Avascular necrosis after nonoperative treatment of developmental hip dislocation:Prognosis in 36 patients followed 17-26 years

Kruczyński, Jacek

doi:10.3109/17453679508995532

Cited by 18 publications

(7 citation statements)

References 13 publications

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“…These classification systems were established for use in patients with developmental dysplasia of the hip (DDH), and patients with neuromuscular conditions were excluded from analysis in the original descriptions of these systems. 12 , 14 – 16 The inter-rater reliability of the Bucholz/Ogden classification in DDH has been found to be low at .34, which is similar to our findings.…”

Section: Discussionsupporting

confidence: 90%

The incidence of avascular necrosis in children with cerebral palsy after hip containment surgery

Bauer

Sienko

Roy

et al. 2022

Journal of Children's Orthopaedics

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Purpose: To establish the rate of avascular necrosis after hip reconstruction surgery in children with cerebral palsy and to identify risk factors that influence the development of avascular necrosis in this population. Methods: An institutional review board–approved retrospective review was conducted on children with cerebral palsy who underwent hip containment surgery at a single institution. Radiographs were evaluated at three time points. The Reimer’s migration percentage, neck shaft angle, epiphyseal shaft angle, acetabular index, center edge angle, and acetabular angle were measured. The presence of avascular necrosis was evaluated and graded by the Bucholz/Ogden and the Kalamchi/MacEwen classification systems. Multivariate logistic regression was performed to identify risk factors associated with the development of avascular necrosis. Results: A total of 154 children with cerebral palsy underwent hip containment surgery on 223 hips. Twenty-nine children (18.8%) underwent both pelvic and femoral procedures; 36 children (23.4%) had only femoral procedures; 47 children (30.5%) had femoral and soft tissue; and 42 children (27.3%) had pelvic, femoral, and soft tissue procedures. Using the Bucholz and Ogden or the Kalamchi classifications, the rate of avascular necrosis was 24.7% (38/154). Of the variables evaluated, preoperative Reimers was found to be significant predictors of avascular necrosis. The rate of avascular necrosis was 26.7% for Gross Motor Functional Classification System level III, 24.1% for Gross Motor Functional Classification System level IV, and 27.3% for Gross Motor Functional Classification System level V. Conclusion: The overall rate of avascular necrosis in children undergoing hip containment surgery was 26.7%. Together, age at surgery, open reduction, previous surgery, preoperative Reimers, and estimated blood loss contributed to the development of postoperative avascular necrosis; however, only preoperative Reimers significantly contributed to the development of avascular necrosis in children with cerebral palsy undergoing hip containment procedures.

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Section: Discussionsupporting

confidence: 90%

The incidence of avascular necrosis in children with cerebral palsy after hip containment surgery

Bauer

Sienko

Roy

et al. 2022

Journal of Children's Orthopaedics

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“…8 It is characterized by retarded growth from the lateral aspect of the physis, which is visualized in an antero-posterior radiograph of the hip as a ''valgus tilt'' appearance of the head on the neck. Earlier studies have described the configuration of the proximal femur in the coronal plane, [8][9][10][11] however, a rotational and flexional deformity may also occur depending on the site of the growth retardation of the proximal femoral physis.…”

mentioning

confidence: 97%

Three-dimensional Computerized Tomographic Analysis of the Deformity of Lateral Growth Disturbance of Proximal Femoral Physis

Joo

Oh²,

Grissom³

et al. 2009

Journal of Pediatric Orthopaedics

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“…4,5,10,11 However, it was reported that to define partial or complete avascular necrosis in the early stage was difficult. [12][13][14] The involved area was often not clearly demarcated until the age of 4 to 6 years. 13 When avascular necrosis is first recognized, the prognosis is When the ossific nucleus of the femoral head had just appeared, fragmentation of the epiphysis could be the new ossification in response to the physiological stress after reduction, and the outcome was often good.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14] The involved area was often not clearly demarcated until the age of 4 to 6 years. 13 When avascular necrosis is first recognized, the prognosis is When the ossific nucleus of the femoral head had just appeared, fragmentation of the epiphysis could be the new ossification in response to the physiological stress after reduction, and the outcome was often good. This condition has been described as a temporary vascular insult or partial avascular necrosis.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value for Femoral Head Sphericity From Early Radiographic Signs in Surgery for Developmental Dysplasia of the Hip

Chang

Yang²,

Kao³

et al. 2011

Journal of Pediatric Orthopaedics

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Avascular necrosis after nonoperative treatment of developmental hip dislocation:Prognosis in 36 patients followed 17-26 years

Cited by 18 publications

References 13 publications

The incidence of avascular necrosis in children with cerebral palsy after hip containment surgery

The incidence of avascular necrosis in children with cerebral palsy after hip containment surgery

Three-dimensional Computerized Tomographic Analysis of the Deformity of Lateral Growth Disturbance of Proximal Femoral Physis

Predictive Value for Femoral Head Sphericity From Early Radiographic Signs in Surgery for Developmental Dysplasia of the Hip

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