Treatment of Graf Type IIa Hip Dysplasia: A Cut-off Value for Decision Making
Background: The rate of spontaneous normalization in type IIa hips is reported to be high, whereas dysplsia persists or worsens in 5%-10% of cases. Aims: To evaluate the natural course of type IIa hips using Graf’s own perspective of physiological immaturity and maturational deficit. Study Design:...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Publishing House
2018-11-01
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| Series: | Balkan Medical Journal |
| Subjects: | |
| Online Access: | http://balkanmedicaljournal.org/abstract.php?id=2020 |
| _version_ | 1797915392769785856 |
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| author | Fuat Bilgili Yavuz Sağlam Süleyman Bora Göksan Önder Murat Hürmeydan Fevzi Birişik Mehmet Demirel |
| author_facet | Fuat Bilgili Yavuz Sağlam Süleyman Bora Göksan Önder Murat Hürmeydan Fevzi Birişik Mehmet Demirel |
| author_sort | Fuat Bilgili |
| collection | DOAJ |
| description | Background: The rate of spontaneous normalization in type IIa hips is reported to be high, whereas dysplsia persists or worsens in 5%-10% of cases.
Aims: To evaluate the natural course of type IIa hips using Graf’s own perspective of physiological immaturity and maturational deficit.
Study Design: A single center, retrospective cohort study.
Methods: This was an institutional review board-approved retrospective review of all patients diagnosed with type IIa hip dysplasia at a single institution from 2012 to 2014. All patients included in the study had hip ultrasonography at about 6 weeks and 3 months of age. To assess reliability in α and β angles, ultrasonography measurements were carried out on the same image individually by all observers. The α and β angles were used as the main outcome measurements to evaluate hip maturation at the last follow-up. A receiver operating characteristics curve was drawn at the 3 month ultrasonography to evaluate the cut-off values for α and β angles for persistent dysplasia.
Results: Sixty-four patients and 88 affected hips (63% unilateral and 37% bilateral) were included. The mean age at diagnosis was 6.4±2.7 weeks. Fifty-four hips were type IIa(+) (physiologically immature) and 34 hips were type IIa(-) (maturational deficit) at the initial ultrasonography evaluation. Improvement to type I was seen in 52 type IIa(+) and 17 type IIa(-) hips. Receiver operating characteristic analyses showed that patients do well if the α angle was >55° (area under the curve: 0.86; p<0.001 for the left hip and area under the curve: 0.72; p=0.008 for the right hip).
Conclusion: The cut-off α angle value of 55° on initial ultrasonography should be considered to prevent future dysplasia. An α angle <55° on the initial ultrasonography was an independent predictor of worsening sonographic findings. |
| first_indexed | 2024-04-10T12:40:54Z |
| format | Article |
| id | doaj.art-b5562b1b8a5046d9866c8e6ca1f13988 |
| institution | Directory Open Access Journal |
| issn | 2146-3123 2146-3131 |
| language | English |
| last_indexed | 2024-04-10T12:40:54Z |
| publishDate | 2018-11-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Balkan Medical Journal |
| spelling | doaj.art-b5562b1b8a5046d9866c8e6ca1f139882023-02-15T16:14:17ZengGalenos Publishing HouseBalkan Medical Journal2146-31232146-31312018-11-0135642743010.4274/balkanmedj.2017.1150Treatment of Graf Type IIa Hip Dysplasia: A Cut-off Value for Decision MakingFuat Bilgili0Yavuz Sağlam1Süleyman Bora Göksan2Önder Murat Hürmeydan3Fevzi Birişik4Mehmet Demirel5Department of Orthopedics and Traumatology, İstanbul University İstanbul School of Medicine, İstanbul, TurkeyDepartment of Orthopedics and Traumatology, Biruni University School of Medicine, İstanbul, TurkeyDepartment of Orthopedics and Traumatology, İstanbul University İstanbul School of Medicine, İstanbul, TurkeyDepartment of Orthopedics and Traumatology, İstanbul University İstanbul School of Medicine, İstanbul, TurkeyDepartment of Orthopedics and Traumatology, İstanbul University İstanbul School of Medicine, İstanbul, TurkeyDepartment of Orthopedics and Traumatology, İstanbul University İstanbul School of Medicine, İstanbul, TurkeyBackground: The rate of spontaneous normalization in type IIa hips is reported to be high, whereas dysplsia persists or worsens in 5%-10% of cases. Aims: To evaluate the natural course of type IIa hips using Graf’s own perspective of physiological immaturity and maturational deficit. Study Design: A single center, retrospective cohort study. Methods: This was an institutional review board-approved retrospective review of all patients diagnosed with type IIa hip dysplasia at a single institution from 2012 to 2014. All patients included in the study had hip ultrasonography at about 6 weeks and 3 months of age. To assess reliability in α and β angles, ultrasonography measurements were carried out on the same image individually by all observers. The α and β angles were used as the main outcome measurements to evaluate hip maturation at the last follow-up. A receiver operating characteristics curve was drawn at the 3 month ultrasonography to evaluate the cut-off values for α and β angles for persistent dysplasia. Results: Sixty-four patients and 88 affected hips (63% unilateral and 37% bilateral) were included. The mean age at diagnosis was 6.4±2.7 weeks. Fifty-four hips were type IIa(+) (physiologically immature) and 34 hips were type IIa(-) (maturational deficit) at the initial ultrasonography evaluation. Improvement to type I was seen in 52 type IIa(+) and 17 type IIa(-) hips. Receiver operating characteristic analyses showed that patients do well if the α angle was >55° (area under the curve: 0.86; p<0.001 for the left hip and area under the curve: 0.72; p=0.008 for the right hip). Conclusion: The cut-off α angle value of 55° on initial ultrasonography should be considered to prevent future dysplasia. An α angle <55° on the initial ultrasonography was an independent predictor of worsening sonographic findings.http://balkanmedicaljournal.org/abstract.php?id=2020Decisioion makingGraf type IIaHip dysplasiaUltrasonography |
| spellingShingle | Fuat Bilgili Yavuz Sağlam Süleyman Bora Göksan Önder Murat Hürmeydan Fevzi Birişik Mehmet Demirel Treatment of Graf Type IIa Hip Dysplasia: A Cut-off Value for Decision Making Balkan Medical Journal Decisioion making Graf type IIa Hip dysplasia Ultrasonography |
| title | Treatment of Graf Type IIa Hip Dysplasia: A Cut-off Value for Decision Making |
| title_full | Treatment of Graf Type IIa Hip Dysplasia: A Cut-off Value for Decision Making |
| title_fullStr | Treatment of Graf Type IIa Hip Dysplasia: A Cut-off Value for Decision Making |
| title_full_unstemmed | Treatment of Graf Type IIa Hip Dysplasia: A Cut-off Value for Decision Making |
| title_short | Treatment of Graf Type IIa Hip Dysplasia: A Cut-off Value for Decision Making |
| title_sort | treatment of graf type iia hip dysplasia a cut off value for decision making |
| topic | Decisioion making Graf type IIa Hip dysplasia Ultrasonography |
| url | http://balkanmedicaljournal.org/abstract.php?id=2020 |
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