Congenital Hip Disease in Adults. Classification of Acetabular Deficiencies and Operative Treatment with Acetabuloplasty Combined with Total Hip Arthroplasty*

Hartofilakidis, George; Stamos, K.; Karachalios, Theofilos; Ioannidis, Theologos T; Zacharakis, Nikolaos

doi:10.2106/00004623-199605000-00007

Cited by 293 publications

(173 citation statements)

References 23 publications

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“…One published study [3] reports sufficient intra-and interobserver reliability of the Hartofilakidis et al [8] classification, with reported kappa values 0.79 and 0.75 respectively. In the present study, the description of the spectrum of morphologic forms of low and high dislocation was stated not to complicate the classification, but to increase its reliability providing further insight into the pathoanatomy of the acetabulum.…”

Section: Discussionmentioning

confidence: 95%

“…Hartofilakidis et al [6][7][8] classification described three types of DDH, namely dysplasia and low and high dislocation. Our clinical experience suggested types B and C could be divided in two subtypes each due to distinct morphological variations found at surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The amount of cephalic migration of the femoral head is used in the Crowe et al classification [2], but it is not a definite criterion for judging the severity of hip malformation because the pathoanatomy of the acetabulum is variable and, as such, it is the primary factor that determines the severity of the deformity. The classification of Hartofilakidis et al [8] is based on the morphology of the deformed acetabulum as observed on anteroposterior pelvis radiographs. It has been confirmed by comparing radiographic observations with intraoperative findings [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

“…The classification of Hartofilakidis et al [8] is based on the morphology of the deformed acetabulum as observed on anteroposterior pelvis radiographs. It has been confirmed by comparing radiographic observations with intraoperative findings [6][7][8]. The implications of the current refinement are: (1) to increase the reliability of the original classification; (2) to identify differences in treatment choices and complications associated with the subtypes; and (3) to help control for confounding preoperative variables in assessing results.…”

Section: Discussionmentioning

confidence: 99%

“…Several classification systems have been proposed to describe the extent of hip involvement [2,4,[6][7][8][9]. Chung [1] described in infants and children dysplastic hips without subluxation, hips with subluxation, and hips with frank dislocation in 1981.…”

Section: Introductionmentioning

confidence: 99%

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The Morphologic Variations of Low and High Hip Dislocation

Hartofilakidis

Yiannakopoulos

Babis

2008

Clinical Orthopaedics &Amp; Related Research

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Three different types of congenital hip disease in adults have been distinguished based upon the position of the femoral head relative to the acetabulum and the underlying pathoanatomy of the joint: (1) dysplasia; (2) low dislocation; and (3) high dislocation. To facilitate classification of borderline or ambiguous cases, we studied the morphologic variations of low and high dislocation as observed on the radiographs of 101 hips with low and 74 hips with high dislocation. In low dislocation, 54 hips (53.5%) had extended coverage of the true acetabulum (Type B1) and 47 hips (46.5%) had limited coverage (Type B2). Among the cases with high dislocation, a false acetabulum with an adjacent femoral head occurred in 46 hips (62.2%) (Type C1), and the femoral head was floating within the gluteal muscles in 28 hips (37.8%) (Type C2). The kappa value for interobserver agreement between two raters who made radiographic measurements was 0.963, and for intraobserver agreement between the two evaluations of the same observer it was 0.946 and 0.971, respectively. The two types of low and high dislocation were associated with high intra-and interobserver agreement. Whether these distinctions have clinical utility requires further validation.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Morphologic Variations of Low and High Hip Dislocation

Hartofilakidis

Yiannakopoulos

Babis

2008

Clinical Orthopaedics &Amp; Related Research

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Long-Term Survival of Cemented Sockets with Roof Graft

Howie

The Well-Cemented Total Hip Arthroplasty

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The Dysplastic Hip

Howie

The Well-Cemented Total Hip Arthroplasty

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In this chapter we will review the indications and problems of hip replacement in the presence of developmental dysplasia of the hip (DDH). The principles of total hip replacement for DDH are similar to those for routine total hip replacement; reconstruction of a near normal soft-tissue envelopes carried out to relieve pain. We are attempting to recreate normal joint biomechanics by restoring the centre of rotation, placing the trochanter lateral to the hip joint, thus improving the lever arm of the abductors, which will reduce the joint reaction force and Trendelenburg dip. We require small implant components and will attempt to insert the largest offset available. We should be able to perform acetabular augmentation and femoral osteotomy to restore the soft-tissue balance around the hip. We should be familiar with anterior and posterior approaches to the hip joint and comfortable with mobilising major neurovascular structures that may be encased in dense fibrosis due to previous surgery in childhood. We will present a system of assessment and reconstruction for the acetabulum and femur we have followed for 10 years (the results of which are recorded in later chapters chapters 8.7, 9.3), which can be used to resolve the many and varied problems. ⊡ Fig. 2.37. Long-leg films showing knee arthritis, the presenting feature in this woman with surgically induced leg-length discrepancies Part II Basic Science Chapter 3 Properties of Bone Cement -52 Chapter 3.1 What is Bone Cement? -52

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Congenital Hip Disease in Adults. Classification of Acetabular Deficiencies and Operative Treatment with Acetabuloplasty Combined with Total Hip Arthroplasty*

Cited by 293 publications

References 23 publications

The Morphologic Variations of Low and High Hip Dislocation

The Morphologic Variations of Low and High Hip Dislocation

Long-Term Survival of Cemented Sockets with Roof Graft

The Dysplastic Hip

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