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development dysplasia of the hip

Lun-Qing Zhu, Guang-Hao Su, Jin Dai, Wen-Yan Zhang, Chun-Hua Yin, Fu-Yong Zhang, Zhen-Hua Zhu, Zhi-Xiong Guo, Jian-Feng Fang, Cheng-da Zou, Xing-Guang Chen, Ya Zhang, Cai-Ying Xu, Yun-Fang Zhen, Xiao-Dong Wang
Developmental dysplasia of the hip (DDH) is a common congenital malformation characterized by mismatch in shape between the femoral head and acetabulum, and leads to hip dysplasia. To date, the pathogenesis of DDH is poorly understood and may involve multiple factors, including genetic predisposition. However, comprehensive genetic analysis has not been applied to investigate a genetic component of DDH. In the present study, 10 pairs of healthy fathers and DDH daughters were enrolled to identify genetic hallmarks of DDH using high throughput whole genome sequencing...
February 24, 2018: Genomics
Stuart L Weinstein, Lori A Dolan, Jose A Morcuende
This review summarizes evidence developed at the University of Iowa concerning the management and outcomes of developmental dysplasia of the hip beginning with the observations and analyses of Dr Arthur Steindler in the early 1900s. The strong evidence-based practice tradition established by Steindler 100 years ago continues as we critically evaluate our procedures and patient outcomes, only altering approaches when warranted by strong personal and research evidence. Our practice continues to be conservative in that we strive to produce the best environment possible for the hip to develop on its own and operate only when less invasive methods have failed...
February 23, 2018: Clinical Orthopaedics and related Research
L Franken, F Thielemann, A Postler, S Blum, A Hartmann, K-P Günther, J Goronzy
INTRODUCTION: Periacetabular osteotomy (PAO) is an effective procedure in treatment of symptomatic hip dysplasia. To achieve a good outcome a strict patient selection has to be applied. The aim of this study was to evaluate the influence of patient age at surgery on clinical outcome. METHODS: In a prospective study 86 patients (106 hips) underwent clinical and radiographic follow-up at a mean time of 5 years (2.5-8.5 years) after PAO. Patient-related outcome measurements (PROMs: EQ-5D, WOMAC, OHS, GTO) were applied preoperatively as well as postoperatively and the deformity correction as well as development of osteoarthritis were evaluated...
February 12, 2018: Der Orthopäde
Dennis Karimi, Thomas Kallemose, Anders Troelsen, Jakob Klit
INTRODUCTION: In Denmark, 20% of all registered total hip arthroplasties (THA) from 1995 to 2014 has been patients younger than 60 years with primary idiopathic osteoarthritis (OA). It is speculated that hip malformations may be a major contributor to early OA development. It has been shown that hip malformation may compromise implant position and, therefore, identifying and knowing the incidence of malformations is important. Our aim was to assess the prevalence and type of hip malformations in a cohort of younger patients undergoing THA...
February 10, 2018: Archives of Orthopaedic and Trauma Surgery
Jason J Shin, Darren L de Sa, Jeremy M Burnham, Craig S Mauro
With increased knowledge and understanding of hip pathology, hip arthroscopy is rapidly becoming a popular treatment option for young patients with hip pain. Despite improved clinical and radiographic outcomes with arthroscopic treatment, some patients may have ongoing pain and less than satisfactory outcomes. While the reasons leading to failed hip arthroscopy are multifactorial, patient selection, surgical technique and rehabilitation all play a role. Patients with failed hip arthroscopy should undergo a thorough history and physical examination, as well as indicated imaging...
January 2018: Journal of Hip Preservation Surgery
Sarah Walton, Emily Schaeffer, Kishore Mulpuri, Peter Cundy, Nicole Williams
INTRODUCTION: Developmental dysplasia of the hip (DDH) affects 4-6 per 1000 live births in developed countries. Effective treatment to realign the hip is necessary to avoid long-term morbidities and maximise functional outcome. Treatment options depend on patient age but typically involve hip bracing and/or reduction under general anaesthetic. Some centres also employ prereduction hip traction. Historical papers suggest traction reduces risk of avascular necrosis (AVN) femoral head and reduces requirement for open reduction...
January 29, 2018: BMJ Open
Hannes Kubo, Hakan Pilge, Karoline Nepp, Bettina Westhoff, Ruediger Krauspe
INTRODUCTION: Early diagnosis and treatment of hip dysplasia are widely accepted as major factors for beneficial outcome. However, modalities for reduction and retention as well as for imaging are currently under clinical investigation. Local and general risk factors, e.g., breech presentation and the family's desire to avoid in-hospital treatment are major concerns in the decision-making process and consultation. For treatment of unstable hips in newborns the treatment with the Tübingen splint has proven good results in recent studies...
