Retrospective observational study comparing the international hip dysplasia institute classification with the Tonnis classification of developmental dysplasia of the hip

Miao, Mingyuan; Cai, Haiqing; Hu, Liwei; Wang, Zhigang

doi:10.1097/md.0000000000005902

Cited by 28 publications

(56 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, the ossi c nucleus was not present in 34% hips. Comparing IHDI classi cation to Tönnis classi cation, Both Miao and Brandon et al [13,14] concluded that IHDI classi cation is more exibly and better re ect the severity of the condition, especially for those cases without ossi c nucleus of the femoral head.…”

Section: Discussionmentioning

confidence: 99%

Timing for Closed Reduction Procedure for Developmental Dysplasia of the Hip and its Failure Analysis

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background It remains controversial whether the older age to perform closed reduction (CR) procedure for developmental dysplasia of the hip (DDH), the higher incidence of complications. The aim of this study is to evaluate the midterm outcome of CR for DDH among difference age groups, and to analyze and identify risk factors for the failure of this procedure. Methods Clinical data of 107 DDH patients, who received CR, were retrospectively reviewed. Data were divided into three groups according to initial treatment age (Group I: younger than 12 months; Group II: 12 months to less or equal to18 months; Group III: older than 18 months). The presence of avascular necrosis (AVN), residual acetabular dysplasia (RAD), re-dislocation, and further surgeries (FS) were observed. The risk factors were identified for those outcomes aforementioned using univariable logistic regression models. For identified risk factor age, pre-op acetabular index (AI) and post-op AI, their prediction of CR failure were evaluated by receiver operating characteristics curve (ROC).Results A total of 107 patients (156 hips) undergoing CR procedure were evaluated with a median age at initial reduction of 13.0±5.4 months (range, 4 to 28 mo). Mean follow-up time in this study was 6.7±0.8 years (range, 3-8 years). The incidence of AVN, RAD and re-dislocation was 15.4% (24/156), 17.3% (27/156) and 14.7% (23/156) respectively. For AVN, RAD and re-dislocation, the significant risk factors are pre-op IHDI IV (p=0.033), age≥18 months (p=0.012), and pre-op IHDI IV (p=0.004) and walking (p=0.011), respectively. The areas under the ROC curve of each type of failures were 0.841 (post-op AI), 0.688 (pre-op AI) and 0.650 (age).Conclusions Severe DDH patients older than 18 months with CR procedure may result in a high risk of RAD complication. Re-dislocation is significantly associated with pre-op IHDI IV and walking. Patients, who are older than 12.5 months or have a pre-op AI of 38.7° or a post-op AI of 26.4°, are also more likely to fail of CR procedure.

show abstract

Section: Discussionmentioning

confidence: 99%

Timing for Closed Reduction Procedure for Developmental Dysplasia of the Hip and its Failure Analysis

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The IHDI classification, continuity of Shenton's line, AI, ossific nucleus center edge angle (ONCEA), and signs of AVN were evaluated in the final follow-up [15][16][17]. AVN also was classified in accordance with Kalamchi-MacEwen classification [18].…”

Section: Radiological Assessmentmentioning

confidence: 99%

Early open reduction of dislocated hips using a modified Smith-Petersen approach in arthrogyposis multiplex congenita

