Developmental Dysplasia of the Hip: Controversies in Management

Garcia, Steven; Demetri, Leah R F; Starcevich, Ana; Gatto, Andrew; Swarup, Ishaan

doi:10.1007/s12178-022-09761-8

Cited by 13 publications

(9 citation statements)

References 105 publications

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“…Osteoarthritis, secondary to hip dysplasia, includes thinning of articular cartilage, narrowing of joint space, subchondral cystic lesions, and even hip joint deformation. The clinical manifestations are hip joint pain and limited activity, which seriously affect the quality of daily life ( Garcia et al, 2022 ). Although there are several alternatives to hip preservation, many adult patients with DDH eventually require hip replacement ( Schmitz et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Biomechanical analysis and clinical observation of 3D-printed acetabular prosthesis for the acetabular reconstruction of total hip arthroplasty in Crowe III hip dysplasia

Liu,

Wang,

Ying

et al. 2023

Front. Bioeng. Biotechnol.

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Objective: This study aimed to evaluate the biomechanical effectiveness of 3D-printed integrated acetabular prosthesis (IAP) and modular acetabular prosthesis (MAP) in reconstructing the acetabulum for patients with Crowe III developmental dysplasia of the hip (DDH). The results of this study can provide a theoretical foundation for the treatment of Crowe III DDH in total hip arthroplasty (THA).Methods: Finite element (FE) analysis models were created to reconstruct Crowe III DDH acetabular defects using IAP and MAP. The contact stress and relative micromotion between the acetabular prosthesis and the host bone were analyzed by gradually loading in three increments (210 N, 2100 N, and 4200 N). In addition, five patients with Crowe III DDH who underwent IAP acetabular reconstruction were observed.Results: At the same load, the peak values of IAP contact stress and relative micromotion were lower than those of MAP acetabular reconstruction. Under jogging load, the MAP metal augment’s peak stress exceeded porous tantalum yield strength, and the risk of prosthesis fracture was higher. The peak stress in the bone interface in contact with the MAP during walking and jogging was higher than that in the cancellous bone, while that of IAP was higher than that of the cancellous bone only under jogging load, so the risk of MAP cancellous bone failure was greater. Under jogging load, the relative micromotion of the MAP reconstruction acetabular implant was 45.2 μm, which was not conducive to bone growth, while under three different loads, the relative micromotion of the IAP acetabular implant was 1.5–11.2 μm, all <40 μm, which was beneficial to bone growth. Five patients with IAP acetabular reconstruction were followed up for 11.8 ± 3.4 months, and the Harris score of the last follow-up was 85.4 ± 5.5. The imaging results showed good stability of all prostheses with no adverse conditions observed.Conclusion: Compared with acetabular reconstruction with MAP, IAP has a lower risk of loosening and fracture, as well as a better long-term stability. The application of IAP is an ideal acetabular reconstruction method for Crowe III DDH.

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Section: Introductionmentioning

confidence: 99%

Biomechanical analysis and clinical observation of 3D-printed acetabular prosthesis for the acetabular reconstruction of total hip arthroplasty in Crowe III hip dysplasia

Liu,

Wang,

Ying

et al. 2023

Front. Bioeng. Biotechnol.

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“…A DDQ é uma doença que precisa ser detectada precocemente, por meio da triagem no exame físico dos quadris dos RNs ao nascer e periodicamente nos primeiros 3 meses, para garantir o sucesso no tratamento, prever o prognóstico e evitar complicações no crescimento e desenvolvimento das crianças. Dentre os fatores de risco estão o sexo feminino, oligoidrâmnio, alto peso ao nascer, primiparidade e histórico familiar de apresentação pélvica, que aumenta o risco em 12 vezes (WANG, 2019, HARSANYI et al, 2020, GARCIA et al, 2022HAN;LI, 2022).…”

Section: Introductionunclassified

“…A maturação esquelética do RN ocorre por volta de 8 semanas de idade, o que estabiliza mais de 80% dos quadris instáveis. Quando não estabilizados, o tratamento é necessário, e a abordagem é guiada pela gravidade da displasia e idade do paciente, visando alcançar uma redução concêntrica na cabeça femoral, mas isso não garante que a displasia acetabular desapareça completamente (SIMIONESCU et al, 2021, GARCIA et al, 2022.…”

Section: Introductionunclassified

Displasia do desenvolvimento do quadril - uma revisão abrangente sobre a epidemiologia, anatomia, etiologia, aspectos genéticos, diagnóstico, tratamento, prognóstico e prevenção

Prinz,

Macedo,

Zortéa

et al. 2023

Braz. J. Hea. Rev.

