Hip arthrogram parameters predict radiographic outcomes of patients with developmental dysplasia of the hip treated by closed reduction

ObjectiveThis study aimed to investigate the relationship between intraoperative hip arthrogram parameters and residual acetabular dysplasia (RAD) and avascular necrosis of the femoral head (AVN) in children with developmental dysplasia of the hip (DDH) treated by closed reduction.MethodsWe retrospe...

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Main Authors: YunFei Tan, Wei Zhao, MinRong Wei, Yi He, HuaJun Deng, DaiWei Su, WuHui Zhu, YuQian Wu, Hao Shen, YiQiang Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-01-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2023.1292928/full
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author YunFei Tan
Wei Zhao
MinRong Wei
Yi He
HuaJun Deng
DaiWei Su
WuHui Zhu
YuQian Wu
Hao Shen
YiQiang Li
author_facet YunFei Tan
Wei Zhao
MinRong Wei
Yi He
HuaJun Deng
DaiWei Su
WuHui Zhu
YuQian Wu
Hao Shen
YiQiang Li
author_sort YunFei Tan
collection DOAJ
description ObjectiveThis study aimed to investigate the relationship between intraoperative hip arthrogram parameters and residual acetabular dysplasia (RAD) and avascular necrosis of the femoral head (AVN) in children with developmental dysplasia of the hip (DDH) treated by closed reduction.MethodsWe retrospectively analyzed the data of 102 patients (110 hips; mean age, 14.6 months ± 4.7 months) with DDH treated by closed reduction. A hip arthrogram was routinely performed during the operation. The femoral head coverage rate (FHC), medial pool distance of the hip (MPD), labral inversion, and reduction quality classification were evaluated under the hip arthrogram. The presence of RAD and AVN was assessed on radiographs at the last follow-up. The relationship between each arthrogram parameter and RAD as well as AVN was investigated using a t-test, chi-square test, and logistic regression.ResultsThe overall FHC and medial pool distance of the hip (MDP) averaged 42.2% ± 12% and 8.1% ± 11.7%, respectively. There were 80 hips (72.7%) with labral inversion and 30 hips (27.2%) without. The reduction quality was type A in 57 hips (51.8%), type B in 28 hips (25.4%), and type C in 25 hips (22.7%). A total of 32 hips (29%) were in the RAD group, and 78 hips (71%) were in the recovered group according to whether pelvic osteotomy was performed or not and according to the last Severin grade. The FHC was significantly higher in the recovered group than that in the RAD group (P = 0.014). No significant difference was observed in sex, age at reduction, side, preoperative acetabular index, International Hip Dysplasia Institute classification, follow-up time, quality of reduction, MDP, and proportion of labral inversion between the recovered and RAD groups. Logistic regression analysis showed that only the FHC was a risk factor for RAD. The incidence of AVN above type II was 11.8% in this group of patients, and the incidence of AVN was significantly higher in patients with labral inversion (23.2%) than that in those without (7.5%; P = 0.041). Logistic regression analysis showed that labral inversion was a risk factor for AVN.ConclusionThe FHC measured under arthrogram can predict the occurrence of RAD after closed reduction of DDH, whereas MDP, reduction quality classification, and labral inversion are of little significance. Labral inversion is a risk factor for AVN.
