Femoral Deformity in Adults With Developmental Hip Dysplasia

Robertson, Douglas D.; Essinger, Jacques; Imura, Satoru; Kuroki, Yoshio; Sakamaki, Toyonori; Shimizu, Tomio; Tanaka, Seiuke

doi:10.1097/00003086-199606000-00025

Cited by 85 publications

(52 citation statements)

References 15 publications

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“…However, the simplification of the complex interaction between the acetabular and femoral shape to a 2-D model might be insufficient. Three-dimensional measurements described in the literature based on CT scans mainly focus on the special morphology of the dysplastic shaft of the proximal femur and its implications for total hip arthroplasty [1,2,23,28,33]. Previous studies of the epiphysis of the longitudinal growth plate of the femur [32] cannot be Table 2.…”

Section: Discussionmentioning

confidence: 99%

Femoral Morphology Differs Between Deficient and Excessive Acetabular Coverage

Steppacher

Tannast

Werlen

et al. 2008

Clinical Orthopaedics &Amp; Related Research

146

111

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Structural deformities of the femoral head occurring during skeletal development (eg, Legg-Calvé-Perthes disease) are associated with individual shapes of the acetabulum but it is unclear whether differences in acetabular shape are associated with differences in proximal femoral shape. We questioned whether the amount of acetabular coverage influences femoral morphology. We retrospectively compared the proximal femoral anatomy of 50 selected patients (50 hips) with developmental dysplasia of the hip (lateral center-edge angle [LCE] B 25°; acetabular index C 14°) with 45 selected patients (50 hips) with a deep acetabulum (LCE C 39°). Using MRI arthrography we measured head sphericity, epiphyseal shape, epiphyseal extension, and femoral head-neck offset. A deep acetabulum was associated with a more spherical head shape, increased epiphyseal height with a pronounced extension of the epiphysis towards the femoral neck, and an increased offset. In contrast, dysplastic hips showed an elliptical femoral head, decreased epiphyseal height with a less pronounced extension of the epiphysis, and decreased head-neck offset. Hips with different acetabular coverage are associated with different proximal femoral anatomy. A nonspherical head in dysplastic hips could lead to joint incongruity after an acetabular reorientation procedure.

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Section: Discussionmentioning

confidence: 99%

Femoral Morphology Differs Between Deficient and Excessive Acetabular Coverage

Steppacher

Tannast

Werlen

et al. 2008

Clinical Orthopaedics &Amp; Related Research

146

111

View full text Add to dashboard Cite

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“…Precise acetabular reorientation is also challenging in the mildly deformed hip, as overcorrection is possible and may lead to post-PAO FAI. It is also known that a high percentage of dysplastic hips (including mildly dysplastic ones) have concurrent femoral deformities associated with FAI [38][39][40][41] and may be at risk for secondary FAI after PAO.…”

mentioning

confidence: 99%

Patient-Reported Outcomes of Periacetabular Osteotomy from the Prospective ANCHOR Cohort Study

Clohisy

Ackerman

Baca

et al. 2017

The Journal of Bone and Joint Surgery

191

138

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“…The ML widths of the cortical and medullary canals were measured at 1-cm intervals, from 2 cm above the center of the lesser trochanter (CLT) to 10 cm below the CLT on the AP radiographs [1,14]. The AP width of the cortical and medullary canals was calculated on the lateral view at 2 cm above the CLT and 2 cm, 4 cm, and 10 cm below the CLT.…”

Section: Methodsmentioning

confidence: 99%

“…The presence and absence of a false acetabulum in high dislocated hips are associated with different loading patterns and different soft tissue conditions. Earlier studies document various morphologic abnormalities with high dislocations: a straight, narrow femur [6], small femoral head size, a short neck length, and an anteverted femoral neck [1,13,14,16]. According to Wolf's law, mechanical loads can affect bone architecture in living beings.…”

Section: Introductionmentioning

confidence: 99%

Femoral Morphologic Differences in Subtypes of High Developmental Dislocation of the Hip

Zhou

Liu

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Previous studies show the shape of the femur in developmental dislocation of the hip (DDH) becomes more abnormal with increasing subluxation. Two kinds of high dislocations associated with DDH have been observed in clinical practice, one with (Type C1) and one without (Type C2) a false acetabulum. The presence or absence of a false acetabulum in high dislocated hips is associated with different loading patterns and could influence the development and shape of the proximal femur. Questions/purposes We therefore determined whether (1) the proximal femoral shape and dimension in Type C1 and Type C2 hips differ from each other, and (2) the femur dislocated with the same height in Types C1 and C2 hips. Patients and Methods We examined the following variables on 54 proximal femurs from 54 patients with high DDH (28 Type C1 hips and 26 Type C2 hips) on AP and lateral radiographs; the ML widths of the cortical and medullary canals, height of the femoral head, height of dislocation, and height of the greater trochanter. Reproducibility of the measurements was tested by two researchers with high interobserver and intraobserver agreement.Results The proximal femur in Type C2 hips was narrower and stovepipe shaped, with a smaller flare index (2.7 ± 0.6), compared with Type C1 hips (3.5 ± 1.2). The proximal femur migrated an average of 18 mm more superiorly in Type C2 than in Type C1 hips. Conclusions Our data confirm distinctions in the shape of the proximal femur in the presence and absence of a false acetabulum. Clinical Relevance Owing to the abnormal shapes, special implants of different geometries or modular stems may be needed for reconstruction Type C2 high dislocations.

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Femoral Deformity in Adults With Developmental Hip Dysplasia

Cited by 85 publications

References 15 publications

Femoral Morphology Differs Between Deficient and Excessive Acetabular Coverage

Femoral Morphology Differs Between Deficient and Excessive Acetabular Coverage

Patient-Reported Outcomes of Periacetabular Osteotomy from the Prospective ANCHOR Cohort Study

Femoral Morphologic Differences in Subtypes of High Developmental Dislocation of the Hip

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