The Fate of DDH Hips Showing Cartilaginous or Fibrous Tissue-filled Joint Spaces Following Primary Reduction

Kim, Hui Taek; Lee, Tae Hoon; Ahn, Tae Young; Jang, Jae Hoon

doi:10.1097/bpo.0000000000000621

Cited by 8 publications

(4 citation statements)

References 36 publications

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“…Articular cartilage thickness has also been shown to exhibit hypertrophy, particularly in the acetabular roof, in newborns with DDH 13,14 . Adults with borderline or frank dysplasia show a similar trend of femoroacetabular cartilage hypertrophy 15 , which is thought to arise as a compensatory mechanism to weight-bearing and sheer stress. The same may be seen in pediatric patients with DDH after hip reduction by decreasing the medially directed force of the femoral head into the acetabulum 13 . The lack of bony coverage places the enlarged labrum in a weightbearing position rendering it susceptible to tears.…”

Section: Hip Instability: a Review Of Hip Dysplasia And Other Contribmentioning

confidence: 71%

“…MRI may be used to measure labral length in the lateral, anterior, and anteroinferior portion of the acetabulum, with increased lengths in all directions being associated with deficient lateral acetabular coverage 11 . MRI may also demonstrate hypertrophic acetabular cartilage and/or intra-articular fibrous tissue in patients with DDH 13 . MRI or magnetic resonance arthrography (MRA) may be used to assess for tears of the ligamentum teres, though MRI has been shown to have lower sensitivity and specificity in detecting partial LT tears 41 .…”

Section: Radiographic Characterizationmentioning

confidence: 99%

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Hip instability: a review of hip dysplasia and other contributing factors

Kraeutler

Garabekyan

Pascual‐Garrido

et al. 2016

MLTJ

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Section: Hip Instability: a Review Of Hip Dysplasia And Other Contribmentioning

confidence: 71%

Section: Radiographic Characterizationmentioning

confidence: 99%

Hip instability: a review of hip dysplasia and other contributing factors

Kraeutler

Garabekyan

Pascual‐Garrido

et al. 2016

MLTJ

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“…The decreased secondary failure rates is shown to have an association with younger age groups at the time of reduction 6 , and also with the initial reduction whether it is congruent or not 2,14 . 2,14 The rate of secondary failure didn't have a relation to an increasing age at the time of the closed reduction, which is normally anticipated, but to a younger age. Failure of four out of five Tönnis 4 hips occured, with the remaining patient needed operation later.…”

Section: Discussionmentioning

confidence: 97%

Outcomes of closed reduction in patients with developmental dysplasia of the hip incorporating open psoas and adductor release and using short leg cast

Abdulqader¹,

Khorsheed²,

Hwaizi³

2021

PJMHS

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Background and objectives: Closed reduction and short leg spica casting are the preferred treatment options for children with developmental dysplasia of the hip. This study aimed to show the efficacy behind a standardized closed reduction for managing patients with developmental dysplasia of the hip with concomitant soft tissue releases when indicated and using a short leg plaster of Paris cast to maintain reduction and reporting mid-term results. Methods: A case series of 95 hips in 84 children aged 6-18 months who had closed reduction, with five years follow up or until next operation, involved in this study. The protocol defines acceptable concentric reduction criteria and the indications for an associated soft tissue release. All the patients were immobilized in a short leg cast for three months. Multiple follow-up radiographs were taken to assess Tönnis grade, Severin grade, acetabular index, and osteonecrosis signs. Results: A total of 48 hips were Tönnis grade 3/4 hips. At one year, 15 reductions couldn’t be maintained, and these patients needed open reduction. Of these 15 failed reductions, 7 patients were Severin 1; others were Severin 2. Of the 80 successful closed reductions, 70 hips were Severin 1. Surgical management for residual dysplasia was offered for 8 hips. Osteonecrosis was seen in 23 hips but was transient in 20. Bilateral hip dislocations and most Tönnis 4 hips were more likely to fail. Two children had severe osteonecrosis. Conclusions: Closed reduction, with subsequent adductor and psoas releases, when indicated and using a short leg plaster of Paris cast for three months, brings about good mid-term results in children with developmental dysplasia of the hip aged 6-18 months. Keywords: Developmental dysplasia of the hip, closed hip reduction, open psoas release, short leg cast.

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Section: Radiographic Characterizationmentioning

confidence: 99%

Hip instability: a review of hip dysplasia and other contributing factors

Kraeutler

Garabekyan

Pascual-Garrido

et al. 2019

Muscle Ligaments and Tendons J

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Background: Hip instability has classically been associated with developmental dysplasia of the hip (DDH) in newborns and children. However, numerous factors may contribute to hip instability in children, adolescents, and adults. Purpose: This review aims to concisely present the literature on hip instability in patients of all ages in order to guide health care professionals in the appropriate diagnosis and treatment of the various disorders which may contribute to an unstable hip. Methods: We reviewed the literature on the diagnosis and surgical management of hip dysplasia and other causes of hip instability. Conclusions: Multiple intra-and extra-articular variables may contribute to hip instability, including acetabular bony coverage, femoral torsion, femoroacetabular impingement, and soft tissue laxity. Physical examination and advanced imaging studies are essential to accurately diagnose the pathology contributing to a patient's unstable hip. Conservative management, including activity modification and physical therapy, may be used as a first-line treatment in patients with intra-articular hip pathology. Patients who continue to experience symptoms of pain or instability should proceed with arthroscopic or open surgical treatment aimed at correcting the underlying pathology. Level of evidence: V. KEY WORDS: developmental dysplasia of the hip, femoral anteversion, femoroacetabular impingement, hip instability, periacetabular osteotomy.

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The Fate of DDH Hips Showing Cartilaginous or Fibrous Tissue-filled Joint Spaces Following Primary Reduction

Abstract: Level IV-prognostic study.

Cited by 8 publications

References 36 publications

Hip instability: a review of hip dysplasia and other contributing factors

Hip instability: a review of hip dysplasia and other contributing factors

Outcomes of closed reduction in patients with developmental dysplasia of the hip incorporating open psoas and adductor release and using short leg cast

Hip instability: a review of hip dysplasia and other contributing factors

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