The natural course of osteoarthritis of the hip due to subluxation or acetabular dysplasia

Abstract

In 59 patients, 86 hips with subluxation or hip dysplasia were examined to determine the natural course of the condition and select suitable treatment. Thirty-three percent of the joints (13/39 hips) developed early osteoarthritis from pre-osteoarthritis within an average term of 9.2 years, while the remaining, sixty-six percent (31/47 hips) developed advanced-stage osteoarthritis from early osteoarthritis within an average term of 7.8 years. Patients were classified into advanced and non-advanced groups according to radiographic analysis of the advanced groups according to radiographic analysis of the advance of the disease and statistical analysis was performed. In pre-osteoarthritis, centre-edge angle, slope of the acetabular roof, acetabular head index, acetabular depth ratio and Japanese Orthopaedic Association (JOA) hip score were significant predictors, while in early osteoarthritis, a broken Shenton's line, cranial joint space and JOA score were significant. On the basis of multiple parameters, formulas for predicting development in patients with pre-osteoarthritis, those with early osteoarthritis, and all patients together were established, with an accuracy of 87%, 71%, and 68%, respectively.

Dynamic femoral head translations in dysplastic hips

“…AHI quantifies relative acetabular support, and ARO and Sharp angles express acetabular inclination. These radiographic indices are not independent, but supplement DDH grading (Hasegawa et al, 1992;Ito et al, 2004;Nicholls et al, 2011). Nakamura et al correlated these radiographic indicators and primary OA and found the CE angle and ARO were strongly correlated to primary OA with superolateral migration (Nakamura et al, 1989).…”

“…Developmental dysplasia of the hip (DDH) is an important disease leading to osteoarthritis (OA) (Hasegawa et al, 1992;Jacobsen and Sonne-Holm, 2005;Lane et al, 2000), and it is well established that high stress concentrations during weight-bearing ambulation cause OA (Mavcic et al, 2008;Pompe et al, 2007). Historically, static geometric factors on radiography, e.g.…”

Do Fluoroscopy and Postoperative Radiographs Correlate for Periacetabular Osteotomy Corrections?

“…Insufficient acetabular coverage of the femoral head in developmental dysplasia of the hip (DDH) is a major cause of hip pain, dysfunction, and secondary osteoarthritis [4,7,9,10,12,21]. The Bernese periacetabular osteotomy (PAO) is commonly used for treating patients with symptomatic dysplasia.…”

JGZ-richtlijn Heupdysplasie

“…De prognose hiervan is veelal ongunstig. Bij een dysplasie 76 JGZ-richtlijn Heupdysplasie [2] van de heup zonder (sub)luxatie ontwikkelt ongeveer 70 % op volwassen leeftijd vroegtijdige slijtage, ofwel coxartrose [13][14][15]. Bij een ge(sub)luxeerde heup treden op de leeftijd van 2 à 3 maanden vaak al veranderingen ten gevolge van de (sub)luxatie op, zoals een verkorting van de heupadductoren.…”

“…Bij een dubbelzijdige luxatie ontwikkelt het kind een holle rug en kan het gaan lopen met een eendengang of waggelgang. Op (jong)volwassen leeftijd zullen meestal pijn en invalidering optreden door coxartrose [4,13,14]. De kans op coxartrose is lager wanneer kinderen vroeg worden behandeld voor DDH.…”