Charnley low-friction arthroplasty with an autograft of the femoral head for developmental dysplasia of the hip

2000 ◽  
Vol 82-B (4) ◽  
pp. 508-511 ◽  
Author(s):  
P. Bobak ◽  
B. M. Wroblewski ◽  
P. D. Siney ◽  
P. A. Fleming ◽  
R. Hall
2010 ◽  
Vol 20 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Haluk Ağuş ◽  
Hakan Ömeroğlu ◽  
Ali Biçimoğlu ◽  
Yücel Tümer

Author(s):  
Anish Sanghrajka ◽  
Deborah M Eastwood

♦ Developmental dysplasia of the hip represents a spectrum of hip pathology with or without hip instability♦ Controversy continues regarding the relative roles of clinical and ultrasound screening programmes♦ Early diagnosis and prompt, appropriate treatment is important♦ All treatment methods risk compromising the vascularity of the developing femoral head♦ Residual dysplasia may require an aggressive surgical approach.


2020 ◽  
Author(s):  
Zhiqiang Zhang ◽  
Hai Li ◽  
Dashan Sui ◽  
Haiyi Qin ◽  
Ziming Zhang

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.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yange Gu ◽  
Wenshu Jin ◽  
Han Zhang ◽  
Zhiwei Shi ◽  
Yaohui Yue ◽  
...  

Abstract Objective To explore the influencing factors of age at onset of pain and severe pain in patients with Hartofilakidis type I developmental dysplasia of the hip (DDH). Methods A retrospective study of 83 patients with DDH treated at our hospital from January 2017 to June 2021 was conducted. The age at onset of pain, patients’ demographic data, and radiographic parameters were collected. Multiple linear regression was used to determine the influencing factors of age at onset of pain. Cox regression analysis was used to determine the influencing factors of severe pain attacks. Results According to the results of multiple linear regression analysis, when the distance between the medial femoral head and the ilioischial line increased by one millimetre, the age at onset of pain decreased by 1.7 years (β = − 1.738, 95% CI − 1.914–[− 1.561], p < 0.001). When the sharp angle increases by one degree, the age at onset of pain decreases by 0.3 years (β = − 0.334, 95% CI − 0.496–[− 0.171], p < 0.001). According to the results of the Cox regression analysis, for each additional degree of the lateral centre-edge angle (LCEA), the probability of severe pain was reduced by 5% (Exp [β]: = 0.947, 95% CI 0.898–0.999, p = 0.044). For each additional millimetre in the distance between the medial femoral head and the ilioischial line, the likelihood of severe pain increased by 2.4 times (Exp [β]: 2.417, 95% CI 1.653–3.533, p < 0.001). Conclusion Larger distances between the medial femoral head and the ilioischial line and sharp angle can lead to an earlier age at onset of pain in patients with DDH. Small LCEA and excessive distance between the medial femoral head and the ilioischial line are risk factors for severe pain.


2013 ◽  
Vol 02 (05) ◽  
pp. 318-321
Author(s):  
Leonard P. Seimon ◽  
Christine Kohler-Ekstrand ◽  
Howard D. Dorfman

Author(s):  
JianPing Wu ◽  
Zhe Yuan ◽  
JingChun Li ◽  
MingWei Zhu ◽  
Federico Canavese ◽  
...  

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


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