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Developmental dysplasia of the hip

Masaki Takao, Takashi Nishii, Takashi Sakai, Nobuhiko Sugano
PURPOSE: Rotational acetabular osteotomy (RAO) is used to treat developmental hip dysplasia (DDH). It requires detailed anatomical knowledge of the pelvic anatomy and three-dimensional cognitive skills. We addressed whether a computer navigation system combined with a preoperative computed tomography-based plan enabled surgeons to perform RAO safely and reliably through a mini-incision regardless of their level of experience with performing osteotomies. METHODS: We enrolled 24 patients (25 hips) with DDH (radiographic grade 0 or 1 osteoarthritic changes: Tönnis classification)...
October 25, 2016: International Journal of Computer Assisted Radiology and Surgery
Jung Min Ko, Jae So Cho, Yongjin Yoo, Jieun Seo, Murim Choi, Jong-Hee Chae, Hye-Ran Lee, Tae-Joon Cho
Wiedemann-Steiner syndrome is a rare genetic disorder characterized by short stature, hairy elbows, facial dysmorphism, and developmental delay. It can also be accompanied by musculoskeletal anomalies such as muscular hypotonia and small hands and feet. Mutations in the KMT2A gene have only recently been identified as the cause of Wiedemann-Steiner syndrome; therefore, only 16 patients from 15 families have been described, and new phenotypic features continue to be added. In this report, we describe 2 newly identified patients with Wiedemann-Steiner syndrome who presented with variable severity...
October 24, 2016: Journal of Child Neurology
Vimarsha G Swami, Lei Liu, Myles Mabee, Jacob L Jaremko
PURPOSE: Indices from 3-D ultrasound may have a role in developmental dysplasia of the hip (DDH) assessment, but require a way to determine spatial orientation relative to body axes. The lateral iliac wall angle is a potentially suitable reference axis in 3-D ultrasound. We sought to quantify normal values and variations of the infant iliac wall angle on radiography, and compare with computed tomography (CT). METHODS: Acetabular and lateral iliac angles were measured on frontal pelvic radiographs of 200 patients (400 hips, 183 with DDH) and coronal CT of 20 patients (40 hips) aged 0-12 months...
October 15, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Mohammed A Zwawi, Faissal A Moslehy, Christopher Rose, Victor Huayamave, Alain J Kassab, Eduardo Divo, Brendan J Jones, Charles T Price
: This study utilized a computational biomechanical model and applied the least energy path principle to investigate two pathways for closed reduction of high grade infantile hip dislocation. The principle of least energy when applied to moving the femoral head from an initial to a final position considers all possible paths that connect them and identifies the path of least resistance. Clinical reports of severe hip dysplasia have concluded that reduction of the femoral head into the acetabulum may occur by a direct pathway over the posterior rim of the acetabulum when using the Pavlik harness, or by an indirect pathway with reduction through the acetabular notch when using the modified Hoffman-Daimler method...
October 20, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Rahul Tyagi, Marcin R Zgoda, Rachel Short
National Health Service Quality Improvement Scotland (NHS QIS) published a health technology scoping report in 2006 acknowledging that there are serious concerns within Scotland in relation to Developmental Dysplasia of Hip (DDH) as there is no formal screening program in place and there are significant variations between NHS boards leading to confusion for staff and parents. NHS QIS identified need for audit work to improve hip screening in Scotland. The aim of this study is review of current practice of selective screening for DDH...
September 19, 2016: Orthopedic Reviews
X M Lü, C Feng, Y F Dong, G Fu, Y Guo
Objective: To explore the influence of the labro-chondral complex (LLC) on the development of the acetabulum after close reduction in developmental dysplasia of the hip (DDH). Methods: Sixty-one cases (72 hips) with DDH presented in Beijing Jishuitan Hospital were reviewed, all the patients were treated by closed reduction, arthrogram and Spica casting from March 2010 to December 2013. The anterior-posterior pelvic radiography was performed to evaluate the morphology of the labro-chondral complex and reduction of the hip...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Joel Wells, Jeffrey J Nepple, Karla Crook, James R Ross, Asheesh Bedi, Perry Schoenecker, John C Clohisy
BACKGROUND: Hip dysplasia represents a spectrum of complex deformities on both sides of the joint. Although many studies have described the acetabular side of the deformity, to our knowledge, little is known about the three-dimensional (3-D) head and neck offset differences of the femora of dysplastic hips. A thorough knowledge of proximal femoral anatomy is important to prevent potential impingement and improve results after acetabular reorientation. QUESTIONS/PURPOSES: (1) Are there common proximal femoral characteristics in patients with symptomatic hip dysplasia undergoing periacetabular osteotomy (PAO)? (2) Where is the location of maximal femoral head and neck offset deformity in hip dysplasia? (3) Do certain subgroups of dysplastic hips more commonly have cam-type femoral morphology? (4) Is there a relationship between hip ROM as well as impingement testing and 3-D head and neck offset deformity? METHODS: Using our hip preservation database, 153 hips (148 patients) underwent PAO from October 2013 to July 2015...
