ◽  
Developmental Dysplasia ◽  
Control Group ◽  
Postoperative Fever ◽  
Vas Score ◽  
Significant Difference ◽  
Dysplasia Of The Hip

Abstract Background: Enhanced recovery after surgery (ERAS) has been shown to shorten the length of hospital stay and reduce the incidence of perioperative complications in many surgical fields. However, there has been a paucity of research examining the application of ERAS in major pediatric orthopedic surgeries. This study aims to compare the perioperative complications and length of hospital stay after osteotomies in children with developmental dysplasia of the hip (DDH) between ERAS and traditional non-ERAS group. Methods: The ERAS group consisted of 86 patients included in the ERAS program from January 2016 to December 2017. The Control group consisted of 82 DDH patients who received osteotomies from January 2014 to December 2015. Length of hospital stay, physiological function, postoperative visual analogue scale (VAS) score, and postoperative complications were compared between the two groups. Results: The mean duration of hospital stay was significantly reduced from 10.0±3.1 in the traditional care group to 6.0±0.8 days in the ERAS(P<0.001). The VAS score in 3-day was significantly lower in ERAS group (2.9±0.8) than traditional non-ERAS group (4.0±0.8) (P<0.001). However, there was no significant difference in the frequency of breakout pain (VAS >4) between two groups (29.5±6.3 vs.30.6±6.5, P=0.276). The frequency of postoperative fever was lower in the ERAS group. The frequency of urinary tract infection in both groups were not noticeable because the catheter was removed promptly after the surgery. Conclusion: The ERAS protocol is both safe and feasible for pediatric DDH patients undergoing osteotomies, and it can shorten the length of hospital stay without increasing the risk of perioperative complications.

scholarly journals The severity of developmental dysplasia of the hip does not correlate with the abnormality in pelvic incidence

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Rongshan Cheng ◽  
Muyin Huang ◽  
Willem Alexander Kernkamp ◽  
Huiwu Li ◽  
Zhenan Zhu ◽  
...  
Keyword(s):  
Pelvic Incidence ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Developmental Dysplasia ◽  
Control Group ◽  
Type I ◽  
Type Ii ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
Dysplasia Of The Hip

Abstract Background The purpose of this study was to investigate the association between the severity of Developmental dysplasia of the hip (DDH) and the abnormality in pelvic incidence (PI). Methods This was a retrospective study analyzing 53 DDH patients and 53 non-DDH age-matched controls. Computed tomography images were used to construct three-dimensional pelvic model. The Crowe classification was used to classify the severity of DDH. The midpoint of the femoral head centers and sacral endplates were projected to the sagittal plane of the pelvis. The PI was defined as the angle between a line perpendicular to the sacral plate at its midpoint and a line connecting this point to the axis of the femoral heads. Independent sample t-tests were used to compare the differences between the PI of DDH group and the non-DDH controls group. Kendall’s coefficient of concordance was used to determine the correlation between the severity of DDH and PI. Results Patients with DDH had a significantly (p = 0.041) higher PI than the non-DDH controls (DDH 47.6 ± 8.2°, normal 44.2 ± 8.8°). Crowe type I patients had a significantly (p = 0.038) higher PI (48.2 ± 7.6°) than the non-DDH controls. No significant difference between the PI in Crowe type II or III patients and the PI in non-DDH controls were found (Crowe type II, 50.2 ± 9.6°, p = 0.073; Crowe type III, 43.8 ± 7.2°, p = 0.930). No correlation was found between the severity of DDH and the PI (r = 0.091, p = 0.222). Conclusions No correlation was found between the severity of DDH and the PI. The study confirmed that the PI in DDH (Crowe type I) group was higher than that of the non-DDH control group, while the PI does not correlate with the severity of DDH.