Miao

Cai

Wang

et al. 2020

BMC Musculoskelet Disord

Self Cite

View full text Add to dashboard Cite

Background: Arthrogryposis multiplex congenita (AMC) is a rare syndrome with multiple joint contractures. Within the medical community, there is controversy surrounding AMC in terms of the ideal surgical approach and age for performing a reduction of dislocated hips. The purpose of this retrospective study was to evaluate the clinical outcomes of early open reduction of infant hip dislocation with arthrogryposis multiplex congenita following a modified Smith-Petersen approach that preserves the rectus femoris. Methods: From 2010 to 2017, we performed this procedure on 28 dislocated hips in 20 infants under 12 months of age with AMC. The clinical and radiology data were reviewed retrospectively. The mean age at surgery was 6.9 ± 5.1 months, with a mean follow-up of 42.4 ± 41.1 months.Results: After open reduction, the average hip acetabular index (AI), the international hip dysplasia institute classification (IHDI), and the hip range of motion significantly improved (all P < 0.001). After the surgery, 16 patients were community walkers, and four patients were home walkers. Three hips in two patients required secondary revision surgery for residual acetabular dysplasia with combined pelvic osteotomy and femoral osteotomy. Seven of the hips that had been operated on showed signs of avascular necrosis (AVN). Among them, four were degree II, two were degree III, and one was degree IV. Multiple linear regression analysis demonstrated that greater age (in months) heightened the risk for secondary revision surgery (P = 0.032). Conclusions: The modified Smith-Petersen approach preserving the rectus femoris is an encouraging and safe option for treating hip dislocation in young AMC patients (before 12 months). If surgery takes place at less than 12 months of age for patients with AMC, this earlier open reduction for hip dislocation may reduce the chances of secondary revision surgery. Level of evidence: IV, retrospective non-randomized study.

show abstract

“…The IHDI classification, continuity of Shenton's line, AI, ossific nucleus center edge angle (ONCEA), and signs of AVN were evaluated in the final follow-up. [15][16][17] AVN was also classified in accordance with Kalamchi-MacEwen classification. [18] Hips in which the Shenton arc was continuous and the CE angle was 15º or greater were considered to be centered.…”

Section: Radiological Assessmentmentioning

confidence: 99%

Clinical efficacy of early open reduction of dislocated hips using a modified Smith-Peterson approach in arthrogyposis multiplex congenita

Miao¹,

Cai²,

Wang³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Arthrogryposis multiplex congenita (AMC) is a rare syndrome with multiple joint contractures. There is controversy regarding what the best surgical approach and age is for performing reduction of dislocated hips in AMC. The purpose of this retrospective study was to evaluate the clinical outcome of early open reduction on infant hip dislocation with arthrogryposis multiplex congenita through the modified Smith-Peterson approach, with retained rectus femoris intact. Methods: From 2010 to 2017, we performed this procedure on 28 dislocated hips in 20 infants under 12 months of age with AMC. The clinical and radiology data were retrospectively reviewed. The mean age at surgery was 6.9 ± 5.1 months, with a mean follow-up of 42.4 ± 41.1 months. Results: After open reduction, the average hip acetabular index (AI), the international hip dysplasia institute classification (IHDI), and hip range of motion were significantly improved (all P<0.001). After the surgery, 16 patients were community walkers and four patients were home walkers. Three hips in two patients required secondary revision surgery for residual acetabular dysplasia with combined pelvic osteotomy and femoral osteotomy. Seven of the hips that had been operated on showed signs of avascular necrosis (AVN). Among them, four were degree II, two were degree III, and one was degree IV. Multiple linear regression analysis demonstrated that the older months are risk factors for secondary revision surgery (P=0.032). Conclusions: The modified Smith-Peterson approach with retained rectus femoris intact is an encouraging and safe option for treating hip dislocation in young AMC patients (before 12 months). Even if surgery takes place at less than 12 months old for patients with AMC, earlier open reduction for hip dislocation may reduce the chance of secondary revision surgery. Level of Evidence: IV, retrospective non-randomized study. Key words: Arthrogryposis, Hip dislocation, Open reduction, Modified Smith-Peterson approach, Retained rectus femoris

show abstract

Retrospective observational study comparing the international hip dysplasia institute classification with the Tonnis classification of developmental dysplasia of the hip

Abstract: Supplemental Digital Content is available in the text

Cited by 28 publications

References 15 publications

Timing for Closed Reduction Procedure for Developmental Dysplasia of the Hip and its Failure Analysis

Timing for Closed Reduction Procedure for Developmental Dysplasia of the Hip and its Failure Analysis

Early open reduction of dislocated hips using a modified Smith-Petersen approach in arthrogyposis multiplex congenita

Clinical efficacy of early open reduction of dislocated hips using a modified Smith-Peterson approach in arthrogyposis multiplex congenita

Contact Info

Product

Resources

About