Crowe Type IV Hip Dysplasia Treated by THA Comebined with Osteotomy to Balance Functional Leg Length Discrepancy: A Prospective Observational Study

Shi, Xiaorui; Cheng, Cheng‐ming; Feng, Chunyang; Li, Chao‐feng; Li, Shu‐xuan; Liu, Jian‐guo

doi:10.1111/os.12655

Cited by 9 publications

(9 citation statements)

References 26 publications

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“…As described in most literature, LLD is defined as the difference of the distance between a femoral and a pelvic landmark on both sides. 3 , 17 As a pelvic reference, the teardrop is used in many studies. 13 , 17 Because the teardrop is less affected by the position of the pelvis, it is more reliable than other pelvic landmarks.…”

Section: Discussionmentioning

confidence: 99%

“… 3 , 17 As a pelvic reference, the teardrop is used in many studies. 13 , 17 Because the teardrop is less affected by the position of the pelvis, it is more reliable than other pelvic landmarks. In our study, we found the difference of the TD-TP and the difference of FL+TL had good correlation and reliability on patients’ perception.…”

Section: Discussionmentioning

confidence: 99%

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<p>Patient’s Perception on Leg Length Discrepancy After Total Hip Arthroplasty in Patients with Unilateral Crowe Type IV Developmental Dysplasia of the Hip</p>

Shen

Sun

et al. 2020

PPA

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Purpose The study assessed the correlation among the patients’ perception of leg length discrepancy (LLD) after total hip arthroplasty (THA) in patients with unilateral Crowe type IV developmental dysplasia of the hip (DDH) and the four methods of measuring the leg length in the full-length standing anteroposterior radiographs. Methods Sixty patients with unilateral Crowe type IV DDH were recruited in this retrospective study between January 2012 and January 2019. Four methods of measurement were used: 1) TD-TP: distance between the inferior aspect of teardrop (TD) and the midpoint of tibial plafond (TP); 2) CH-TP: distance between the center of the hip (CH) or acetabular cup and the TP; 3) GT-TP: distance between the apex of greater trochanter (GT) and the TP; and 4) FL+TL: the sum of femoral length (FL) and tibial length (TL). Results Association was found among the patients’ perception on LLD with difference in TD-TP (OR=1.157), and the difference in FL+TL (OR=1.166). The area under the curve of the difference in FL+TL and the difference TD-TP (0.704 and 0.679) was significantly higher than those of the difference in CH-TP and the difference in GT-TP (0.564 and 0.483). With the calculated threshold of LLD set at 9.0 mm, the sensitivity and specificity of the difference in TD-TP and the difference in FL+TL were 57.7%, 79.4% and 61.5%, 79.4%, respectively. Conclusion Patients’ perception on LLD had good correlation and reliability on the difference of FL+TL and the difference of TD-TP on both sides in the full-length standing anteroposterior radiographs after THA in patients with unilateral Crowe type IV DDH. The calculated threshold of the difference in FL+TL and the difference in TD-TP was set at 9.0 mm to assess the patients’ perception on LLD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

<p>Patient’s Perception on Leg Length Discrepancy After Total Hip Arthroplasty in Patients with Unilateral Crowe Type IV Developmental Dysplasia of the Hip</p>

Shen

Sun

et al. 2020

PPA

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show abstract

“…As described in most literature LLD is de ned as the difference of the distance between a femoral and a pelvic landmark on both sides [4,17]. As a pelvic reference, the teardrop is used in many study [13,17]. Because the teardrop is less affected by the position of the pelvis, it is more reliable than other pelvic landmarks.…”

Section: Discussionmentioning

confidence: 99%

Patient’s perception on leg length discrepancy after total hip arthroplasty in patients with unilateral Crowe type IV developmental dysplasia of the hip

Shen

Sun

et al. 2020

Preprint

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Background: The study assessed the correlation among the patients’ perception on leg length discrepancy (LLD) after total hip arthroplasty (THA) in patients with unilateral Crowe type IV developmental dysplasia of the hip (DDH) and the four methods of measuring the leg length in the full-length standing anteroposterior radiographs. Methods: 60 patients with unilateral Crowe type IV DDH were recruited in this retrospective study between January 2012 and January 2019. Four methods of measurement were used: (1) TD-TP: distance between the inferior aspect of teardrop and the midpoint of tibial plafond (TP). (2) CH-TP: distance between the center of femoral head or acetabular cup and the TP. (3) GT-TP: distance between the apex of greater trochanter and the TP. (4) FL + TL: the sum of femoral length and tibial length. Results: Association was found among the patients’ perception on LLD with difference in TD-TP (OR, 1.157), and the difference in FL + TL (OR, 1.166). The area under the curve of the difference in FL + TL and the difference TD-TP (0.704 and 0.679) was significantly higher than those of the difference in CH-TP and the difference in GT-TP (0.564 and 0.483). With the calculated threshold of LLD set at 9.0 mm, the sensitivity and specificity of the difference in TD-TP and the difference in FL + TL were 57.7%, 79.4% and 61.5%, 79.4%, respectively.Conclusion: Patients’ perception on LLD had good correlation and reliability on the difference of FL + TL and the difference of TD-TP.

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“…Intraoperative fractures are likely to occur in 5.2%-26.8% of THA in cases of DDH [37][38][39][40]. Otherwise, if the femoral canal is too narrow to allow the insertion of the smallest stem, splitting of the femur, as proposed by Li et al [27], is an alternative.…”

Section: Complicationsmentioning

confidence: 99%

“…Several techniques, including transverse, oblique, z-shaped, or the double chevron osteotomy, have been proposed [23,24]. Current evidence suggests that THA combined with sub-trochanteric osteotomy is likely to provide satisfactory functional results [22,37,38,39]. If clinically significant limping is mentioned post-operatively, physical therapy and a shoe lift should be considered, as well as re-operation.…”

Section: Complicationsmentioning

confidence: 99%

Total Hip Replacement in Developmental Hip Dysplasia: A Narrative Review

Papachristou¹,

Pappa²,

Chytas³

et al. 2021

Cureus

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The reconstruction of the hip joint in patients suffering from developmental hip dysplasia (DDH) is a demanding procedure and presents many challenges to the reconstructive surgeon. Higher rates of mechanical complications are present in this group of patients. The results of cemented and uncemented implants used in DDH patients are very promising, according to recent outcomes. However, the surgeon has to be aware of several complications, in order to establish an uneventful surgical management of DDH. The specific article investigates the technical challenges and clinical results of total hip arthroplasty in patients with DDH.

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Crowe Type IV Hip Dysplasia Treated by THA Comebined with Osteotomy to Balance Functional Leg Length Discrepancy: A Prospective Observational Study

Abstract: Objective: To measure the factors that affect functional leg length of Crowe type IV Developmental dysplasia of the hip (DDH) patients and to review our own methods to balance leg length discrepancy (LLD) in Crowe type IV DDH patients.

Cited by 9 publications

References 26 publications

<p>Patient’s Perception on Leg Length Discrepancy After Total Hip Arthroplasty in Patients with Unilateral Crowe Type IV Developmental Dysplasia of the Hip</p>

<p>Patient’s Perception on Leg Length Discrepancy After Total Hip Arthroplasty in Patients with Unilateral Crowe Type IV Developmental Dysplasia of the Hip</p>

Patient’s perception on leg length discrepancy after total hip arthroplasty in patients with unilateral Crowe type IV developmental dysplasia of the hip

Total Hip Replacement in Developmental Hip Dysplasia: A Narrative Review

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