Purpose According to hip ultrasonography by Graf’s method, the type IIa hip has a certain degree of physiological delay in ossification of the bony acetabular roof. The aim of this case–control study was to evaluate the natural history of the type IIa hip. Methods Four hundred and thirty-one type IIa hips were identified in 312 of 1,690 ultrasonographically screened newborns with a mean age of 27 days. Parents were accurately informed about the prognosis of such a hip condition and invited for ultrasonographic re-examination at 6–7 weeks of age. Results Type IIa hip was more common in newborn girls than in boys (P < 0.001). Among 431 type IIa hips, 146 (34 %) missed the follow-up examination at 6–7 weeks of age. Among the completely followed 285 hips, 225 (79 %) developed into a normal hip at 6–7 weeks of age. Newborn boys’ hips had a higher rate of spontaneous normalization than girls’ hips at 6–7 weeks of age (P = 0.006). All but one type IIa(+) hip became type I without any treatment. According to our management protocol, 35 type IIa(−) hips and one type IIa(+) hip, which later became type IIb, underwent treatment. The rate of treatment was higher in newborn girls’ hips than in boys’ hips (P = 0.019). Conclusions As Graf type IIa hip is more common, has a lower rate of spontaneous normalization and higher rate of treatment in newborn girls than in boys, we recommend paying more attention the type IIa hip in newborn girls. The rate of missing the required follow-up is unacceptably high due to parents’ insensitivity regarding the type IIa hip.

No abstract

No abstract

Background: Total hip arthroplasty (THA) performed for developmental dysplasia of the hip is a technically difficult procedure with a high complication rate, especially in the presence of completely dislocated hips. This study aimed to evaluate at least 10 years of follow-up results of cementless, ceramicon-ceramic (CoC) THA performed with transverse subtrochanteric osteotomy in Crowe type IV hips. Methods: We retrospectively reviewed 50 patients' 67 hips that underwent CoC, cementless THA with transverse subtrochanteric osteotomy between 2008 and 2011. Clinical and radiological data of the hips were examined. Clinical results were evaluated using the Harris Hip Score and the Western Ontario and McMaster Universities Osteoarthritis Index. Results: The mean Harris Hip Score improved from 22.9 ± 9.9 preoperatively to 94.1 ± 8.1 at the final follow-up (P < 0.001). The median Western Ontario and McMaster Universities Osteoarthritis Index score improved from 72 (interquartile range: 17) preoperatively to 2 (interquartile range: 17) postoperatively (P < 0.001). The preoperative mean leg length discrepancy was improved from 4.9 ± 1 cm to 1.5 ± 1 cm in unilateral cases at the last follow-up (P < 0.001). Revision surgery was required because of nonunion in two patients, prosthetic infection in one patient, and aseptic femoral loosening in the other patient. The overall ten-year survival rate was 94% for femoral stems and 98.5% for acetabular components as per Kaplan-Meier survival analysis. Conclusion: Transverse subtrochanteric shortening osteotomy combined with using cementless acetabular and femoral components with a CoC bearing surface promises successful clinical results and high prosthesis survival in the treatment of Crowe IV hips at long-term follow-up.

No abstract