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spelling doaj.art-47e047b31dd740918efe54b58268c0e72024-01-15T08:41:17ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602024-01-011110.3389/fped.2023.12929281292928Hip arthrogram parameters predict radiographic outcomes of patients with developmental dysplasia of the hip treated by closed reductionYunFei Tan0Wei Zhao1MinRong Wei2Yi He3HuaJun Deng4DaiWei Su5WuHui Zhu6YuQian Wu7Hao Shen8YiQiang Li9Department of Pediatric Orthopaedics, Liuzhou Hospital of Guangzhou Women and Children's Medical Center, Liuzhou, ChinaDepartment of Pediatric Orthopaedics, Liuzhou Hospital of Guangzhou Women and Children's Medical Center, Liuzhou, ChinaDepartment of Pediatric Orthopaedics, Liuzhou Hospital of Guangzhou Women and Children's Medical Center, Liuzhou, ChinaDepartment of Pediatric Orthopaedics, Liuzhou Hospital of Guangzhou Women and Children's Medical Center, Liuzhou, ChinaDepartment of Pediatric Orthopaedics, Liuzhou Hospital of Guangzhou Women and Children's Medical Center, Liuzhou, ChinaDepartment of Pediatric Orthopaedics, Liuzhou Hospital of Guangzhou Women and Children's Medical Center, Liuzhou, ChinaDepartment of Pediatric Orthopaedics, Liuzhou Hospital of Guangzhou Women and Children's Medical Center, Liuzhou, ChinaDepartment of Pediatric Orthopaedics, Liuzhou Hospital of Guangzhou Women and Children's Medical Center, Liuzhou, ChinaDepartment of Pediatric Orthopaedics, Liuzhou Hospital of Guangzhou Women and Children's Medical Center, Liuzhou, ChinaDepartment of Pediatric Orthopaedics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, ChinaObjectiveThis study aimed to investigate the relationship between intraoperative hip arthrogram parameters and residual acetabular dysplasia (RAD) and avascular necrosis of the femoral head (AVN) in children with developmental dysplasia of the hip (DDH) treated by closed reduction.MethodsWe retrospectively analyzed the data of 102 patients (110 hips; mean age, 14.6 months ± 4.7 months) with DDH treated by closed reduction. A hip arthrogram was routinely performed during the operation. The femoral head coverage rate (FHC), medial pool distance of the hip (MPD), labral inversion, and reduction quality classification were evaluated under the hip arthrogram. The presence of RAD and AVN was assessed on radiographs at the last follow-up. The relationship between each arthrogram parameter and RAD as well as AVN was investigated using a t-test, chi-square test, and logistic regression.ResultsThe overall FHC and medial pool distance of the hip (MDP) averaged 42.2% ± 12% and 8.1% ± 11.7%, respectively. There were 80 hips (72.7%) with labral inversion and 30 hips (27.2%) without. The reduction quality was type A in 57 hips (51.8%), type B in 28 hips (25.4%), and type C in 25 hips (22.7%). A total of 32 hips (29%) were in the RAD group, and 78 hips (71%) were in the recovered group according to whether pelvic osteotomy was performed or not and according to the last Severin grade. The FHC was significantly higher in the recovered group than that in the RAD group (P = 0.014). No significant difference was observed in sex, age at reduction, side, preoperative acetabular index, International Hip Dysplasia Institute classification, follow-up time, quality of reduction, MDP, and proportion of labral inversion between the recovered and RAD groups. Logistic regression analysis showed that only the FHC was a risk factor for RAD. The incidence of AVN above type II was 11.8% in this group of patients, and the incidence of AVN was significantly higher in patients with labral inversion (23.2%) than that in those without (7.5%; P = 0.041). Logistic regression analysis showed that labral inversion was a risk factor for AVN.ConclusionThe FHC measured under arthrogram can predict the occurrence of RAD after closed reduction of DDH, whereas MDP, reduction quality classification, and labral inversion are of little significance. Labral inversion is a risk factor for AVN.https://www.frontiersin.org/articles/10.3389/fped.2023.1292928/fulldevelopmental dysplasia of the hipclosed reductionhip arthrogramresidual acetabular dysplasiaavascular necrosis of the femoral head
spellingShingle YunFei Tan
Wei Zhao
MinRong Wei
Yi He
HuaJun Deng
DaiWei Su
WuHui Zhu
YuQian Wu
Hao Shen
YiQiang Li
Hip arthrogram parameters predict radiographic outcomes of patients with developmental dysplasia of the hip treated by closed reduction
Frontiers in Pediatrics
developmental dysplasia of the hip
closed reduction
hip arthrogram
residual acetabular dysplasia
avascular necrosis of the femoral head
title Hip arthrogram parameters predict radiographic outcomes of patients with developmental dysplasia of the hip treated by closed reduction
title_full Hip arthrogram parameters predict radiographic outcomes of patients with developmental dysplasia of the hip treated by closed reduction
title_fullStr Hip arthrogram parameters predict radiographic outcomes of patients with developmental dysplasia of the hip treated by closed reduction
title_full_unstemmed Hip arthrogram parameters predict radiographic outcomes of patients with developmental dysplasia of the hip treated by closed reduction
title_short Hip arthrogram parameters predict radiographic outcomes of patients with developmental dysplasia of the hip treated by closed reduction
title_sort hip arthrogram parameters predict radiographic outcomes of patients with developmental dysplasia of the hip treated by closed reduction
topic developmental dysplasia of the hip
closed reduction
hip arthrogram
residual acetabular dysplasia
avascular necrosis of the femoral head
url https://www.frontiersin.org/articles/10.3389/fped.2023.1292928/full
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