scholarly journals Coronal and Sagittal Balance of Spine in Patients with Developmental Dysplasia of the Hip

2021 ◽  
Author(s):  
yang yu ◽  
kai song ◽  
jinjin liu ◽  
bing wu ◽  
zheng wang ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Sagittal Plane ◽  
Pearson Correlation ◽  
Hip Dislocation ◽  
Developmental Dysplasia ◽  
Healthy Adults ◽  
Control Group ◽  
Study Group ◽  
Pelvic Parameters ◽  
Dysplasia Of The Hip

Abstract Objective: To explore the spino-pelvic alignment changes in patients with Developmental dysplasia of the hip (DDH) and the effect of Total hip arthroplasty (THA) on the spino-pelvic alignment.Methods: In this study, patients with DDH are selected as the study group and healthy adults are selected as the control group. The differences of sagittal spino-pelvic parameters between patients with DDH and healthy adults are compared by independent sample t-test. Paired sample t-test is performed for spine-pelvis parameters before and after THA. Pearson correlation analysis is used to analyze the correlation about coronal spine-pelvic parameters. SPSS 22.0 software is used for statistical analysis, and p < 0.05 is the result of statistical significance.Results: In this study, there are 48 patients with DDH in study group, with an average age of 43.1±10.3 years old, consist of 42 females and 6 males. SVA =-4.1±33.9 mm, PI=42.9±18.9°, PT=4.6±15.6°, SS=38.2±13.9°, LL=53.3±12.6°, TK=22.8±9.2°, TLK=6.7±5.7°. There are 214 subjects in control group, SVA=-11.3±28.9mm, PI=45.6±9.4°, PT=9.9±6.8°, SS=35.5±7.1°, LL=48.4±10.8°, TK=27.7±10.4°，TLK=5.7±10°. The differences of SVA, PT, LL and TK were statistically significant. Before THA, IO = 6.7 ± 4.6°, SO = 6.4 ± 5.4°, HO = 5.3 ± 5.8°, L5O = 6.1 ± 5.5°, Cobb angle = 11.0 ± 10.7°; After THA, IO=3.5 ± 3°, SO=3.7 ± 3.4°, HO=3.7 ± 3.6°, L5O= 4.3 ± 4.7°, Cobb angle = 6.8±7.7°. The Cobb angle is related to SO and IO respectively (r=0.610, r=0.570). Conclusions: Due to acetabular dysplasia and dislocation of hip joint, patients with DDH will have changes in sagittal and coronal spino-pelvic alignment. In sagittal plane, PT is decreased, TK is decreased and LL is increased. And THA cannot correct the sagittal spino-pelvic alignment in patients with DDH. In coronal plane, there are Leg length discrepancy (LLD) and hip dislocation in patients with DDH, which together lead to coronal pelvic obliquity (PO). The overall coronal imbalance tendency caused by PO leads to compensatory scoliosis. And THA can significantly improve the degree of PO and compensatory scoliosis in patients with DDH.

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.

Developmental Hip Dysplasia

2019 ◽  
pp. 297-300
Author(s):  
Dorothy L. Gilbertson-Dahdal
Keyword(s):  
Risk Factors ◽  
Problem Solving ◽  
Imaging Modality ◽  
Treatment Options ◽  
Hip Dislocation ◽  
Clinical Findings ◽  
Developmental Dysplasia ◽  
Developmental Hip Dysplasia ◽  
Hormonal Factors ◽  
Dysplasia Of The Hip

Chapter 112 focuses on developmental dysplasia of the hip, which includes a spectrum of abnormalities ranging from a stable hip with a mildly dysplastic acetabulum to complete hip dislocation. Pathophysiology, clinical findings, and screening studies are explored. The pathophysiology is multifactorial including mechanical, genetic and hormonal factors. Imaging strategies, findings, and treatment options are also discussed. Screening US, which is the imaging modality of choice, is performed on infants with predisposing risk factors. Outcome is quite variable with many cases resolving spontaneously without treatment whereas others stabilize with acetabular dysplasia. Treatment options include immobilization and surgery. MRI is used for problem solving in postoperative patients.

scholarly journals Risk Factor Assessment and a Ten-Year Experience of DDH Screening in a Well-Child Population

