Patella alignment abnormality in patients with developmental dysplasia of the hip

Hu, Baijun; Lin, Shaofeng; Gao, Dawei; Wu, Yufeng; Zhang, Hong; Luo, Dan

doi:10.1177/2309499019854039

Cited by 3 publications

(5 citation statements)

References 33 publications

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“…Researchers, like Hu et al, also confirmed that DDH could lead to abnormal patella alignment and patella instability. 26 Similarly, in our study, we found that patients with recurrent dislocation of patella combined with TD also experienced changes in hip morphology. Therefore, in the process of clinical treatment, besides considering the disease of the knee joint, attention should also be paid to morphological changes of the hip joint, and the hip joint should be evaluated.…”

Section: Discussionsupporting

confidence: 75%

Morphological Analysis of Hip Joint of Patients Suffering From Recurrent Patella Dislocation

Fan

Niu

et al. 2022

J Knee Surg

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The purpose was to investigate morphological changes of the hip joint in patients with recurrent dislocation of the patella combined with trochlear dysplasia. There was a retrospective analysis of 148 patients and 150 control subjects. The selection of participants was randomized. Hip and knee data for all participants were obtained from X-ray or computed tomography measurements. Nine values, that is, central edge angle (CEA), acetabulum index angle (AIA), femoral neck-shaft angle, sharp angle, the depth of the acetabulum, femoral anteversion angle (FAA), anterior acetabular section angle (AASA), posterior acetabular section angle (PASA), and sulcus angle, were measured to evaluate differences between the control group and the patient group and analyze the correlation of the sulcus angle in patients to FAA and CEA. Patients with recurrent dislocation of the patella had less acetabular coverage and are more likely to develop developmental dysplasia of the hip than the hips of patients with normal knees. For the patient group, three values, that is, CEA (27.68 ± 5.25 vs. 34.30 ± 3.51 degrees, p < 0.001), AASA (57.14 ± 6.17 vs. 63.08 ± 7.23 degrees, p < 0.001), and PASA (89.53 ± 6.51 vs. 99.63 ± 5.94 degrees, p < 0.001), were decreased. The sharp angle (43.77 ± 3.23 vs. 39.28 ± 3.19 degrees, p < 0.001), AIA (11.52 ± 4.41 vs. 3.73 ± 2.51 degrees, p < 0.001), and FAA (24.68 ± 3.44 vs. 18.49 ± 3.55 degrees, p < 0.001) were increased. The acetabulum became shallower in-depth (7.05 ± 2.18 vs. 10.45 ± 1.61 mm, p < 0.001). There was a weak correlation between the sulcus angle and CEA (r = − 0.302, p < 0.001) and FAA (r = 0.212, p = 0.022). Recurrent patellar dislocation combined with trochlear dysplasia may be associated with the hip morphology. Developmental disorders of the knee joint, and hip joint should be considered in the treatment of patients with recurrent dislocation of the patella.

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Section: Discussionsupporting

confidence: 75%

Morphological Analysis of Hip Joint of Patients Suffering From Recurrent Patella Dislocation

Fan

Niu

et al. 2022

J Knee Surg

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“…The TT-TG measurement is the distance between lines "b" and "c" line is the perpendicular line from the medial edge of the patella to the tangent line of the posterior condyle. If LSP is greater than 5 mm, it is defined as lateral patella shift [18].…”

Section: Methodsmentioning

confidence: 99%

“…During clinical practice, we noticed that some patients with DDH complained of anterior knee pain (AKP) before and after PAO surgery. Previous studies have reported that patients with hip dysplasia also have knee anatomical deformities [18][19][20]. Therefore, this study intends to analyze the anatomical characteristics of the knee joints of DDH patients and the impact of PAO surgery on the patellofemoral joint (PFJ).…”

Section: Introductionmentioning

confidence: 99%

Characteristics of the patellofemoral joint of patients with DDH and the effects of Bernese periacetabular osteotomy on the patellofemoral joint

