Acetabular Dysplasia: a Modern View of the Problem (Literature Review)

Abstract

Summary. Hip dysplasia is the most common orthopedic problem in the practice of pediatric orthopedists. A significant problem with hip dysplasia is the divergence of nomenclature units, which is related to different points of view on the pathophysiology of the process. Contemporary conception defines hip dysplasia as a dynamic condition – “developmental dysplasia of the hip (DDH)”, which (in the absence of treatment) worsens with age and leads to the development of early hip osteoarthritis and requires hip replacement in young people. The leading macromorphological substrate of DDH is acetabular dysplasia, which is a spatial and structural change of acetabulum. For the treatment of acetabular dysplasia, conservative or surgical treatment (depending on the age of the child and the presence of previous treatment) is used. The most problematic solution is the treatment tactics for walking-age children. This is due to two factors: 1) increased loading on certain parts of the articular cartilage of the acetabulum during gait, which leads to the progression of deformity of the acetabulum and to progression of pathology; 2) changes in morphology of the intra-articular and extra-articular structures. However, better results with fewer complications are achieved after surgery. Biomechanically justified for acetabular dysplasia are pelvic osteotomies, which are divided into reconstructive and “salvage” procedures (preference is given to reconstructive procedures, which allows saving the native articular cartilage of acetabulum). Each osteotomy has its own advantages and disadvantages. When comparing three pelvic osteotomies commonly used in children (Salter, Pemberton and Dega), it is found that better results are achieved in children younger than 4 years after Salter’s osteotomy, results in older children are better after Dega’s osteotomy, and there is a high risk of femoroacetabular impingement following Pemberton’s osteotomy in the future.

The Method of Contact Area Assessment between the Femoral Head and Acetabulum in Children that Takes into Account Triradiate Cartilage

“…1 , Melnyk M.V. 1 , Ziablovskyi Ye.V. 2 1 SI "Institute of Traumatology and Orthopedics of NAMS of Ukraine", Kyiv 2 Center of Radiology, Department of Radiation and Radionuclide Diagnostics, National Specialized Children's Hospital "Ohmatdyt", Kyiv Summary.…”

“…Різна патологія кульшових суглобів (дисплазія кульшових суглобів, хвороба Лег -Кальве -Пертеса, ДЦП) характеризується патологічними змінами морфології кульшової западини [1][2][3]. Такі зміни за відсутності своєчасного лікування призводять до виникнення дефіциту перекриття головки стегнової кістки (ГСК) та надалі до появи раннього остеоартрозу кульшового суглоба [4].…”

“…Суворов В.Л., vasil_suvorov@ukr.net 1 ДУ "Інститут травматології та ортопедії НАМН України", м. Київ 2 Центр радіології, відділення променевої та радіонуклідної діагностики, НДСЛ "Охматдит", м. Київ глоба з бази даних Національної дитячої спеціалізованої лікарні "Охматдит". Сканування проводилося на апараті "Siemens SOMATOM Definition As, USA", товщина зрізу вибраних КТ-сканів становила 1,5 мм.…”

“…Було відібрано КТ-дослідження таза пацієнта 6 років чоловічої статі без патології кульшового су-УДК: 611.061.1 DOI:Методика вивчення зони контакту головки стегнової кістки з кульшовою западиною у дітей з урахуванням наявності Y-подібного хрящаФіліпчук В.В 1 ,. Суворов В.Л 1 ,. Мельник М.В 1 ,.…”

Femoral Head Coverage Assessment in Healthy Children Younger than 6 Years

“…Developmental dysplasia of the hip (DDH) is one of the commonest hip joint pathologies in pediatric orthopedist practice [1]; without treatment, it leads to early hip arthritis [2]. In younger patients, treatment is usually nonsurgical, but in older patients (who began to walk), surgical treatment is preferable [3].…”