October 17, 2016: Clinical Orthopaedics and related Research
So Minokawa, Masatoshi Naito, Koichi Kinoshita, Takuaki Yamamoto
BACKGROUND: The vascular supply to the acetabular labrum is important in the treatment of labral lesions. However, in vivo blood flow measurements in the acetabular labrum have not been described in the literature. The purpose of this study was to examine this blood flow in vivo using laser Doppler flowmetry (LDF) in patients with acetabular dysplasia. METHODS: Periacetabular osteotomy combined with arthroscopy was performed in 47 consecutive patients (three males, 44 females; mean age at surgery, 35...
October 17, 2016: Journal of Orthopaedic Surgery and Research
Atul Bhaskar, Hardik Desai, Gaurav Jain
BACKGROUND: Re-dislocation after primary treatment of developmental dysplasia of the hip is a serious complication. We analyzed the various risk factors that contribute to re-dislocation, and whether the bony ossific nucleus (ON) confers increased stability against re-dislocation. MATERIALS AND METHODS: Fifty-five children (60 hips) were classified into three treatment groups: Closed reduction (CR) in 15 children (17 hips), open reduction (OR) in 26 children (28 hips), and OR with bony surgery (ORB) in 14 children (15 hips)...
September 2016: Indian Journal of Orthopaedics
Vikesh V Chandaria, James McGinty, Niamh C Nowlan
Mechanical forces due to fetal movements play an important role in joint shape morphogenesis, and abnormalities of the joints relating to abnormal fetal movements can have long-term health implications. While mechanical stimulation during development has been shown to be important for joint shape, the relationship between the quantity of mechanical stimulation and the growth and shape change of developing cartilage has not been quantified. In this study, we culture embryonic chick limb explants in vitro in order to reveal how the magnitude of applied movement affects key aspects of the developing joint shape...
October 12, 2016: Journal of Biomechanics
Xuyi Wang, Jianping Peng, De Li, Linlin Zhang, Hui Wang, Leisheng Jiang, Xiaodong Chen
BACKGROUND: The success of Bernese periacetabular osteotomy depends significantly on how extent the acetabular fragment can be corrected to its optimal position. This study was undertaken to investigate whether correcting the acetabular fragment into the so-called radiological "normal" range is the best choice for all developmental dysplasia of the hip with different severities of dysplasia from the biomechanical view? If not, is there any correlation between the biomechanically optimal position of the acetabular fragment and the severity of dysplasia? METHODS: Four finite element models with different severities of dysplasia were developed...
October 4, 2016: Journal of Orthopaedic Surgery and Research
L J Ding, Y L Liu, G Ma, Y Q Jia, Y S H Wei, X M Liu
This study aimed to determine whether abnormal apoptosis is present in acetabular cartilage in early developmental dislocations of the hip (DDH), and if so, whether it is correlated with the expression of caspase-3 and Bcl-2. DDH was induced in 24 4-week-old New Zealand white rabbits. Acetabular cartilage specimens from the experimental and control groups were stained with hematoxylin and eosin (H&E). Animals from the experimental group developed acetabular dysplasia. Apoptotic chondrocytes were observed by ultrastructural electron microscopy and H&E...
September 23, 2016: Genetics and Molecular Research: GMR
Aizhen Qiu, Zhongxiu Yang, Jiping Wang, Taotao Wang
The aim of the study was to assess the clinical value of ultrasound screenings for the developmental dysplasia of the hip (DDH) and explore its etiology in high-risk infants with cerebral palsy in follow-up visits. A group of 98 cases of infants at high-risk of cerebral palsy who received rehabilitation treatment between July, 2009 and July, 2010 were selected. Infants included 58 men and 40 women, aged <6 months and not lost to follow-up visits. Ultrasound (using Graf static inspection) screening of hips was performed and the infants with abnormalities were given clinical intervention, and 1- to 2-year-old infants were given outpatient follow-ups...
