Acetabular Development After Reduction in Developmental Dislocation of the Hip

Gotoh, Eiji; Tsuji, Muneharu; Matsuno, Takeo; Ando, Mifumi

doi:10.1097/00003086-200009000-00027

Cited by 20 publications

(22 citation statements)

References 19 publications

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“…It was surprising to find that varying the rate of avascular necrosis did not change the optimum screening strategy. However, whereas not all developmental dysplasia of the hip leads to early arthritis, similarly, not all avascular necrosis leads to early arthritis 31,38 . Because some hips with avascular necrosis are not at risk for early arthritis, the effect of avascular necrosis on the optimum screening strategy is blunted.…”

Section: Discussionmentioning

confidence: 99%

“…The probability that residual acetabular dysplasia after the age of one year leads to or increases the risk of early arthritis varies. Albinana et al 32 reported that 78% of dislocated dysplastic hips at twelve months were Severin class I/II at maturity, whereas Gotoh et al 31 found that only 68% of such hips were Severin class I/II at maturity; others have found this percentage to be much higher 30,36 .…”

Section: Rates Of Developmental Dysplasia Of the Hip With Nomentioning

confidence: 98%

“…A Severin class-II hip has moderate deformity of the head, neck, or acetabulum in an otherwise well-developed joint, with a center-edge angle of >20°; a Severin class-III hip is dysplastic but not subluxated, with a center-edge angle of £20°; and a Severin class-IV hip is subluxated, with a center-edge angle usually of much less than 20°. The Severin classification is applied at skeletal maturity on the basis of the radiographic appearance of the hip 21,31,32 . This classification system has fair to moderate reliability (an interobserver kappa statistic of 0.19 to 0.54 and an intraobserver kappa statistic of 0.66 to 0.85) 33 and is predictive of early arthritis 32 .…”

Section: Definition Of Outcome and Outcome Utilitiesmentioning

confidence: 99%

“…studies combined Severin class-III and IV hips 21,31,38,39 , we were obliged to do the same, and the average baseline rate of early arthritis for Severin class-III/IV hips was set to 40% (or, in the algorithm, a 60% chance of a non-arthritic hip). Other studies also provided rates of early arthritis with residual dysplasia 25,36 .…”

Section: Sensitivity Analysismentioning

confidence: 99%

See 3 more Smart Citations

To Screen or Not to Screen? A Decision Analysis of the Utility of Screening for Developmental Dysplasia of the Hip

Mahan

Katz

Kim

2009

The Journal of Bone and Joint Surgery-American Volume

134

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Section: Discussionmentioning

confidence: 99%

Section: Rates Of Developmental Dysplasia Of the Hip With Nomentioning

confidence: 98%

Section: Definition Of Outcome and Outcome Utilitiesmentioning

confidence: 99%

Section: Sensitivity Analysismentioning

confidence: 99%

See 2 more Smart Citations

To Screen or Not to Screen? A Decision Analysis of the Utility of Screening for Developmental Dysplasia of the Hip

Mahan

Katz

Kim

2009

The Journal of Bone and Joint Surgery-American Volume

134

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“…To establish early and reliable predictors of RAD, several radiographic parameters have been investigated such as the acetabular index (AI), central edge angle (CEA) etc. But, determination of the time when a further procedure is required remains controversial because these parameters need to be observed over a long time period [8][9][10][11][12][13][14][15][16]. Surgeons need some radiographic parameter that will predict future changes in RAD after CR that will enable earlier correction of the RAD.…”

Section: Introductionmentioning

confidence: 99%

Teardrop And Sourcil Line (TSL): A Novel Radiographic Sign That Predicts Residual Acetabular Dysplasia in DDH After Closed Reduction

Huang¹,

Wang²,

Mo³

et al. 2021

Preprint

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Background: Residual acetabular dysplasia (RAD) is a major problem of developmental dysplasia of the hip (DDH) after closed reduction (CR). Several parameters have been investigated as ways of predicting RAD; however, early prediction of RAD remains controversial. The purpose of this study was to evaluate the radiographic sign of teardrop and sourcil line (TSL) in pediatric patients with DDH to enable prediction of RAD after CR early.Methods: One hundred and twenty-five hips with DDH treated with CR and followed up for at least 2 years were included in this study. The mean age at CR was 18.3 months (range, 9 to 32 months) and the average follow-up time was 44.2 months (range, 24 to 83 months). The acetabular index (AI) was measured at different time points. RAD was determined according to the modified Severin criteria. The cases were divided into two groups according to whether TSL became continuous or not. The relationships among TSL, AI and RAD were analyzed.Results: The RAD incidence was 73.6% (92/125) at the last follow-up. AI at CR and TSL were the prognostic factors for RAD (p=0.017 and 0.001, respectively). Thirty-four hips showed a continuous TSL. The mean time when TSL became continuous after CR was 20.9 months (range, 8 to 57 months). There was a lower RAD rate in the TSL continuous group (p<0.001). There was no statistical difference in the AI at CR between the TSL continuous and discontinuous groups; however, the level of AI after CR was lower in the TSL continuous group. In the TSL continuous group, there was no significant difference in the time at which TSL became continuous after CR between RAD and non-RAD hips.Conclusions: The TSL continuous group had a lower AI and incidence of RAD than the discontinuous group. The TSL can be a predictive factor of RAD in DDH after CR and can predict RAD at an earlier time than AI measurement.

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Acetabular index is the best predictor of late residual acetabular dysplasia after closed reduction in developmental dysplasia of the hip

Guo

et al. 2017

International Orthopaedics (SICOT)

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Satisfactory and unsatisfactory hips show different patterns of acetabular development after reduction. AI, CEA and RI are all predictors of final radiographic outcomes in DDH treated by CR, although AI showed the best results. AI continues to improve until seven years after CR in hips with satisfactory outcomes, while it ceases to improve three to four years after CR in hips with unsatisfactory outcomes. According to our results, surgery is indicated if AI >28° 1 year following CR or AI >25° two to four years after CR. CEA and RI should be used as a secondary index to aid in the selection of patients requiring surgery.

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Acetabular Development After Reduction in Developmental Dislocation of the Hip

Cited by 20 publications

References 19 publications

To Screen or Not to Screen? A Decision Analysis of the Utility of Screening for Developmental Dysplasia of the Hip

To Screen or Not to Screen? A Decision Analysis of the Utility of Screening for Developmental Dysplasia of the Hip

Teardrop And Sourcil Line (TSL): A Novel Radiographic Sign That Predicts Residual Acetabular Dysplasia in DDH After Closed Reduction

Acetabular index is the best predictor of late residual acetabular dysplasia after closed reduction in developmental dysplasia of the hip

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