Is acetabular dysplasia and pelvic deformity properly interpreted in patients with congenital femoral deficiency? A 3D analysis of pelvic computed tomography

Musielak, Bartosz; Shadi, Milud; Kubicka, Anna Maria; Koczewski, Paweł; Rychlik, Michał; Premakumaran, Pirunthi; Jóźwiak, Marek

doi:10.1302/1863-2548.14.200065

Cited by 5 publications

(8 citation statements)

References 22 publications

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“…Radiographs can lack specificity for classifying CFD among the very young but are acceptable for initial evaluation of acetabular dysplasia. 16 CT or MRI provides more data on axial and cartilaginous acetabular morphology and can be combined with arterial mapping for preoperative planning 12,13,15,17 (Figure 3). MRIs of the knee can identify deficient cruciate ligaments.…”

Section: Discussionmentioning

confidence: 99%

“…If present, it is deficient posteriorly and laterally, leading to relative retroversion of the dome and may be globally smaller than the contralateral side. 12,13…”

Section: Acetabulummentioning

confidence: 99%

“…In younger patients, reshaping pelvic osteotomies such as Dega, San Diego, or Paley ilioischial limb type osteotomies have been recommended 2,8,13,21 to improve superolateral and posterior lip deficiencies. Concern exists, however, that posterior coverage may be best obtained with reorientational (compared with reshaping) osteotomies, such as the triple innominate pelvic osteotomy, which are not indicated for all ages.…”

Section: Acetabular Deformitymentioning

confidence: 99%

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Proximal Femoral Focal Deficiency/Congenital Femoral Deficiency: Evaluation and Management

Nossov

Hollin

Phillips

et al. 2022

J Am Acad Orthop Surg

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Proximal focal femoral deficiency is a congenital transverse deficiency in which the femur is globally smaller with a typical proximal deformity at the hip that may include distal involvement of knees, leg, and feet. Congenital femoral deficiency (CFD) describes a broader spectrum of longitudinal deficiency inclusive of proximal focal femoral deficiency. CFD may also include lateral distal femoral hypoplasia, knee cruciate ligament deficiency, rotational instability, patellar dislocation, fibular hemimelia, ray absence, and contralateral limb involvement. Treatment intends to maximize function by limb equalization and deformity correction ranging from nonsurgical management using prosthetics to amputation and may include lengthening, shortening, and complex limb reconstruction. Management decisions depend on overall severity and the patient and family's preferences and priorities. Owing to its complexity, CFD is best treated by clinicians with considerable deformity treatment experience who can help guide decision making and embark on a treatment course that will maximize the functional outcome.

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Section: Discussionmentioning

confidence: 99%

“…If present, it is deficient posteriorly and laterally, leading to relative retroversion of the dome and may be globally smaller than the contralateral side. 12,13…”

Section: Acetabulummentioning

confidence: 99%

Section: Acetabular Deformitymentioning

confidence: 99%

See 1 more Smart Citation

Proximal Femoral Focal Deficiency/Congenital Femoral Deficiency: Evaluation and Management

Nossov

Hollin

Phillips

et al. 2022

J Am Acad Orthop Surg

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“…In a 3-dimensional anatomical study of the pelvis and acetabulum in congenital femoral deficiency, Musielak et al quantified the anatomic distortion in many ways, concluding that there is not simply a posterolateral wall deficit, but frequently a complete malorientation of the acetabular axis, perhaps suggesting that reorienting osteotomies are preferable to acetabuloplasty 22 .…”

