Developmental dysplasia of the hip – angle trends after operation in different age groups

Abstract

IntroductionThe aim of our study was to evaluate changes in collodiaphyseal, Hilgenreiner and Wiberg’s centre-edge angle values in different age groups of children before and after surgical correction of developmental dysplasia of the hip.Material and methodsWe evaluated 78 children with developmental hip dysplasia treated at University Children’s Hospital in Belgrade during a 10-year period. Three age groups were analysed: the first group younger than 24 months of life, the second group between 25 and 48 months, and the third group older than 48 months of life. Three angles were evaluated separately before and after surgical correction: collodiaphyseal angle, Hilgenreiner angle and Wiberg’s centre-edge angle.ResultsWe found a highly statistically significant difference (p < 0.001) before and after the operation for collodiaphyseal and Hilgenreiner angle in the first and second age group, while there was a statistically significant difference (p < 0.05) in the third age group. Regarding Wiberg’s centre-edge angle, there was a highly statistically significant difference (p < 0.001) in all age groups. One way ANOVA revealed a highly statistically significant difference (p < 0.001) for collodiaphyseal and Hilgenreiner angle in age groups before the operation, while after surgery such a trend remained for Hilgenreiner angle. Regarding collodiaphyseal and Wiberg’s centre-edge angle in the period after correction, there was no statistical difference (p > 0.05) between age groups of the participants.ConclusionsOur findings demonstrate that age of participants is in correlation with correction of values for collodiaphyseal angle, Hilgenreiner angle and Wiberg’s centre-edge angle in surgically treated children diagnosed with developmental dysplasia of the hip.

State of the art paper Evolution of the term and definition of dysplasia of the hip – a review of the literature

“…All the analyzed definitions of hip dysplasia refer to the hip joint in the stage of development, but there are no definitions of the deformity of the hip after completion of its growth. It seems that the morphological and clinical picture of hip dysplasia should be then supplemented by the secondary changes such as loss of articular cartilage, subchondral sclerosis of the acetabulum or thickening of its bony roof [ 34 ]. Another aspect relating to the hip joint after completion of its growth is frequently observed, so-called, secondary’ hip dysplasia, resulting in the thickening of the acetabular roof in the course of development of osteoarthritis, which leads to the dislocation of the femoral head to the side, and ultimately upwards.…”