Acetabular Development after Reduction of Congenital Dislocation of the Hip

Schwartz, Donald R.

doi:10.2106/00004623-196547040-00005

Cited by 59 publications

(42 citation statements)

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“…Thirty studies did not report osteonecrosis occurrence for all patients eligible for open or closed reduction specific to age at index reduction (12 months or younger versus older than 12 months). Ten studies [11,15,19,20,24,38,40,64,67,74] reported the age-specific occurrence of Grade I or greater osteonecrosis but not Grade II or greater osteonecrosis. One additional study [46] reported osteonecrosis occurrence by age at index open reduction but not by operative approach (medial versus anterior) and was excluded from the meta-analysis.…”

Section: Critical Reviewmentioning

confidence: 99%

“…1 The search process is illustrated using a modified version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram [60]. [69,77,81], and five were Level IV (case series) [1,29,33,74,83]. One study was diagnostic Level IV (poor reference standard study) [6].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Sufficient subject-level data were available to exclude the following ineligible cases: four dislocations of the hip secondary to neuromuscular or teratologic causes [15,67], 188 hips treated by open reduction with concomitant pelvic osteotomy [8,10,19,20,29,31,33,38,46,59,69,74,95,96], and 280 hips treated by other ineligible interventions [23,64,85,94]. Additionally, one study [13] included 12 hips treated by medial open reduction that at least partly overlapped with a more recently published article [49].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Ten studies [4,20,23,24,45,58,63,66,74,84] did not report the criteria used to assess osteonecrosis.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis

Novais

Hill

Carry

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Osteonecrosis of the femoral head is a major complication that negatively impacts the clinical and radiographic long-term outcome after treatment of developmental hip dysplasia (DDH). There are conflicting results in the literature whether age at the time of closed or open reduction and a specific surgical approach are associated with osteonecrosis. Better understanding of the impact of age at reduction and surgical approach is important to reduce the risk of osteonecrosis in patients with DDH. Questions/purposes We aimed to evaluate the association between occurrence of osteonecrosis and (1) age at closed reduction; (2) age at open reduction; and (3) medial versus anterior operative approaches.Methods A systematic review identified studies reporting osteonecrosis occurrence after treatment of DDH and at least 2 years of followup. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Methodologic quality was assessed using the methodologic index for nonrandomized studies. Generalized logistic models were used to estimate pooled odds ratios (ORs) in the meta-analysis. Sixty-six studies were included in the systematic review and 24 in the meta-analysis. Data on 481 hips treated by closed reduction and 584 hips treated by open reduction were available to evaluate the association between osteonecrosis and age. The association between osteonecrosis and operative approach was assessed using data on 364 hips treated by medial open reduction and 220 hips treated by anterior open reduction. Results Age at reduction ([ 12 months versus B 12 months) was not associated with osteonecrosis after closed reduction (OR, 1.1; 95% confidence interval [CI], 0.4-3.2; p = 0.9) or open reduction (OR, 1.1; 95% CI, 0.7-1.9; p = 0.66). The overall, adjusted incidence of osteonecrosis (C Grade II) was 8.0% (95% CI, 2.8%-20.6%) among patients treated with closed reduction at or before 12 months of age and 8.4% (95% CI, 3.0%-21.

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Section: Critical Reviewmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

“…Ten studies [4,20,23,24,45,58,63,66,74,84] did not report the criteria used to assess osteonecrosis.…”

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis

Novais

Hill

Carry

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…[10][11][12] Asetabulum gelişimi üzerine yapılan birçok çalışmada, Aİ, asetabüler Sharp açısı, asetabulum derinlik gibi radyolojik parametreler göz önün-de bulundurularak asetabüler gelişimin takip süresiyle ilişkisi değerlendirilmiştir. Schwartz [13] ve Salter [14] kapalı redüksiyon sonrası Aİ gelişimi-nin ilk 18 ayda en fazla olduğunu belirtmişlerdir. Enkondral kemikleşme başta olmak üzere apozisyonel ve intertisyel kemikleşme ile büyüyen asetabulumun [15] hızlı kemikleşmesinin ilk dört yılda olduğu gösterilmiştir.…”

Section: Discussionunclassified

Early-term hip development following Pemberton osteotomy: a radiological follow-up

