Morphology of the Knee in Adult Patients With Neglected Developmental Dysplasia of the Hip

Kandemir, Utku; Yazıcı, Muharrem; Alpaslan, A. Mumtaz; Surat, Adil

doi:10.2106/00004623-200212000-00019

Cited by 34 publications

(26 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, the studies showed that the cause was lower limbs alignment change. [6][7][8] Patients with DDH often complained of knee pain as the mainly symptom in the first visit. Therefore, we may ignore hip disorder.…”

Section: Discussionmentioning

confidence: 99%

“…Alexis and Robin considered that patellar instability was caused by the limb alignment, bone structure, and soft tissue, and it should adopted the operation to balance the multiple factors. 10 Many studies 7,8 mainly explored the limb alignment and the knee morphology change in DDH patients. However, very few manuscripts discussed the patella alignment in DDH patients by far.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Patella alignment abnormality in patients with developmental dysplasia of the hip

Lin

Gao

et al. 2019

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Background: The purpose of this study was to assess the influence of developmental dysplasia of the hip (DDH) on patella alignment. Methods: The radiographic data of all the patients who met the inclusion criteria from January 2015 to July 2017 were reviewed, including the quadriceps angle (QA), patellar lateral tilt (PTA), sulcus angle (SA), lateral shift of patella (LSP), and lower limbs alignment. The patients were divided into three groups in accordance with lateral center-edge angle (LCE) and femoral neck torsion angle (FNTA): group A (LCE > 25 and FNTA < 40), group B (LCE < 20 and FNTA < 40), and group C (LCE < 20 and FNTA > 40). Results: One hundred thirty-eight patients with 230 hips (115 females and 23 males) were recruited with an average age of 22 years. There were significant differences between group A and group C as well as group B and group C in QA, SA, PTA, LSP, and lower limbs alignment (p < 0.01). There were no differences in SA, PTA, LSP, and lower limbs alignment (p >0.05) and significant differences in QA (p < 0.01) between group B and group C. The "Pearson's" correlation analysis of the data in total of group B and group C showed that FNTA and LCE and QA and LCE were negatively correlated, whereas FNTA and QA, PTA, SA, and lower limbs alignment as well as SA, PTA, and lower limbs alignment were positively correlated. Conclusion: Patients with DDH not only have hip joint change, but also have the patella alignment abnormality, which may lead to patella instability. In the clinic, we should pay attention to the hip development of the patella instability patients for excluding DDH. Level of Evidence: Prognostic level III.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patella alignment abnormality in patients with developmental dysplasia of the hip

Lin

Gao

et al. 2019

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

show abstract

“…It has been suggested that anatomical changes at the hip joint are associated with abnormalities in the ipsilateral knee joint. We had previously reported that the morphologies of the knees in patients with DDH changed compared with the knees in patients with normal hips.…”

Section: Introductionmentioning

confidence: 87%

Changes in Alignment of Ipsilateral Knee on Computed Tomography after Total Hip Arthroplasty for Developmental Dysplasia of the Hip

Zhang

et al. 2019

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective To assess the changes in alignment of ipsilateral knee joint after total hip arthroplasty (THA) for patients with developmental dysplasia of the hip (DDH). Methods Thirty‐four patients with DDH (38 hips) who underwent THA between February and December 2008 were included in the study: 4 men and 30 women with a mean age of 56.2 years. According to Crowe classification, 11 patients were grade I, 12 were grade II, 9 were grade III, and 6 were grade IV. Computed tomography scans were performed from the anterior superior iliac spine to the tibial tubercle before surgery and at last follow‐up. Femoral anteversion angle, leg lengthening, and knee alignment, including patellar tilt angle, lateral patellar displacement, and tibiofemoral rotation angle, were measured on computed tomography scans, and their relationships were analyzed. Results The mean follow‐up period was 51.5 months (range, 39–70 months). There were no intraoperative fractures, and no infections occurred during the follow‐up period. One patient developed deep venous thrombosis and another suffered from femoral nerve palsy. The mean preoperative Harris Hip Score was 48.9 ± 7.5 and improved to 91.2 ± 8.3 by the last follow‐up (P < 0.001). There was no sign of prosthetic loosening in all hips. Postoperatively, mean leg lengthening was 26.08 ± 21.81 mm (P < 0.001), femoral anteversion decreased 9.03° ± 12.80° (P < 0.001), and patellar tilt, lateral patellar displacement, and tibiofemoral rotation increased by 3.58° ± 4.96° (P < 0.001), 1.78 ± 3.36 mm (P = 0.002), and 2.56° ± 3.37° (P < 0.001), respectively. Postoperative increase in patellar tilt and lateral patellar displacement had significant linear relationships with the decrease in femoral anteversion (r = 0.621, P < 0.001 and r = 0.437, P = 0.0037, respectively). These results revealed that patellofemoral alignment would change more with the decrease in femoral anteversion. Postoperative increase in external rotation of the tibia had significant positive linear relationships with leg lengthening (r = 0.34, P = 0.037) and the decrease in femoral anteversion (r = 0.693, P < 0.001). These results revealed that the external rotation of the proximal tibia would increase with the leg lengthening or the decrease of femoral anteversion. Postoperative changes in patellar tilt and lateral patellar displacement had no significant linear relationships with leg lengthening (P = 0.795 and P = 0.082, respectively). Conclusions Total hip arthroplasty for DDH could induce changes in alignment of ipsilateral patellofemoral and tibiofemoral joints, with increases in patellar tilt and displacement, and increases in external rotation of the tibia. These secondary alterations still existed at medium‐term follow‐up after surgery, which should be considered during THA for patients with DDH. Extended follow‐up is necessary to evaluate long‐term changes in the knee joint.

show abstract

“…1). The following soft-tissue and skeletal changes in DDH have also been reported in the clinical literature: acetabular labral tears (Fujii et al, 2009;Noguchi et al, 1999;Tanzer and Noiseux, 2004;Cashin et al, 2008;Tschauner and Hofman, 1998), degenerative changes to the acetabular rim (Ganz and Leunig, 2007;McCarthy and Lee, 2002;Fujii et al, 2009), abnormal femoral head and neck morphology and differences in limb length (Storer and Skaggs, 2006), valgus angulation at the knee (Kandemir et al, 2002), and osteoarthritis (OA) (Jacobsen et al, 2005;McCarthy and Lee, 2002;Haene et al, 2007;Jessel et al, 2009). Even if dysplasia and subluxation present as a unilateral condition, the contralateral hip joint will also be abnormal compared with a normal healthy hip, in terms of femoral neck anteversion, femoral neck-shaft angle, and increased acetabular anteversion (Jacobsen et al, 2006).…”

mentioning

confidence: 83%

Brief communication: Developmental dysplasia of the hip in medieval London

Mitchell

Redfern

2010

American J Phys Anthropol

View full text Add to dashboard Cite

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.

show abstract

Morphology of the Knee in Adult Patients With Neglected Developmental Dysplasia of the Hip

Cited by 34 publications

References 29 publications

Patella alignment abnormality in patients with developmental dysplasia of the hip

Patella alignment abnormality in patients with developmental dysplasia of the hip

Changes in Alignment of Ipsilateral Knee on Computed Tomography after Total Hip Arthroplasty for Developmental Dysplasia of the Hip

Brief communication: Developmental dysplasia of the hip in medieval London

Contact Info

Product

Resources

About