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A displasia do desenvolvimento do quadril (DDQ) é uma condição ortopédica comum em lactentes e crianças, caracterizada por anormalidades na articulação do quadril. Sua incidência varia em diferentes regiões geográficas, mas estima-se que afete cerca de 1 a 3 em cada 100 recém-nascidos, sendo mais frequente em meninas e bebês com histórico familiar de DDQ. Essa articulação complexa é composta pelo osso do quadril (osso ilíaco), a cabeça femoral e o acetábulo. A DDQ ocorre devido a desarmonias na formação dessas estruturas, o que acarreta má posição e estabilidade inadequada do quadril. Quanto à etiologia, múltiplos fatores genéticos, ambientais e mecânicos contribuem para o desenvolvimento da DDQ, incluindo posição intrauterina, primeira gravidez e posição do feto. O diagnóstico precoce é crucial para o tratamento eficaz da condição, sendo o exame físico e métodos de imagem, como ultrassonografia do quadril em recém-nascidos e radiografia em bebês mais velhos, fundamentais para determinar a gravidade da displasia. O tratamento varia conforme a gravidade e a idade do paciente, com opções que vão desde dispositivos ortopédicos, como o coxal de Pavlik, em casos leves a moderados, até a cirurgia corretiva para casos mais graves ou tardios. O prognóstico geralmente é positivo quando o diagnóstico é precoce e o tratamento adequado é instituído, evitando complicações a longo prazo, como osteoartrite e dor crônica. Por fim, a prevenção é essencial por meio do rastreamento adequado em exames de rotina, exames clínicos cuidadosos e conscientização dos pais sobre os fatores de risco, a fim de assegurar o desenvolvimento adequado do quadril e o tratamento bem-sucedido da DDQ.

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“…Developmental dysplasia of the hip (DDH) is a common congenital disorder, mainly rendered by the incompatibility of the femoral head and the abnormal hip joint socket, that causes a wide spectrum of pathologies including a joint subluxation and instability, irreducible dislocation of the hip, and dysplasia of the femoral head and acetabulum 1–3. After the age of 18 mo, DDH treatment generally includes open reduction and hip reconstruction surgery using osteotomy techniques 4,5. The Salter innominate osteotomy has been used for many years in the treatment of DDH, and excellent short- and long-term results have been reported.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] After the age of 18 mo, DDH treatment generally includes open reduction and hip reconstruction surgery using osteotomy techniques. 4,5 The Salter innominate osteotomy has been used for many years in the treatment of DDH, and excellent short-and long-term results have been reported. Even so, this procedure is not without complications and several modifications have been made over the years to address these limitations.…”

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confidence: 99%

Improving the cosmetic outcome of Salter osteotomy through the modification of iliac crest graft harvesting site: a pilot clinical study

Yeganeh

Moghtadaei

Farahini

et al. 2022

Current Orthopaedic Practice

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Background:The conventional graft harvesting site in a Salter osteotomy might impair the cosmetic appearance of patients with developmental dysplasia of the hip (DDH). The authors evaluated if an alternative graft donor site on the iliac bone could eliminate this concern. Methods:In a prospective study, 23 patients who had DDH with an indication for Salter osteotomy were included. In 10 patients (study group), the vertical triangular graft was harvested from the one-third anterolateral section of the iliac wing. In the remaining 13 patients (control group), the graft was harvested from the conventional site. The radiographic measures, including acetabular index and center edge angle, Severin criteria, clinical outcomes (McKay criteria), and complication rates of the two groups were compared. Results:The clinical outcome, acetabular index, center-edge angle, and Severin criteria of the patients of the two groups were statistically comparable. Union of harvested sites was seen in all patients. The mean duration of surgery and blood loss were statistically comparable (P = 0.49 and P = 0.33, respectively). The rate of osteonecrosis was similar in the two groups. The only graft site morbidity was the anterior superior iliac spine (ASIS) asymmetry that was seen in all patients of the control group and no patients of the study group; a mean horizontal level difference of 2.2 ± 0.5 cm was observed between the affected and unaffected ASIS of the control group. Conclusions:Vertical triangular graft harvest from the one-third anterolateral section of iliac wing in Salter osteotomy improves the cosmetic outcome through the reduction of pelvic deformity.

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Developmental Dysplasia of the Hip: Controversies in Management

Cited by 13 publications

References 105 publications

Biomechanical analysis and clinical observation of 3D-printed acetabular prosthesis for the acetabular reconstruction of total hip arthroplasty in Crowe III hip dysplasia

Biomechanical analysis and clinical observation of 3D-printed acetabular prosthesis for the acetabular reconstruction of total hip arthroplasty in Crowe III hip dysplasia

Displasia do desenvolvimento do quadril - uma revisão abrangente sobre a epidemiologia, anatomia, etiologia, aspectos genéticos, diagnóstico, tratamento, prognóstico e prevenção

Improving the cosmetic outcome of Salter osteotomy through the modification of iliac crest graft harvesting site: a pilot clinical study

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