January 19, 2018: Archives of Orthopaedic and Trauma Surgery
Adrian J Talia, Cassandra Coetzee, Oren Tirosh, Phong Tran
BACKGROUND: Total hip arthroplasty is one of the most commonly performed surgical procedures worldwide. There are a number of surgical approaches for total hip arthroplasty and no high-level evidence supporting one approach over the other. Each approach has its unique benefits and drawbacks. This trial aims to directly compare the three most common surgical approaches for total hip arthroplasty. METHODS/DESIGN: This is a single-centre study conducted at Western Health, Melbourne, Australia; a large metropolitan centre...
January 8, 2018: Trials
YiQiang Li, YueMing Guo, Ming Li, QingHe Zhou, Yuanzhong Liu, WeiDong Chen, JingChun Li, Federico Canavese, HongWen Xu
PURPOSE: Our objective was to find the best predictor of late residual acetabular dysplasia in developmental dysplasia of the hip (DDH) after closed reduction (CR) and discuss the indications for secondary surgery. METHODS: We retrospectively reviewed the records of 89 patients with DDH (mean age 16.1 ± 4.6 months; 99 hips) who were treated by CR. Hips were divided into three groups according to final outcomes: satisfactory, unsatisfactory and operation. The changes in the acetabular index (AI), centre-edge angle of Wiberg (CEA), Reimer's index (RI) and centre-head distance discrepancy (CHDD) over time among groups were compared...
December 29, 2017: International Orthopaedics
Christoph E Albers, Piet Rogers, Nicholas Wambeek, Sufian S Ahmad, Piers J Yates, Gareth H Prosser
Redirective, periacetabular osteotomies (PAO) represent a group of surgical procedures for treatment of developmental dysplasia of the hip (DDH) in skeletally mature and immature patients. The ultimate goal of all procedures is to reduce symptoms, improve function and delay or prevent progression of osteoarthritis. During the last two decades, the understanding of the underlying pathomechanisms has continuously evolved. This is mainly attributable to the development of the femoroacetabular impingement concept that has increased the awareness of the underlying three-dimensional complexity associated with DDH...
December 2017: Journal of Hip Preservation Surgery
Cecilia Pascual-Garrido, Farshid Guilak, M Farooq Rai, Michael D Harris, Mandi J Lopez, Rory J Todhunter, John C Clohisy
Developmental dysplasia of the hip (DDH) in humans is a common condition that is associated with hip pain, functional limitations, and secondary osteoarthritis (OA). Surgical treatment of DDH has improved in the last decade, allowing excellent outcomes at short- and mid-term follow-up. Still, the etiology, mechanobiology, and pathology underlying this disease are not well understood. A pre-clinical animal model of DDH could help advance the field with a deeper understanding of specific pathways that initiate hip joint degeneration secondary to abnormal biomechanics...
December 11, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Ayumi Matsunaga, Shunsuke Akiho, Koichi Kinoshita, Masatoshi Naito, Takuaki Yamamoto
PURPOSE: Curved periacetabular osteotomy (CPO) has been developed for the treatment of acetabular dysplasia. While several studies have reported its good clinical results, the complications of CPO include delayed union and nonunion of the superior pubic ramus. The purpose of this study is to investigate the prevalence of delayed union of the pubis one year after CPO, and to determine the risk factors for this complication. METHODS: The study examined 113 hips that underwent CPO between 2008 and 2012...
December 5, 2017: International Orthopaedics
Niels C Pedersen, Bonnie Shope, Hongwei Liu
Background: Pure breeding of dogs has led to over 700 heritable disorders, of which almost 300 are Mendelian in nature. Seventy percent of the characterized mutations have an autosomal recessive mode of inheritance, indicative of positive selection during bouts of inbreeding primarily for new desired conformational traits. Samoyed suffer from several common complex genetic disorders, but up to this time only two X-linked and one autosomal dominant disorder have been identified. Previous studies based on pedigrees and SNP arrays have concluded that Samoyed breeders have done a good job in maintaining genetic diversity and avoiding excessive inbreeding...