Sarıkaya

Sipahioğlu

Sarıkaya

et al. 2016

Eklem Hastalik Cerrahisi

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ÖZAmaç: Bu çalışmada Pemberton osteotomisi sonrası erken dönemde görülen radyolojik değişikliklerin kalça eklemi gelişimi ile olan ilişkisi değerlendirildi. Hastalar ve yöntemler:Ocak 2010 -Aralık 2014 tarihleri arasında yapılan bu çalışmaya gelişimsel kalça displazisi nedeniyle Pemberton osteotomisi uygulanan 75 hastanın (25 erkek, 50 kız; ort. yaş 31.5 ay; dağılım 15-71 ay) 101 kalçası (26 iki taraflı) dahil edildi. Radyolojik olarak merkez kenar açısı, asetabüler indeks (Aİ), asetabüler derinlik indeksi (ADİ) parametreleri değerlendirildi. Ön-arka pelvis grafilerinde femur başı kemikleşme merkezinin yüzey alanı ölçüldü. Kalça dislokasyon derecesi Tönnis sınıflandırmasına göre, femur başı avasküler nekrozu KalamchiMacEwen sınıflandırmasına göre derecelendirildi. Ameliyat edilen kalçalar tüm hastalarda ve sadece tek taraflı ameliyat edilen hastalarda takip sürelerine göre 12 ay, 12-24 ay ve 24 aydan fazla olmak üzere üç gruba ayrıldı. Tüm takip sürelerinde radyolojik parametrelerin ilişkileri incelendi. Bulgular: Ortalama takip süresi 22.5 ay (dağılım, 6-66 ay) idi. Ameliyat öncesi ortalama Aİ 42.25° (dağılım, 29°-60°), son takip ortalama Aİ 20.45° (dağılım, 10°-32°) idi. Ameliyat öncesi ortalama ADİ 16.48° (dağılım, 9°-30°), son takip ortalama ADİ 26.1° (dağılım, 23°-47°) idi. Altmış kalça Tönnis tip 4, 26 kalça tip 3 ve 15 kalça tip 2 idi. Takip süresi sınıflandırmasına göre; 12 ay takip süresi olan 32 kalça (21 tek taraf), 12-24 ay takip süresi olan 43 kalça (17 tek taraf) ve 24 aydan fazla takip süresi olan 26 kalça (11 tek taraf) vardı. On sekiz femura kısaltıcı osteotomi uygulandı. Kalamchi-MacEwen sınıflandırmasına göre; 16 kalçada tip 1, iki kalçada tip 2, üç kalçada tip 3, iki kalçada ise tip 4 avasküler nekroz vardı. Tekrar eden subluksasyonlar nedeniyle beş kalçada revizyon ameliyatı uygulandı.Sonuç: Pemberton osteotomisi sonrası erken dönemde, kalça eklemlerinde ve bunun sonucu olarak da radyolojik parametrelerde progresif düzelme görüldü.Anahtar sözcükler: Kalça displazisi; kalça çıkığı; Pemberton osteotomisi; radyolojik takip. ABSTRACTObjectives: This study aims to evaluate the relationship of early-term radiological changes with development of the hip joint after Pemberton osteotomy. Patients and methods:This study, which was conducted between January 2010 and December 2014, included 101 hips (26 bilateral) of 75 patients (25 males, 50 females; mean age 31.5 months; range 15 to 71 months) which were performed Pemberton osteotomy due to developmental dysplasia of the hip. Radiologically, we assessed the parameters of centeredge angle, acetabular index (AI), and acetabular depth index (ADI). We measured the surface area of the femoral head ossific nucleus on anteriorposterior pelvic X-rays. We graded the degree of hip dislocation according to Tönnis classification while the femoral head avascular necrosis was graded according to Kalamchi-MacEwen classification. We separated the operated hips in all patients and in only unilaterally operated patients in three groups according to their follow-up dura...

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Developmental Dysplasia of the Hip

Shapiro¹

2019

Pediatric Orthopedic Deformities, Volume 2

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Acetabular Development after Reduction of Congenital Dislocation of the Hip

Cited by 59 publications

References 0 publications

Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis

Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis

Early-term hip development following Pemberton osteotomy: a radiological follow-up

Developmental Dysplasia of the Hip

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