Anatomical parameters of and differences in the proximal femoral cavity in adult patients with developmental hip dysplasia

2021 ◽  
pp. 1-12
Author(s):  
Ran Zhao ◽  
Hong Cai ◽  
Hua Tian ◽  
Ke Zhang ◽  
Admin
Keyword(s):  
Femoral Head ◽  
Developmental Dysplasia ◽  
Adult Patients ◽  
Control Group ◽  
Marrow Cavity ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Dysplasia Of The Hip ◽  
Anatomical Parameters

Objective: To explore the anatomical parameters proximal femoral cavity and developmental dysplasia of the hip. Methods: The retrospective study was conducted at Peking University Third Hospital, Beijing, China, and comprised data of adult patients of either gender who underwent total hip arthroplasty from January 2009 to August 2015. Paients with a diagnosis of primary osteoarthrosis or aseptic necrosis of the femoral head were taken as the control group A, while patients with developmental dysplasia of the hip in group B were graded into subgroups I-IV using the Crowe classification. For each patient, the inner diameter of the proximal femoral medullary cavity was measured on preoperative radiographs using Noble’s technique. Data was analysed using SPSS 20. Results: Of the 835 hips, 571(68.4%) were in group A and 264(31.6%) in group B. The mean age of the patients at the time of surgery was 58.3 ± 12.3 years. Overall, there were 404(48.4%) hips of male patients; 59(22.3%) in group B. There were 431(51.6%) hips of female patients; 205(77.7%) in group B. In group B, 186(70.5%) hips were graded I, 38(14.4%)grade II, 22(8.3%)grade III, and 18(6.8%) hips were graded IV. There were significant differences in femoral offset, height of the femoral head, and canal flare index of the metaphysis between groups A and B (p<0.05). There was no significant difference in the morphology of the marrow cavity between subgroups II and III.

scholarly journals Long-term outcome following medial open reduction in developmental dysplasia of the hip: a retrospective cohort study

2016 ◽  
Vol 10 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Richard O. E. Gardner ◽  
Catharine S. Bradley ◽  
Om P. Sharma ◽  
Lin Feng ◽  
Michelle EyunJung Shin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Open Reduction ◽  
Retrospective Cohort ◽  
Developmental Dysplasia ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Medial Open Reduction ◽  
Dysplasia Of The Hip

scholarly journals Prognostic value of severity of dislocation in late-detected developmental dysplasia of the hip

2020 ◽  
Vol 14 (4) ◽  
pp. 266-272 ◽  
Author(s):  
Terje Terjesen ◽  
Joachim Horn
Keyword(s):  
Closed Reduction ◽  
Prognostic Value ◽  
Developmental Dysplasia ◽  
Long Term Outcomes ◽  
Level Of Evidence ◽  
Femoral Metaphysis ◽  
Group 2 ◽  
Dysplasia Of The Hip

Purpose The aims of this study were to evaluate the reliability of three classifications of severity of dislocation in late-detected developmental dysplasia of the hip (DDH), especially to assess whether they are predictive of long-term outcomes. Methods Two groups of patients were analyzed. Group 1 (57 patients, 69 hips) underwent closed reduction between 1958 and 1962. Mean age at reduction was 20.3 months (4 to 65). Group 2 (50 patients, 54 hips) treated between 1996 and 2005, was used for analysis of the association between severity of dislocation and treatment (open or closed reduction). The primary radiographs were graded according to the Tönnis classification, the classification of the International Hip Dysplasia Institute and a new method based on the position of the most lateral point of the proximal femoral metaphysis (lateral metaphysis height classification, LMH). The outcome at a mean age of 51.2 years (55 to 60) was graded according to the occurrence of osteoarthritis (OA) and total hip arthroplasty (THA). Results There were significant associations between the classifications, and the intra- and interobserver agreements were high. More severe grades of DDH were significantly associated with age ≥ 18 months and with open reduction. None of the classifications were significantly associated with long-term OA. The LMH method was significantly associated with the need for THA, whereas the other classifications were not. Conclusion All the classifications were reliable in grading severity of DDH. The LMH method seems preferable in clinical practice because the main landmarks were easy to define and because it had long-term prognostic value. Level of Evidence III

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