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Bahar Kural ◽  
Esra Devecioğlu Karapınar ◽  
Pınar Yılmazbaş ◽  
Tijen Eren ◽  
Gülbin Gökçay
Keyword(s):  
Risk Factors ◽  
Multiple Pregnancy ◽  
Breech Presentation ◽  
Clinical Findings ◽  
Developmental Dysplasia ◽  
Control Group ◽  
Case Group ◽  
Retrospective Case ◽  
Female Sex ◽  
Dysplasia Of The Hip

Aim. Risk based screening for developmental dysplasia of the hip (DDH) with ultrasound is common. However, risk factors vary from one country to the other since data are insufficient to give clear recommendations. We aimed to evaluate the risk factors for developmental dysplasia of the hip (DDH). Methods. In this retrospective case-control study, the health records of all children, who were followed up between 2004 and 2014 at a well-child unit, were investigated for the diagnosis of DDH in Turkey. Of 9758 children, 57 children were found to have abnormal ultrasonographic findings (according to Graf classification) and these constituted the case group. As the control group, healthy 228 children who matched the case children in birth months were selected. Two groups were compared for the risk factors. Results. A total of 19516 hips of 9758 children were examined for DDH. 97 hips of 57 children were found to have abnormal ultrasonographic findings. When the two groups were compared, breech presentation, multiple pregnancy, and torticollis were identified as risk factors. The female sex was also found to have a significantly high prevalence among the children in the case group. Limited hip abduction, positive Ortolani, and Barlow signs were important clinical findings in the case group. Conclusion. According to our findings, breech presentation, female sex, torticollis, and multiple pregnancy were found to be the risk factors of this disorder. Infants with these risk factors should be investigated carefully for DDH.

scholarly journals Total Hip Arthroplasty after Treatment of Pseudojoint Infection in a Patient with a Highly Dislocated Hip

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Kyung-Soon Park ◽  
Jong-Keun Seon ◽  
Seon-Yoon Nah ◽  
Taek-Rim Yoon
Keyword(s):  
Total Hip Arthroplasty ◽  
Infection Control ◽  
Hip Arthroplasty ◽  
English Literature ◽  
Hip Dislocation ◽  
Developmental Dysplasia ◽  
Hip Pain ◽  
Total Hip ◽  
Thorough Debridement ◽  
Dysplasia Of The Hip

Infection at the pseudoacetabulum in a patient with a high hip dislocation has not been reported previously in the English literature. We report a case of total hip arthroplasty in a 28-year-old female who presented to us with hip pain following debridement of the infected pseudojoint in a case of neglected developmental dysplasia of the hip. The infection was treated with thorough debridement and drainage. However, even after achieving complete infection control, this patient complained of disabling right hip joint pain. Total hip arthroplasty with subtrochanteric osteotomy was performed to relieve the pain and improve gait. After surgery, the patient's symptoms were relieved. We consider that in this case of acute pseudojoint infection simple arthrotomy and debridement combined with irrigation and drainage provide effective treatment. But muscle weakness and more increased joint laxity can cause hip pain even after infection control. So total hip arthroplasty is likely to be necessary after the infection has been controlled in a patient with a highly dislocated hip.

scholarly journals Closed Reduction in Developmental Dysplasia of the Hip in Patients Older than One Year

Folia Medica ◽  
2020 ◽  
Vol 62 (2) ◽  
pp. 276-281
Author(s):  
Zoran Bozinovski ◽  
Milena Bogojevska Doksevska ◽  
Keti P. Tokmakova
Keyword(s):  
Avascular Necrosis ◽  
Closed Reduction ◽  
Screening Method ◽  
Hip Dislocation ◽  
Developmental Dysplasia ◽  
Type I ◽  
Range Of Movement ◽  
Cast Immobilization ◽  
Recommended Treatment ◽  
Dysplasia Of The Hip

