The Development of Leg Length Difference and Influence on Persistent Dysplasia in Patients with Developmental Dysplasia of the Hip

Tolk, Jaap J.; Merchant, Rajiv; Eastwood, Deborah M.; Buddhdev, Pranai; Hashemi-Nejad, Aresh

doi:10.1007/s43465-021-00492-5

Cited by 5 publications

(3 citation statements)

References 16 publications

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“…Furthermore, in patients with DDH undergoing THA, LLD is also another serious problem. Restoring equal limb lengths not only alleviates pelvic and spinal tilt, reduces symptoms such as lower back pain and limping, thereby improving patient satisfaction with the surgery, but also reduces the occurrence of aseptic loosening of the prosthesis, increasing the lifespan of the implant, which is highly bene cial for patients (32). According to the report by Nossa et al (33), postoperative LLD in the range of 0-1 cm is acceptable and does not adversely affect the subjective perception and clinical functional recovery of patients.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Integrated acetabular prosthesis versus bone grafting in total hip arthroplasty for Crowe type II and III hip dysplasia: a retrospective case–control study

Cheng,

刘,

Wang

et al. 2024

Preprint

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Background Many methods of acetabular reconstruction with total hip arthroplasty (THA) for Crowe type II and III adult developmental dysplasia of the hip (DDH) acetabular bone defect have been implemented clinically. However, there was no study comparing the results of integrated acetabular prosthesis (IAP) with bone grafting (BG). Method The clinical data of 45 patients with unilateral Crowe type II and III DDH who underwent THA were retrospectively analyzed. The patients were divided into two groups: 25 patients using 3D printed IAP (group A) and 20 patients using BG (group B). Clinical and radiographic outcomes were evaluated. Results There were no significant differences between the two groups in Harris hip score (HHS) (preoperative, 6 months postoperative and the last follow-up), leg length discrepancy (LLD), cup inclination, cup anteversion, vertical center of rotation (V-COR) and horizontal center of rotation (H-COR) and proportion of cup coverage (P > 0.05). The HHS in group A was higher than in group B at 1 and 3 months postoperative (P<0.05). The surgical time and time to full weight-bearing in group A was shorter than in group B (P<0.05). The blood loss in group A was less than in group B (P<0.05). No complications were observed in either group during the follow-up period. Conclusion IAP and BG have similar radiographic outcomes and long-term clinical efficacy in THA for Crowe type II and III DDH, but IAP technique has higher surgical safety and facilitates the recovery of hip joint function, which is worthy of clinical promotion.

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Section: Clinical Outcomesmentioning

confidence: 99%

Integrated acetabular prosthesis versus bone grafting in total hip arthroplasty for Crowe type II and III hip dysplasia: a retrospective case–control study

Cheng,

刘,

Wang

et al. 2024

Preprint

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“…Zhang et al [ 20 ] studied long-leg radiographs of 67 skeletally mature patients with unilateral developmental hip dislocations and found that tibial length, lesser trochanter to tibial plafond length, and overall leg lengths on the affected leg were significantly longer, regardless of high or low dislocations. LLD is important to quantify since Tolk et al [ 22 ] demonstrated a trend towards impaired acetabular development in unoperated DDH patients with greater limb length discrepancy. Other studies have shown an increased risk of total hip replacement on the longer side [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

The Importance of Monitoring and Factors That May Influence Leg Length Difference in Developmental Dysplasia of the Hip

et al. 2022

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In unilateral Developmental Dysplasia of the Hip (DDH), avascular necrosis (AVN), femoral or pelvic osteotomy, and residual dysplasia causing subluxation of the proximal femur may influence Leg Length Discrepancy (LLD). This can lead to gait compensation, pelvic obliquity, and spinal curvature. The aim of this study is to determine the prevalence of LLD, establish which limb segment contributes to the discrepancy, describe how AVN influences LLD, and ascertain variables that may influence the need for LLD corrective procedures. Methodology: This study assessed long-leg radiographs at skeletal maturity. Radiographs were assessed for the articulo-trochanteric distance (ATD) and femoral and tibial length. AVN was classified according to Kalamchi–MacEwen. Results: 109 patients were included. The affected/DDH leg was longer in 72/109 (66%) patients. The length difference was mainly in the subtrochanteric segment of the femur. AVN negatively influenced leg length. Older (≥three years) patients with multiple procedures were more likely to have AVN. LLD interventions were performed in 30 (27.5%) patients. AVN grade or type of DDH surgery did not influence the odds of needing a procedure to correct LLD. Conclusions: Procedures to correct LLD were performed irrespective of previous DDH surgery or AVN grades. In most patients, the affected/DDH leg was longer, mainly in the subtrochanteric segment of the femur, largely influenced by femoral osteotomy in patients with multiple operative procedures for DDH. We recommend careful monitoring of LLD in DDH.

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“…Badrinath et al [23] quantified the 3D acetabular morphology in children with DDH compared to age-and sex-matched controls using pelvic CT scans and a custom 3D image processing software, and found a wide variability in acetabular coverage patterns in dysplastic hips, while Patwardhan et al [24] evaluated acetabular development in late-diagnosed DDH treated by open reduction at a mean age of 2 years with or without a concomitant femoral osteotomy. Tolk et al analysed the development of leg length discrepancy (LLD) and its influence on persistent acetabular dysplasia in children with DDH [25]. They observed a trend towards impaired acetabular improvement in patients with more initial LLD, emphasizing the need for thorough assessment of leg lengths early in the follow-up period and at set intervals until skeletal maturity, as per the Stanmore DDH surveillance protocol.…”

mentioning

confidence: 99%

Hip and Happening: Current Concepts in the Diagnosis and Management of Developmental Dysplasia of the Hip in 2022

Aroojis

Mehta

2021

JOIO

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The Development of Leg Length Difference and Influence on Persistent Dysplasia in Patients with Developmental Dysplasia of the Hip

Cited by 5 publications

References 16 publications

Integrated acetabular prosthesis versus bone grafting in total hip arthroplasty for Crowe type II and III hip dysplasia: a retrospective case–control study

Integrated acetabular prosthesis versus bone grafting in total hip arthroplasty for Crowe type II and III hip dysplasia: a retrospective case–control study

The Importance of Monitoring and Factors That May Influence Leg Length Difference in Developmental Dysplasia of the Hip

Hip and Happening: Current Concepts in the Diagnosis and Management of Developmental Dysplasia of the Hip in 2022

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