Correlation of postoperative magnetic resonance image measurements with persisting acetabular dysplasia in open reduction of developmental hip dysplasia

Abstract

Objectives: The aim of this study was to evaluate correlation of post-reduction magnetic resonance imaging (MRI)-based parameters with residual acetabular dysplasia in developmental dysplasia of the hip (DDH) patients who underwent open reduction. Patients and methods: A total of 62 hips of 54 children (5 males, 57 females; mean age: 8.5±3.5 months; range, 0 to 24 months) with a diagnosis of DDH who underwent open reduction between January 2012 and January 2017 were retrospectively analyzed. The acetabular head index (AHI), head coverage index (HCI), sphericity, bony acetabular index (BAI), cartilage acetabular index (CAI), anterior acetabular index (AAI), posterior acetabular index (PAI), abduction angle (AA), and acetabular medial wall thickness were measured by MRI. The correlation between MRI measurements and residual acetabular dysplasia was evaluated. Results: The mean follow-up was 23.7±10.1 (range, 12 to 56) months. The mean age at the final examination was 47.6±10.4 months. The age at the time of operation (r=0.250, p=0.049), medial wall thickness (r=0.304, p=0.016), AAI (r=0.729, p<0.001), PAI (r=0.590, p<0.001), and early postoperative AI (r=0.900, p<0.001) at the third postoperative month were positively correlated with the last follow-up AI. The AHI (r=-0.512, p<0.001), sphericity (r=-0,661, p<0.001), and HCI (r=-0.554, p< 0.001) were negatively correlated with the last follow-up AI. Conclusion: Post-reduction MRI parameters can be used to evaluate correlation with persistent acetabular dysplasia in DDH patients.

Cartilaginous predictors of residual acetabular dysplasia (RAD) in developmental dysplasia of the hip following closed or open reduction: A systematic review and meta-analysis

“…AUC values of 0.50 to 0.70, 0.70 to 0.90, and ≥0.90 represent low, moderate, and high diagnostic accuracy, respectively ( 42 ). As Onaç et al ( 8 ) concluded that a series of indicators measured in MRI including CAI had a good correlation with persistent dysplasia, and these indicators could be used to predict the RAD of DDH patients after early treatment. However, when it came to specific clinical applications, Fagan plot analysis showed that in the case of a predicted probability of 50%, the CAI group and the CCE group had a 75% and 76% probability of correctly detecting positive results, which was, acetabular dysplasia.…”

“…Osteoarthritis will develop more rapid and have to be treated by arthroplasty eventually if DDH is not identified timely and not treated in early childhood (3,4). However, there is a substantial likelihood of residual acetabular dysplasia (RAD) even after systematic therapy in infancy and early childhood, and acetabuloplasty is needed to protect the hip in the later stage (5)(6)(7)(8). There is still no uniform standard for the surgical timing and indications of RAD, so if some predictors can be identified to accurately assess and forecast the developmental prognosis after treatment, it can help to guide the timing of correction or avoid unnecessary surgery.…”