Acetabular development in the contralateral hip in patients with unilateral developmental dysplasia of the hip.

BACKGROUND Adult patients may present with acetabular dysplasia without a history of developmental dysplasia of the hip. The purpose of the present study was to clarify the development of primary acetabular dysplasia in patients under the age of eighteen years by evaluating the contralateral hip in those with unilateral developmental dysplasia of the hip. METHODS Radiographs of the contralateral hip of eighty-eight patients with unilateral developmental dysplasia of the hip were reviewed retrospectively. The center-edge angle was measured at the age of eighteen years. The primary acetabular dysplasia group included hips with a center-edge angle of <20 degrees , and the normal group included hips with an angle of > or =20 degrees . The acetabular index at the age of three years, the center-edge angle between the ages of three and eighteen years, and the acetabular angle of Sharp between the ages of six and eighteen years were measured. RESULTS According to our classification system, twelve hips (13.6%) were assigned to the primary acetabular dysplasia group. At the age of three years, there were no significant differences between the two groups radiographically. A significant difference in the center-edge angle between the two groups was seen at each evaluation period after the age of six years. However, twenty-two patients in the normal group had poor acetabular coverage and three patients in the primary acetabular dysplasia group had good acetabular coverage at the age of nine years. After the age of nine years, improvements in the center-edge angle and the acetabular angle of Sharp were noted in the normal group, whereas no acetabular growth was seen in the primary acetabular dysplasia group. There was no patient with a center-edge angle of <15 degrees at the age of twelve years in the normal group. CONCLUSIONS After the age of six years, a difference in acetabular growth develops between patients with primary acetabular dysplasia and those with normal hips. However a final prognosis for acetabular development appears to be difficult to determine until the age of twelve years.

[1]  J. Clohisy,et al.  Incidence and Characteristics of Femoral Deformities in the Dysplastic Hip , 2009, Clinical orthopaedics and related research.

[2]  J. McCarthy,et al.  The Incidence of Occult Dysplasia of the Contralateral Hip in Children With Unilateral Hip Dysplasia , 2008, Journal of pediatric orthopedics.

[3]  M. Tannast,et al.  Femoral Morphology Differs Between Deficient and Excessive Acetabular Coverage , 2008, Clinical orthopaedics and related research.

[4]  K. Søballe,et al.  The Other Hip in Unilateral Hip Dysplasia , 2006, Clinical orthopaedics and related research.

[5]  S. Weinstein,et al.  Acetabular Development in Developmental Dysplasia of the Hip Complicated by Lateral Growth Disturbance of the Capital Femoral Epiphysis* , 2000, The Journal of bone and joint surgery. American volume.

[6]  S B Murphy,et al.  The prognosis in untreated dysplasia of the hip. A study of radiographic factors that predict the outcome. , 1995, The Journal of bone and joint surgery. American volume.

[7]  S. Weinstein,et al.  Closed reduction for congenital dysplasia of the hip. Functional and radiographic results after an average of thirty years. , 1994, The Journal of bone and joint surgery. American volume.

[8]  M. Benson,et al.  Improvement in acetabular index after reduction of hips with developmental dysplasia. , 1993, The Journal of bone and joint surgery. British volume.

[9]  Westin Gw,et al.  Acetabular development in the infant's dislocated hips. , 1989 .

[10]  則竹 耕治.  ACETABULAR DEVELOPMENT AFTER CLOSED REDUCTION OF CONGENITAL DISLOCATION OF THE HIP , 1989, The Lancet.

[11]  D. Cherney,et al.  Acetabular development in the infant's dislocated hips. , 1989, Clinical orthopaedics and related research.

[12]  S. Stulberg,et al.  Acetabular dysplasia in the adult. , 1983, Clinical orthopaedics and related research.

[13]  B. Bolton-Maggs,et al.  The opposite hip in congenital dislocation of the hip. , 1983, The Journal of bone and joint surgery. British volume.

[14]  S. Weissman,et al.  Growth and development of congenitally dislocated hips reduced in early infancy. , 1979, The Journal of bone and joint surgery. American volume.

[15]  I. Ponseti.  Growth and development of the acetabulum in the normal child. Anatomical, histological, and roentgenographic studies. , 1978, The Journal of bone and joint surgery. American volume.

[16]  N. Fredensborg.  The CE angle of normal hips. , 1976, Acta orthopaedica Scandinavica.

[17]  N. Harris,et al.  Acetabular development in congenital dislocation of the hip. With special reference to the indications for acetabuloplasty and pelvic or femoral realignment osteotomy. , 1975, The Journal of bone and joint surgery. British volume.

[18]  I. Sharp.  ACETABULAR DYSPLASIA: The Acetabular Angle , 1961 .

[19]  G. Wiberg,et al.  Studies on dysplastic acetabula and congenital subluxation of the hip joint : with special reference to the complication of osteoarthritis , 1939 .