Section: Congenital Limb Deficienciesmentioning

confidence: 99%

What’s New in Limb Lengthening and Deformity Correction

Georgiadis

Morrison

Dahl

2021

Journal of Bone and Joint Surgery

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The purpose of this form is to provide readers of your manuscript with information about your other interests that could influence how they receive and understand your work. The form is designed to be completed electronically and stored electronically. It contains programming that allows appropriate data display. Each author should submit a separate form and is responsible for the accuracy and completeness of the submitted information. The form is in six parts. Identifying information. The work under consideration for publication.This section asks for information about the work that you have submitted for publication. The time frame for this reporting is that of the work itself, from the initial conception and planning to the present. The requested information is about resources that you received, either directly or indirectly (via your institution), to enable you to complete the work. Checking "No" means that you did the work without receiving any financial support from any third party --that is, the work was supported by funds from the same institution that pays your salary and that institution did not receive third-party funds with which to pay you. If you or your institution received funds from a third party to support the work, such as a government granting agency, charitable foundation or commercial sponsor, check "Yes". Relevant financial activities outside the submitted work.This section asks about your financial relationships with entities in the bio-medical arena that could be perceived to influence, or that give the appearance of potentially influencing, what you wrote in the submitted work. You should disclose interactions with ANY entity that could be considered broadly relevant to the work. For example, if your article is about testing an epidermal growth factor receptor (EGFR) antagonist in lung cancer, you should report all associations with entities pursuing diagnostic or therapeutic strategies in cancer in general, not just in the area of EGFR or lung cancer.Report all sources of revenue paid (or promised to be paid) directly to you or your institution on your behalf over the 36 months prior to submission of the work. This should include all monies from sources with relevance to the submitted work, not just monies from the entity that sponsored the research. Please note that your interactions with the work's sponsor that are outside the submitted work should also be listed here. If there is any question, it is usually better to disclose a relationship than not to do so.For grants you have received for work outside the submitted work, you should disclose support ONLY from entities that could be perceived to be affected financially by the published work, such as drug companies, or foundations supported by entities that could be perceived to have a financial stake in the outcome. Public funding sources, such as government agencies, charitable foundations or academic institutions, need not be disclosed. For example, if a government agency sponsored a study in which you have been involved and drugs w...

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“…Reconstruction of acetabular dysplasia in CFD needs to take into consideration studies regarding acetabular morphology, such as research by Dora et al or Musielak et al who have demonstrated that the acetabulum in CFD is different from those of patients with developmental dysplasia of the hip and smaller, posteriorly reversed, and more inclined than those in healthy hips [17,18]. Currently used methods of acetabular reconstruction, that try to address those issues, are based on Dega or modified Dega osteotomies [2,19,20].…”

Section: Introductionmentioning

confidence: 99%

Hip Joint Stability during and after Femoral Lengthening in Congenital Femoral Deficiency

Tschurl,

Shadi,

Kotwicki

2024

Children

Self Cite

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Background: Hip stability remains a major preoccupation during femoral lengthening in Congenital Femoral Deficiency (CFD). We aimed to review hip stability in Paley type 1a CFD patients undergoing femoral lengthening. Methods: A total of 33 patients with unilateral CFD, who were treated between 2014 and 2023, were retrospectively reviewed. In 20/33 cases (60.6%) the SUPERhip preparatory surgery was performed at a mean age of 4.3 years (range 2.7–8.1). The femoral lengthening using an external fixator was performed at a mean age of 7.8 years (range 4.3–14.3). Results: All patients presented with a stable hip joint after preparatory surgery and during femoral lengthening. Six cases of hip instability at a mean of 637 days after the external fixator removal were observed (range 127 to 1447 days). No significant differences between stable and unstable hips were noted for (1) Center-Edge Angle: 23.7 vs. 26.1 deg; (2) Acetabular Inclination: 12.8 vs. 11.7 deg; and (3) Ex-Fix Index: 35.6 days/cm vs. 42.4 days/cm; p > 0.05. Late hip instability was related to Coxa Vara and decreased femoral antetorsion before lengthening. Conclusions: Late hip joint instability in Paley type 1a CFD patients may occur long after femoral lengthening despite hip morphology appearing to be normal on radiograms before and at the end of femoral lengthening. Coxa Vara, femoral torsional deformity, and posterior acetabular deficiency might be risk factors for hip instability.

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Is acetabular dysplasia and pelvic deformity properly interpreted in patients with congenital femoral deficiency? A 3D analysis of pelvic computed tomography

Cited by 5 publications

References 22 publications

Proximal Femoral Focal Deficiency/Congenital Femoral Deficiency: Evaluation and Management

Proximal Femoral Focal Deficiency/Congenital Femoral Deficiency: Evaluation and Management

What’s New in Limb Lengthening and Deformity Correction

Hip Joint Stability during and after Femoral Lengthening in Congenital Femoral Deficiency

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