The feasibility of ultrasound Graf method in screening infants and young children with congenital hip dysplasia and follow-up of treatment effect

Liu, Dandan; Mou, Xiaping; Yu, Gang; Liang, Weizhang; Cai, Chun; Xiao, Li; Zhang, Gang

doi:10.21037/tp-21-137

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…Currently, multiple factors such as the child's body mass, breech pregnancy, foot deformity, family history of Evidence-Based Complementary and Alternative Medicine hip dysplasia, and skeletal muscle deformity are considered to be strongly associated with the development of hip dysplasia. Children with congenital dysplasia benefit from early diagnosis and reasonable treatment to achieve a favorable prognosis [17,18], but there are still some cases with delayed diagnosis or poor conservative treatment efficacy that require surgical treatment. Surgical treatment is mainly to restore the concentric relationship between the femoral head and the acetabulum, whilst avoiding femoral head necrosis and reoperation [19,20].…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy and Safety of Ibuprofen plus Traction, Reposition, and Hip Spica Cast in the Treatment of Developmental Dysplasia of the Hip

Feng

Liu

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To assess the clinical efficacy and safety of ibuprofen plus traction, reposition, and hip spica cast in the treatment of developmental dysplasia of the hip (DDH). Methods. Between January 2019 and July 2020, 60 children with DDH treaded in department of orthopedics of our institution were assessed for eligibility and recruited. They were assigned at a ratio of 1 : 1 to receive either traction + reposition + hip spica cast plus analgesia pump (observation group) or traction + reposition + hip spica cast plus analgesia pump and oral ibuprofen (control group). The outcome measures included clinical efficacy, pain scores, unexpected pain calls, the dosage of analgesia pump, and adverse events. Results. The two groups had similar clinical efficacy ( P > 0.05 ). The patients given oral ibuprofen were associated with significantly lower pain scores at 24 h and 72 h postoperatively versus those without oral ibuprofen ( P < 0.05 ). Analgesics with oral ibuprofen resulted in fewer unexpected pain calls versus analgesics without oral ibuprofen within 72 h postoperatively ( P < 0.05 ). The application of oral ibuprofen in the analgesia pump showed great improvement in lowering the dosage of analgesia pump versus the absence of ibuprofen ( P < 0.05 ). The incidence of adverse events was similar between the two groups of patients ( P > 0.05 ). Conclusion. Traction + reposition + hip spica cast plus analgesia pump and oral ibuprofen effectively mitigated postoperative pain in children with DDH and reduces analgesic drug dosage with a high safety profile.

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Section: Discussionmentioning

confidence: 99%

Clinical Efficacy and Safety of Ibuprofen plus Traction, Reposition, and Hip Spica Cast in the Treatment of Developmental Dysplasia of the Hip

Feng

Liu

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…We hypothesize that in animals with hip dysplasia it is possible to verify the increase in tissue resistance of the main muscles responsible for hip mobility. In medicine, ultrasound evaluation of the hip has been used since 1980, when it was first developed by Graf with the objective of identifying instabilities in the hip joints of newborn children [ 16 ]. In veterinary medicine, a similar technique has been described in dogs, but so far the results have been inconsistent with the development of dysplasia in adult dogs [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

B-mode ultrasonography and ARFI elastography of articular and peri-articular structures of the hip joint in non-dysplastic and dysplastic dogs as confirmed by radiographic examination