October 2016: Experimental and Therapeutic Medicine
Ran Schwarzkopf, Garwin Chin, Kelvin Kim, Dermot Murphy, Antonia F Chen
BACKGROUND: The incidence of hip fractures is growing with the increasing elderly population. Typically, hip fractures are treated with open reduction internal fixation, hemiarthroplasty, or total hip arthroplasty (THA). Failed hip fracture fixation is often salvaged by conversion THA. The total number of conversion THA procedures is also supplemented by its use in treating different failed surgical hip treatments such as acetabular fracture fixation, Perthes disease, slipped capital femoral epiphysis, and developmental dysplasia of the hip...
September 1, 2016: Journal of Arthroplasty
Ilhan A Bayhan, Kubilay Beng, Timur Yildirim, Evren Akpinar, Cagri Ozcan, Firat Yagmurlu
The aim of this study was to compare the midterm clinical and radiological outcomes of the Salter osteotomy (SO) and Tonnis lateral acetabuloplasty (TLA) with concomitant open reduction for the treatment of developmental dysplasia of the hip. Twenty-five hips of 20 patients who underwent SO with open reduction and 26 hips of 23 patients who underwent TLA with open reduction were evaluated retrospectively. The average age of the patients at the time of the operation was 35.6 months in the SO and 36.6 months in the TLA group, without a statistically significant difference (P=0...
November 2016: Journal of Pediatric Orthopedics. Part B
Gregory B Firth, Anthony J F Robertson, Yammesh Ramguthy, Manoj Ramachandran, Anton Schepers
BACKGROUND: The aim of this paper was to determine the prognostic potential of the ossific nucleus center edge angle (ONCEA) in patients below 5 years of age treated for developmental dysplasia of the hip (DDH) to predict final outcome and the need for a secondary procedure. METHODS: The interobserver and intraobserver reliability was calculated using the intraclass correlation coefficient for measurement of the ONCEA. The ONCEA was divided a priori into 3 groups: group A≥10 degrees, group B -9 to 9 degrees, and group C ≤-10 degrees...
September 23, 2016: Journal of Pediatric Orthopedics
Eduardo N Novais, Julia Sanders, Lauryn A Kestel, Patrick M Carry, Mariana L Meyers
BACKGROUND: We asked whether patient-specific factors and ultrasound (US) measurements of hip dysplasia severity at initial examination influence short-term residual acetabular dysplasia in patients successfully treated with Pavlik harness for developmental hip dysplasia. METHODS: After IRB approval, 134 hips (84 patients) successfully treated by the Pavlik method between August 2011 and October 2014 with follow-up at 12 months of age were identified. Early successful treatment was defined as normal examination and US after approximately 12 weeks of Pavlik treatment...
September 22, 2016: Journal of Pediatric Orthopedics
Timothy Woo, Thuzar Win
INTRODUCTION: Infantile myofibromatosis (IM) is a rare paediatric fibrous tumour also known as a desmoid tumour that occurs in around 1:150000 live births. It manifests as solitary or multicentric fibrous masses in the musculoaponeurotic soft tissues and can affect the visceral organs and bones. CASE DISCUSSION: We report a case of infantile myofibromatosis of the gluteus maximus muscle in an 18-day old neonate presenting atypically as a case of developmental dysplasia of the hip due to local involvement of the sciatic nerve...
September 7, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
C Druschel, K Heck, C Kraft, R Placzek
OBJECTIVE: PemberSal osteotomy to improve femoral head coverage by rotating the acetabular roof ventrally and laterally. INDICATIONS: Insufficient coverage of the femoral head, and can be combined with other surgical procedures such as femoral intertrochanteric varus-derotation osteotomy and open reduction for developmental dysplasia and dislocation of the hip or to improve sphericity and containment in Legg-Calvé-Perthes disease. This specific acetabuloplasty can only be performed in patients with an open epiphyseal growth-plate...
September 14, 2016: Operative Orthopädie und Traumatologie
Zhong-Li Zhang, Zhe Fu, Jian-Ping Yang, Kan Wang, Li-Wei Xie, Shu-Zhen Deng, Zhao-Qiang Chen
OBJECTIVE: To determine the incidence of residual dysplasia after closed reduction (CR) of developmental dysplasia of the hip (DDH) and assess correlations between quality of arthrogram-guided CR and residual dysplasia using a new intraoperative radiographic criterion. METHODS: Data of a consecutive series of 126 patients with DDH in 139 hips treated at our institution by arthrogram-guided CR from March 2006 to June 2013 were reviewed in this retrospective study...
August 2016: Orthopaedic Surgery
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