2017: Canine Genetics and Epidemiology
Turgut Akgul, Osman Coskun, Murat Korkmaz, Ilke Ali Gurses, Cengiz Sen, Ozcan Gayretli
Background: Developmental hip dysplasia is diagnosed when the femoral head is not sufficiently covered by the acetabulum. Anterior and lateral cover deficiency is seen, as a result a dysplastic hip joint. Various incision modifications have been developed because of the muscle dissection and wide wound scar in Smith-Peterson incision, which was originally used in Bernese osteotomy. This study evaluates applicability of the modified Stoppa approach in the performance of Bernese periacetabular osteotomy (PAO)...
November 2017: Indian Journal of Orthopaedics
George Feldman, Arlene Offemaria, Hind Sawan, Javad Parvizi, Theresa A Freeman
BACKGROUND: Developmental dysplasia of the hip (DDH) is a debilitating condition whose distinguishing signs include incomplete formation of the acetabulum leading to dislocation of the femur, accelerated wear of the articular cartilage and joint laxity resulting in osteoarthritis. It is a complex disorder having environmental and genetic causes. Existing techniques fail to detect milder forms of DDH in newborns leading to hip osteoarthritis in young adults. A sensitive, specific and cost effective test would allow identification of newborns that could be non-invasively corrected by the use of a Pavlik harness...
November 10, 2017: Journal of Translational Medicine
Heidi Prather, Andrew Creighton, Chris Sorenson, Scott Simpson, Maria Reese, Devyani Hunt, Monica Rho
BACKGROUND: In young and middle-aged adults with and without hip deformity, hip pain receives treatment focused primarily related to hip structure. Because this hip pain may be chronic, these patients develop other coexisting, modifiable disorders related to pain that may go undiagnosed in this young and active population, including insomnia and anxiety. OBJECTIVE: The objective of this study was to compare assessments of insomnia and anxiety in young and middle-aged adults presenting with hip pain with no greater than minimal osteoarthritis (OA) compared to asymptomatic healthy controls...
October 27, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Wilshaw R Stevens, Alicia Y Kokoszka, Anthony M Anderson, Kirsten Tulchin-Francis
INTRODUCTION: Squatting biomechanics assessed using motion analysis relies on the identification of specific events: start of descent, transition between descent/ascent and end of ascent. Automated identification reduces the time needed to process trials while allowing consistency across studies. The purpose of this study was to develop criteria for the identification of events and apply them to two squatting protocols in pathological patient and typically developing (TD) groups. METHODS: Thirty-four subjects with hip dysplasia and 41 TD subjects were enrolled in this study...
October 26, 2017: Gait & Posture
Hannes Kubo, Hakan Pilge, Kristina Weimann-Stahlschmidt, Karoline Stefanovska, Bettina Westhoff, Ruediger Krauspe
AIM: Hip dysplasia is one of the most common skeletal disorders. As a late consequence 20-25% of the patients are at risk to develop secondary osteoarthritis and may require total hip replacement early in life. The treatment principles of hip dislocation are (1) concentric reposition, (2) retention, i.e., plaster in human post or Pavlik harness and (3) maturation in abduction flexion orthesis. The Tübingen splint was introduced as a further development of abduction devices for the treatment of (residual) hip dysplasia with stable hips...
October 28, 2017: Archives of Orthopaedic and Trauma Surgery
Clayton B Hess, Rebecca Stein-Wexler, LiHong Qi, Jon R Davids, Ruben C Fragoso
BACKGROUND: Few studies exist to inform the extrapolated practice of irradiating children for heterotopic ossification (HO) prevention. We report the incidence of HO formation following prophylactic preoperative compared with postoperative radiation therapy (RT) in children with neuromuscular hip dysplasia (NHD) following proximal femoral resection (PFR). METHODS: A retrospective, 2-institution chart review was performed. Eligibility was limited to patients with at least 1 year of follow-up...
October 24, 2017: Journal of Pediatric Orthopedics
Charlotte L Williams, Susie Weller, Lisa Roberts, Isabel Reading, Andrew Cook, Louisa Little, Wendy Wood, Louise Stanton, Andreas Roposch, Nicholas Mp Clarke
BACKGROUND: Developmental dysplasia of the hip (DDH) is a very common congenital disorder, and late-presenting cases often require surgical treatment. Surgical reduction of the hip may be complicated by avascular necrosis (AVN), which occurs as a result of interruption to the femoral head blood supply during treatment and can result in long-term problems. Some surgeons delay surgical treatment until the ossific nucleus (ON) has developed, whereas others believe that the earlier the reduction is performed, the better the result...
October 2017: Health Technology Assessment: HTA
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