Brief communication: Developmental dysplasia of the hip in medieval London

Abstract

Developmental dysplasia of the hip (DDH) is a spectrum of disease starting in childhood and in many cases persisting into adulthood. The spectrum ranges from acetabular dysplasia, through hip subluxation to dislocation. The aim of this research was to determine the prevalence and pathoanatomy of acetabular dysplasia and subluxation in excavated human skeletal remains, to complement past research on dislocation in DDH. The material under study was the medieval cemetery of St. Mary Spital in London, in use from c.1100 to 1539 AD. A series of 572 adults with both hips preserved were analyzed. Acetabular dysplasia was indicated by a shallow acetabulum with upward sloping roof. Subluxation was suggested by degenerative change along the margin of the acetabulum suggestive of labral tears, and degenerative change in the outer part of the acetabular roof suggestive of osteoarthritis. The prevalence of DDH (acetabular dysplasia, subluxation, or dislocation) was 1.7%. Because this a congenital musculoskeletal disorder of relatively high frequency, with significant variation in prevalence between populations around the world, it is a topic that warrants targeted research from physical anthropologists studying past populations.

To swaddle, or not to swaddle? paleoepidemiology of developmental dysplasia of the hip and the swaddling dilemma among the indigenous populations of North America

“…In the past, this condition was called congenital dysplasia/dislocation of the hip, referring to complete dislocation at birth. However, a higher frequency of DDH cases begin with only a slight abnormality of the acetabulum and develop over the life of the individual into more severe forms, taking tissue growth and differentiation into consideration, hence the clinical appropriateness of the name change recognizing it as a developing pathology (Gulati et al, ; Harcke, ; Mitchell and Redfern, ). Misalignment can be the result of trauma or congenital abnormalities in the joint which increase the likelihood of further damage (Aufderheide and Rodriguez‐Martin, ; Godley, ; Ortner, ; Weinstein, ).…”

“…Overall, DDH is not uncommon clinically, with a global incidence of 1 to 34 per 1,000 live births and by ultrasonographic detection in 25 to 50 out of 1,000 infants (known as neonate instability). Only in the last decade have sizeable case series been reported in archaeological/historical populations (Marfet et al, 2007; Mitchell and Redfern, ; Noordin et al, in press; Schoenecker and Flynn, ), leading some to infer temporal change in prevalence and to speculate as to why (see Table ). Consequently, the paleoepidemiology, prevalence, and identifying criteria of DDH amongst populations in antiquity remain relatively unknown and possibly under‐ or misreported.…”

Conservative Treatment of Hip Dysplasia

“…Дисплазия тазобедренных суставов у детей является объектом пристального изучения специ-алистов как в нашей стране [1,3, 11,13,15], так и за рубежом [23,26,34]. Однако лечение врож-денного вывиха бедра, являющегося наиболее тя-желой формой дисплазии тазобедренных суставов у детей, несмотря на значительные успехи совре-менной медицины, в настоящее время продолжает оставаться одной из актуальных проблем ортопе-дии детского возраста.…”

“…Однако лечение врожденного вывиха бедра, являющегося наиболее тяжелой формой дисплазии тазобедренных суставов у детей, в настоящее время продолжает оставаться одной из актуальных проблем ортопедии детского возраста. Несмотря на большое количество исследований в этой области, принципы лечения дисплазии до сих пор остаются предметом обсуждения.Ключевые слова: дисплазия тазобедренных суставов, врожденный вывих бедра, тазобедренный сустав, дети.Дисплазия тазобедренных суставов у детей является объектом пристального изучения специ-алистов как в нашей стране [1,3, 11,13,15], так и за рубежом [23,26,34]. Однако лечение врож-денного вывиха бедра, являющегося наиболее тя-желой формой дисплазии тазобедренных суставов у детей, несмотря на значительные успехи совре-менной медицины, в настоящее время продолжает оставаться одной из актуальных проблем ортопе-дии детского возраста.…”

Reconstruction of the Shallow Acetabulum With a Combination of Autologous Bulk and Impaction Bone Grafting Fixed by Cement

“…Developmental dysplasia of the hip (DDH), including acetabular dysplasia, subluxation, or dislocation, is relatively common, eg, 1.7% to 10% [2, 3, 12, 22, 27, 30]. Yoshimura et al [41] reported that the dimensions of dysplastic acetabuli are considerably shallower in Japanese subjects than in their British counterparts of similar age (60–79 years) and sex.…”