Hip Dysplasia in the Young Adult

Gala, Luca; Clohisy, John C.; Beaulé, Paul E.

doi:10.2106/jbjs.o.00109

Cited by 207 publications

(170 citation statements)

References 112 publications

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“…Periacetabular osteotomy (PAO) is frequently the surgical treatment of choice for symptomatic hip dysplasia in skeletally mature patients [5]. PAO strives to increase the anterior and lateral coverage of the femoral head with the goal of improved pain and function by normalizing the mechanics of the hip after acetabular reorientation [17].…”

Section: Introductionmentioning

confidence: 99%

Operative Fluoroscopic Correction Is Reliable and Correlates With Postoperative Radiographic Correction in Periacetabular Osteotomy

Wylie

Ross

Erickson

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Intraoperative fluoroscopy is commonly used to both guide the osteotomy and judge correction of the acetabular fragment in periacetabular osteotomy (PAO). Prior studies that have compared intraoperative fluoroscopic correction with postoperative radiographic correction were small studies that did not report intra-or interreader reliability. Questions/purposes (1) What is the correlation between intraoperative fluoroscopic correction in PAO compared with the correction seen on postoperative radiographs? (2) What is the reliability of radiographic measures of correction in PAO? Methods We performed a retrospective study of 121 patients (141 hips) who underwent PAO for symptomatic hip dysplasia at a tertiary referral center. Patients were included in the study if they had preoperative radiographs, intraoperative fluoroscopy, and minimum 6-week postoperative radiographs. Of the 272 PAO procedures performed in this time period, 61 patients who underwent PAO for retroversion and five patients with a history of Perthes disease were excluded as a result of the inability for these radiographic measures to judge fragment correction in PAOs for retroversion and the difficulty in measurement in post-Perthes deformity. Of the 206 PAOs performed for symptomatic acetabular dysplasia, 65 (32%) could not be analyzed because they lacked appropriate preoperative films, leaving 141 PAOs in 121 patients for analysis. The patients lacking appropriate preoperative films had them performed at an outside facility or had plain films that have since been destroyed. The lateral center-edge angle (LCEA) and acetabular index (AI) on the fluoroscopic views and postoperative radiographs were measured by two authors. The concordance between the amount of correction on intraoperative fluoroscopy and minimum 6-week postoperative measurements was analyzed using the concordance correlation coefficient (r c ) and a Bland-Altman analysis. Intra-and interrater reliability was calculated between measurements.

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Section: Introductionmentioning

confidence: 99%

Operative Fluoroscopic Correction Is Reliable and Correlates With Postoperative Radiographic Correction in Periacetabular Osteotomy

Wylie

Ross

Erickson

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…The rising rate of osteoarthritis (OA) in young adult patients (i.e., younger than 50 years of age) is a growing concern in orthopaedic health . A leading precursor to OA is acetabular dysplasia, which is involved in 20–40% of patients with hip OA . Additionally, malformations of the hip have also been linked to an increased risk of OA, and can manifest from altered mechanical loading and subsequent impingement .…”

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confidence: 99%

Novel model for the induction of postnatal murine hip deformity

Killian

Locke

James

et al. 2018

Journal Orthopaedic Research

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Acetabular dysplasia is a common, multi-etiological, pre-osteoarthritic (OA) feature that can lead to pain and instability of the young adult hip. Despite the clinical significance of acetabular dysplasia, there is a paucity of small animal models to investigate structural and functional changes that mediate morphology of the dysplastic hip and drive the subsequent OA cascade. Utilizing a novel murine model developed in our laboratory, this study investigated the role of surgically induced unilateral instability of the postnatal hip on the initiation and progression of acetabular dysplasia and impingement up to 8-weeks post-injury. C57BL6 mice were used to develop titrated levels of hip instability (i.e., mild, moderate, and severe instabillity or femoral head resection) at weaning. Joint shape, acetabular coverage, histomorphology, and statistical shape modeling were used to assess quality of the hip following 8 weeks of destabilization. Acetabular coverage was reduced following severe, but not moderate, instability. Moderate instability induced lateralization of the femur without dislocation, whereas severe instability led to complete dislocation and pseudoacetabulae formation. Mild instability did not result in morphological changes to the hip. Removal of the femoral head led to reduced hip joint space volume. These data support the notion that hip instability, driven by mechanical loss-of-function of soft connective tissue, can induce morphometric changes in the growing mouse hip. This work developed a new mouse model to study hip health in the murine adolescent hip and is a useful tool for investigating the mechanical and structural adaptations to hip instability during growth.

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“…A similar etiopathogenesis has been observed in people with hip dysplasia, which has been recently documented to be a major cause of hip OA in millions of patients treated each year . Early identification of affected patients still remains a challenge, which delays or excludes many potentially effective treatment options in children and young adults …”

mentioning

confidence: 57%

Protein biomarkers in serum and urine for determining presence or absence of hip dysplasia in a canine model

Ahner

Stoker

Bozynski

et al. 2019

Journal Orthopaedic Research

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This study compares serum and urine concentrations of relevant protein biomarkers among adult dogs with or without radiographic canine hip dysplasia (CHD). Adult (≥2 years of age), client‐owned dogs (n = 74) radiographically categorized as having at least “good” hips (n = 49) or having “mild,” “moderate,” or “severe” hip dysplasia (n = 25) by the Orthopedic Foundation for Animals (OFA). Urine and serum samples were obtained from each dog at a single time‐point and processed and analyzed for relevant protein biomarkers. Urinary concentrations of CTX‐II (p < 0.001) and TIMP‐1 (p = 0.002) were significantly lower in dogs with CHD compared to dogs with no CHD. ROC curve analyses were successful in establishing a panel of four biomarkers (urinary CTX‐I and II, serum MMP‐9, and serum PIICP) with high discriminatory capability for the presence or absence of hip dysplasia in adult dogs (AUC = 0.89). Urine and serum biomarkers can distinguish adult dogs with radiographic CHD from those with no CHD with a sensitivity of 0.95 and specificity of 0.77 using ROC analysis with AUC 0.89. Clinical Significance: This finding suggests that this simple, minimally invasive diagnostic technique has potential for discriminating dysplastic dogs from dogs with normal hips, with possible translational application to humans based on similar etiopathogenesis. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:1–5, 2019.

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Hip Dysplasia in the Young Adult

Cited by 207 publications

References 112 publications

Operative Fluoroscopic Correction Is Reliable and Correlates With Postoperative Radiographic Correction in Periacetabular Osteotomy

Operative Fluoroscopic Correction Is Reliable and Correlates With Postoperative Radiographic Correction in Periacetabular Osteotomy

Novel model for the induction of postnatal murine hip deformity

Protein biomarkers in serum and urine for determining presence or absence of hip dysplasia in a canine model

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