Introduction: Besides an effective screening method for developmental dysplasia of the hip, there is certain number of children in whom the condition has been overseen or they have never been screened and the parents have noticed the odd walking pattern in their toddler. Treatment of such patients is controversial. One of the recommended treatment methods because of the short-term hospitalization, but often considered unsuccessful is closed reduction of the hip followed by cast immobilization. Hypothesis: Closed hip reduction in late diagnosed developmental dysplasia of the hip gives good results.&nbsp; Aim: Our aim in this retrospective study was evaluation of the success of the treatment with closed reduction of hip dislocation in children older than 12 months.&nbsp; Patients and methods: In the study, we included 20 patients treated at our clinic from June 2004 to May 2017. Of these 20 patients, 8 had bilateral involvement, 12 had unilateral, in a total of 28 hips. In all patients we noted preoperatively the range of movement, the presence of limp, any limb inequality, and hip pain. We used clinical and radiological parameters for evaluation. Clinically, we examined the range of movement, limb inequality as well as limb function and we classified it according to the modified McKay&rsquo;s criteria. Same examinations were done at 1, 3, and 5 years after closed reduction. Results: At the last follow-up examination, using McKey&rsquo;s criteria for clinical evaluation we rated the hips in two patients (7%) as grade III, i.e. fair grade, 10 hips (36%) were grade II &ndash; rated good, and 16 hips (57%) were evaluated as grade I. In four hips, there were signs of avascular necrosis of the hip, while in one patient the avascular necrosis developed after the closed reduction. Radiographic assessment (Figs 3, 4) using Severin&rsquo;s scoring system showed no hips with types V and VI, type IV was observed in 7%, type III in 21%, type II in 29%, while most of the hips (12, 43%) were type I. Conclusion: We concluded that the procedure was justified. An advantage of this method is that it is inexpensive; it entails no direct operative changes of the bone structures and gives good results.

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 Analysis of Coronal And Sagittal Spinopelvic Parameters In Developmental Dysplasia of The Hip

2022 ◽  
Author(s):  
Guangyang Zhang ◽  
Mufan Li ◽  
Hang Qian ◽  
Xu Wang ◽  
Xiaoqian Dang ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Scoring System ◽  
Oswestry Disability Index ◽  
Pearson Correlation ◽  
Developmental Dysplasia ◽  
Low Back ◽  
Spinopelvic Parameters ◽  
Pelvic Radiograph ◽  
Dysplasia Of The Hip

Abstract Background: The observational study aimed to investigate the change and correlations of the spinopelvic parameters as well as the relationships with the related symptoms in unilateral developmental dysplasia of the hip (DDH) patients. Methods: The clinical data of 22 unilateral DDH patients and 20 healthy volunteers were collected from 2016 to 2021. All patients and volunteers were taken the antero-posterior pelvic radiograph and the frontal and lateral radiography of the whole spine as a routine examination. And the clinical symptoms, signs and functions were measured according to Oswestry Disability Index and Low Back Pain Scoring System. Then the t test and Pearson correlation were used to analyze the data. Results: The Cobb(8.68±6.21°), L3(4.79±5.47°), CB(1.65±1.57cm), PT(15.02±9.55°) and TLK (7.69±6.66°) were significantly larger in the DDH patients, whereas LL(37.41±17.17°) were significantly smaller (P＜0.05). As for the coronal spinopelvic parameters, CB was found to be associated with L3 (R=0.58, P＜0.01). Of the sagittal spinopelvic parameters, SS was found to be associated with LL (R=0.48, P=0.02), and TLK was found to be related to ST and TK, respectively (R=0.49, P=0.02; R=-0.45, P=0.04). In terms of relations between the spinal and pelvic parameters, PI were found to be related to the SS (R=0.58, P＜0.01). An analysis of relations revealed a correlation between the Oswestry Disability Index and Cobb(R=0.59, P＜0.01), PT(R=0.49, P=0.02), TK(R=-0.46, P=0.03) and TLK(R=0.44, P=0.04). Furthermore, an analysis of relations revealed a correlation between Low Back Pain Scoring System and Cobb (R=-0.44, P=0.04), L3(R=-0.53, P=0.01), PT (R=-0.44, P=0.04), TK(R=0.46, P=0.03) and TLK(R=-0.43, P=0.05). Conclusion: The parameters are related to each other and compensate each other to maintain the balance of the coronal and sagittal planes of the spine. In addition, the change of some parameters is closely related to the quality of life of the patients, and can provide some clues for the clinical diagnosis and treatment of DDH.

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