Is There an Association Between Borderline-to-mild Dysplasia and Hip Osteoarthritis? Analysis of CT Osteoabsorptiometry

Irie, Tohru; Takahashi, Daisuke; Asano, Tsuyoshi; Arai, Ryuta; Terkawi, Mohamad Alaa; Ito, Yoichi M.; Iwasaki, Norimasa

doi:10.1097/01.blo.0000533619.50951.e3

Cited by 24 publications

(30 citation statements)

References 44 publications

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“…With these findings, Irie and colleagues [4] have provided a link to previous studies [2,5], which showed that the weight bearing area extends medially with increasing coverage of the femoral head by the acetabulum.…”

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confidence: 70%

“…In the current study, Irie and colleagues [4] used CT absorptiometry to evaluate subchondral bone density (as a surrogate for cumulative stress and loading abnormalities), and found important differences in severity and patterns of loading based on the severity of dysplasia. They divided the population into four groups according to the extent of dysplasia from mild to severe.…”

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confidence: 74%

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CORR Insights®: Is There an Association Between Borderline-to-mild Dysplasia and Hip Osteoarthritis? Analysis of CT Osteoabsorptiometry

Kralj‐Iglič

2018

Clin Orthop Relat Res

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confidence: 70%

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confidence: 74%

CORR Insights®: Is There an Association Between Borderline-to-mild Dysplasia and Hip Osteoarthritis? Analysis of CT Osteoabsorptiometry

Kralj‐Iglič

2018

Clin Orthop Relat Res

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“…On the other hand, the effect of borderline dysplasia on the hip joint, more specifically to the labrum and the cartilage, is still not fully understood. Recently, a study by Irie et al13) reported an association between borderline to mild dysplasia and hip osteoarthritis. Their study evaluated patients with developmental dysplasia of the hip using computed tomography scans and concluded that: i) cumulative hip stress distribution was not concentrated on the lateral side of acetabulum in their patent cohort and ii) the mechanism of failure may be different than in cases of severe dysplasia.…”

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confidence: 99%

Hip Arthroscopy of a Painful Hip with Borderline Dysplasia

et al. 2019

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Purpose Hip arthroscopy has been considered for treating hip dysplasia; however, its efficacy is still a matter of controversy. Here, we report outcomes of patients with borderline dysplasia treated with a contemporary hip arthroscopy technique. Materials and Methods Forty-seven hips with borderline hip dysplasia were treated using hip arthroscopy. Patients underwent procedures to correct torn labrums or ligamentum teres with additional procedure on the acetabular capsule. Patient outcomes were assessed using visual analogue scale (VAS), modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS) and patient satisfaction. Risk factors for poor prognosis were also investigated. Results The mean follow up period was 25.9 months. At the last follow up, mean VAS score decreased from 6.1±1.6 to 3.5±2.8 ( P =0.016). The mHHS and NHAS at the last follow up improved from 61.0±7.6 to 78.6±19.5 ( P =0.001) and 62.1±7.5 to 80.0±18.5 ( P =0.002), respectively. While significant improvement was observed in all patient reported outcome measures tested, 19 (40.4%) hips indicated that “the operation was unsatisfactory.” The only factor shown to influence outcomes was preoperative VAS (i.e., worse scores potentially an indicator of poor outcomes). Conclusion The results of the current study indicate that arthroscopic management may be beneficial for a subset of patients with borderline dysplasia; however, the dissatisfaction rate associated with this treatment approach may be as high as 40%. The poor preoperative pain score appears to be the sole indicator for poor outcomes.

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“…All dysplastic hips were categorized as Crowe 1 [25]. According to the category of dysplasia severity [26], 7 hips were classified as borderline-mild DDH (15 lateral CEA < 25 ), 4 hips were classified as moderate DDH (5 lateral CEA < 15 ), and 3 hips were classified as severe DDH (lateral CEA < 5 ). The healthy subjects included 6 males and 4 females, with an average age of 30.7 years (range, 24e36) and BMI of 21.0 kg/m 2 (range, 17.0e26.1).…”

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confidence: 99%

Dynamic hip kinematics before and after periacetabular osteotomy in patients with dysplasia

Yoshimoto

Hamai

Higaki

et al. 2020

Journal of Orthopaedic Science

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Background: We prospectively analyzed the hip kinematics in patients with developmental dysplasia of the hip (DDH) before and after periacetabular osteotomy (PAO) and in healthy subjects while squatting to determine the influence of coverage of the femoral head on hip kinematics. Methods: 14 hips in 14 patients with DDH and 10 hips in 10 volunteers were included. Continuous radiographs while squatting and computed tomography images were obtained to assess the in vivo kinematics of the hip and the rim-neck distance using density-based 3D-to-2D model-to-image registration techniques. Results: The maximum hip flexion angles were 100.4 and 94.9 before and after PAO (p ¼ 0.0863), respectively. The maximum hip flexion angles after PAO did not significantly differ from those of normal hips (102.2 ; p ¼ 0.2552). The hip abduction angles at maximum hip flexion were 31.7 and 26.2 before and after PAO (p ¼ 0.1256), respectively. The rim-neck distance decreased from averaged 12.2 mm e8.9 mm (p ¼ 0.0044) after PAO. The lateral center edge angle (LCEA) and anterior center edge angle (ACEA) significantly improved 14.7 e42.4 and 50.4 e54.0 after PAO (p < 0.0001, p ¼ 0.0347), respectively; in particular, the ACEA after PAO did not significantly differ from that in the normal hips (p ¼ 0.1917). The ACEA was not correlated with hip flexion, or the rim-neck distance (p ¼ 0.9601, 0.8764). The LCEA was also not correlated with hip abduction (p ¼ 0.1683). Conclusion: Patients after PAO showed no significant difference in maximum hip flexion while squatting compared to before PAO and normal hips. Horizontalized weight-bearing acetabulum with normalized ACEA could be adequate correction of the acetabular fragment to restore hip RoM without coxalgia that induce the inability to perform squats after PAO.

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Is There an Association Between Borderline-to-mild Dysplasia and Hip Osteoarthritis? Analysis of CT Osteoabsorptiometry

Abstract: Based on the stress distribution pattern, our results may suggest that there is no association between borderline-to-mild dysplasia and the pathogenesis of OA. Further studies are needed to evaluate the association between borderline-to-mild dysplasia and instability of the hip.

Cited by 24 publications

References 44 publications

CORR Insights®: Is There an Association Between Borderline-to-mild Dysplasia and Hip Osteoarthritis? Analysis of CT Osteoabsorptiometry

CORR Insights®: Is There an Association Between Borderline-to-mild Dysplasia and Hip Osteoarthritis? Analysis of CT Osteoabsorptiometry

Hip Arthroscopy of a Painful Hip with Borderline Dysplasia

Dynamic hip kinematics before and after periacetabular osteotomy in patients with dysplasia

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