Carneiro,

da Cruz,

Gasser

et al. 2023

BMC Vet Res

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Background Canine hip dysplasia is a common orthopedic disease in veterinary practice. The diagnosis is made by radiographic examinations that evaluate bone alterations associated with hip dysplasia. Although radiographic examination is the gold standard for diagnosis, it does not allow a detailed evaluation of soft tissues such as the joint capsule and periarticular muscles. This study aimed to evaluate the accuracy of B-mode ultrasonography and acoustic radiation force impulse (ARFI) elastography in assessing the joint capsule and periarticular muscles of dogs using the Orthopedic Foundation of Animals (OFA) classification and the distraction index (DI) in the early and late diagnosis of hip dysplasia. This study sought to propose a protocol for the ultrasonographic evaluation of the structures involved in canine hip dysplasia. Methods Radiographic and ultrasonographic evaluations were performed on 108 hip joints of 54 dogs. Thirty dogs were older than 2 years and 24 were aged between 4 and 10 months. Results It was verified that an increase in pectineus muscle stiffness (cutoff value > 2.77 m/s) by elastography in some dysplastic dogs and an increase in the thickness of the joint capsule (cutoff value > 0.9 mm) in B-mode ultrasonography, were associated with a distraction index > 0.5, with both having a positive correlation. In B-mode ultrasonographic evaluation, the presence of signs of degenerative joint disease, such as irregularities of the cranial edge of the acetabulum and femoral head, were associated with a distraction index > 0.5 in canines, with a specificity of 94%. In adult dogs, the findings of degenerative joint disease on ultrasound were associated with a diseased OFA classification (P < 0.05). Measurement of the joint capsule > 1.10 mm was diagnostic for dysplasia in unhealthy dogs by OFA. Conclusions ARFI elastography has shown that the pectineus muscle may experience changes in stiffness in dysplastic animals. Additionally, changes in joint capsule thickness can be identified in B-mode in young and adult dogs with dysplastic joints, which contributes to the diagnosis of hip dysplasia.

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“…Ultrasound is a commonly used method of diagnosis because it provides detailed static and dynamic imaging of the hip joints even before the femoral head ossifies [4]. Graf classification is based on ultrasound results, the purpose of which is to assess the morphology of the hip joint quantitatively and qualitatively [7]. The classification includes a critical assessment of the anatomical features of the hip joint and the results of two measurements: the alpha angle (α), which is a measure of the slope of the superior surface of the acetabulum, and the beta angle (β), which evaluates the acetabular cartilage.…”

Section: Introductionmentioning

confidence: 99%

Non-invasive methods of treating hip dysplasia in infants – a scoping review

Ostrzyżek-Przeździecka¹,

Gąsior²,

Ferenstein³

et al. 2022

phr

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Background: Developmental dysplasia of the hip (DDH), characterized by abnormal development and maturation of the hip joint components, is one of the most common orthopedic problems in pediatrics. Aims:The aim of this paper was to present and discuss, based on a scope review of the literature, non-invasive methods of DDH treatment in infants. Material and methods:The literature review was conducted according to the 2020 updated PRISMA protocol using the extension for literature coverage review. The publication search process was conducted using the PubMed medical database.Results: Overall, 121 publications were identified. A total of 18 fulltext articles were investigated, 13 of which met the inclusion criteria. The reviewed articles describe the results of treatment with the Pavlik harness, Frejka pillow, as well as Tubingen and Denis Brown splint. Conclusions:The choice of treatment depends primarily on the attending physician, who pays attention to the process of the disorder progression and the parents' needs. In the reviewed studies, the results of treatment with the selected methods were not found to be significantly different. Moreover, it was emphasized that systematic observation and assessment of dysplastic hips, and therefore deferral of treatment, in many cases allows orthotic treatment to be avoided due to the frequent normalization of hip parameters in the first months of life.

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The feasibility of ultrasound Graf method in screening infants and young children with congenital hip dysplasia and follow-up of treatment effect

Cited by 7 publications

References 20 publications

Clinical Efficacy and Safety of Ibuprofen plus Traction, Reposition, and Hip Spica Cast in the Treatment of Developmental Dysplasia of the Hip

Clinical Efficacy and Safety of Ibuprofen plus Traction, Reposition, and Hip Spica Cast in the Treatment of Developmental Dysplasia of the Hip

B-mode ultrasonography and ARFI elastography of articular and peri-articular structures of the hip joint in non-dysplastic and dysplastic dogs as confirmed by radiographic examination

Non-invasive methods of treating hip dysplasia in infants – a scoping review

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