Peng

Xiao

Zhu

et al. 2022

BMC Musculoskelet Disord

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Background Some patients with developmental dysplasia of the hip (DDH) complained of anterior knee pain (AKP) before and after Bernese periacetabular osteotomy (PAO) surgery. The purpose of this study was to (1) identify the characteristics of patellofemoral joint (PFJ) deformities in patients with DDH and (2) to determine the effects of PAO on the PFJ. Methods Seventy patients (86 hips) were included in the DDH group. Thirty-three patients (33 knees) without AKP and hip pain were included in the control group. All patients underwent simultaneous CT scans of the hip and knee joints before PAO and after hardware removal surgery. The distance from the anterior inferior iliac spine to the ilioischial line (DAI), was measured in DDH patients. Imaging parameters of knees, including the sulcus angle (SA), femoral trochlear depth (FTD), patellar width (PW), tibial tuberosity-trochlear groove (TT-TG), patellar tilt angle (PTA) and lateral shift of the patella (LSP) were measured in patients in both the DDH and control group. TT-TG, PTA, and LSP of DDH patients were measured before PAO and after hardware removal. The DAI, PTA, LSP and TT-TG of all DDH patients before and after Bernese PAO were compared using paired t-tests. The FTD, PW, and SA of the DDH patients and the control group were analyzed using independent t-tests. PTA, TT-TG, and LSP between the control group and preoperative DDH patients, between the control group and post PAO patients were compared using independent t-tests. Results The DAI changed from 4.04 ± 0.61 mm before PAO surgery to 5.44 ± 0.63 mm after PAO surgery. The SA of the DDH group (140.69 ± 11.30 degree) was greater than that of the control group (130.82 ± 6.43 degree). The FTD and the PW of the DDH group (5.45 ± 1.59 mm, 4.16 ± 0.36 mm) were smaller than that of the control group (7.39 ± 1.20 mm, 4.24 ± 0.38 mm). The changes in LSP, PTA, and TT-TG before and after surgery were not statistically significant. Both before and after PAO, there was no statistically significant difference in the parameters of LSP, PTA, and TT-TG compared with the control group. Conclusion The knee joints of DDH patients presented a certain degree of femur trochlear groove dysplasia and patellofemoral instability. PAO surgery did not change PFJ stability, although the origination point of the rectus femoris muscle moved laterally during PAO surgery.

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“…Developmental dysplasia of the hip (DDH) is associated with morphological changes in the knee joint [1][2][3][4]. The femoral condyles of dysplastic hips are smaller and asymmetric, the trochlea is more shallow, the lateral patellar shift is reduced, the patellar tilt angle is increased, and the lower limb alignment is generally in the valgus [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Total Hip Arthroplasty for Low-Grade Developmental Hip Dysplasia Changes the Ipsilateral Knee Alignment on the Axial and Coronal Planes

Lucchini,

Castagnini,

Perdisa

et al. 2023

JCM

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Background: There is a paucity of data regarding the post-operative influence of total hip arthroplasty (THA) on the axial and coronal alignments of the ipsilateral knee. A CT study was designed to assess the post-THA changes in axial and coronal knee alignments in low-grade dysplastic hips. Methods: Forty Crowe I–II dysplastic hips in 37 patients were assessed: a pre-operative CT scan from the fourth lumbar vertebra to the tibial plateaus was compared to a similar post-operative CT scan performed after a minimum of 2 years after THA. Results: THA implantation caused significant post-operative changes in terms of the rotation height (2 mm lowering; p = 0.003); center of rotation medialization (10 mm medialization; p < 0.001); femoral offset (11 mm increase; p < 0.001); femoral antetorsion (22° internal rotation; p < 0.001), and hip internal rotation (9° internal rotation; p < 0.001). The femoral axis angle deviated in the valgus (5.5° ± 1.1°, p < 0.001) and the mechanical lateral distal femoral angle deviated in the varus (86° ± 2.7°, p = 0.001). The pelvic–tibial alignment changed from 88.2° ± 11.7° to 96° ± 9.3° (p < 0.001). Patellar alignment was not influenced. Conclusions: In conclusion, THA imposes significant changes in low-grade dysplastic hips: all the modifications tend to neutralize the coronal alignment and, mostly, the rotational alignment, without substantial and durable variations of the patellofemoral joint. Large clinical trials should confirm whether radiological changes impact anterior knee pain and patellar stability.

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Patella alignment abnormality in patients with developmental dysplasia of the hip

Cited by 3 publications

References 33 publications

Morphological Analysis of Hip Joint of Patients Suffering From Recurrent Patella Dislocation

Morphological Analysis of Hip Joint of Patients Suffering From Recurrent Patella Dislocation

Characteristics of the patellofemoral joint of patients with DDH and the effects of Bernese periacetabular osteotomy on the patellofemoral joint

Total Hip Arthroplasty for Low-Grade Developmental Hip Dysplasia Changes the Ipsilateral Knee Alignment on the Axial and Coronal Planes

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