3D Characterization of Acetabular Deficiency in Children with Developmental Dysplasia of the Hip.

Autor: Badrinath R; Department of Orthopedics and Rehabilitation, University of California - San Diego, 200 W. Arbor Drive, MC 8894, San Diego, CA 92103 USA., Jeffords ME; Orthopedics and Scoliosis, Rady Children's Hospital San Diego, 3020 Children's Way, MC 5062, San Diego, CA 92123 USA., Bomar JD; Orthopedics and Scoliosis, Rady Children's Hospital San Diego, 3020 Children's Way, MC 5062, San Diego, CA 92123 USA., Ahmed SI; Pediatric Orthopedics, 9300 Dewitt Loop, Fort Belvoir, VA 22060 USA., Pennock AT; Orthopedics and Scoliosis, Rady Children's Hospital San Diego, 3020 Children's Way, MC 5062, San Diego, CA 92123 USA., Upasani VV; Orthopedics and Scoliosis, Rady Children's Hospital San Diego, 3020 Children's Way, MC 5062, San Diego, CA 92123 USA.
Jazyk: angličtina
Zdroj: Indian journal of orthopaedics [Indian J Orthop] 2021 Jul 23; Vol. 55 (6), pp. 1576-1582. Date of Electronic Publication: 2021 Jul 23 (Print Publication: 2020).
DOI: 10.1007/s43465-021-00458-7
Abstrakt: Background: The purpose of this study is to determine if a quantitative method can be used to identify differences in 3D morphology between normal and developmentally dysplastic hips and to identify specific areas of undercoverage in children with DDH compared to age- and sex-matched controls.
Methods: Subjects were included if they were typically developing children with no other underlying conditions affecting their musculoskeletal system and had an available pelvic CT scan (67 hips). Custom software was used to measure standard variables defining acetabular morphology (version, tilt, surface area). Acetabuli were divided into equal octants; coverage angles were measured for each octant of interest. Variables were compared with age- and sex-matched controls (128 hips) using analysis of variance or the Mann-Whitney test.
Results: Hips with DDH were more anteverted compared to normal hips (DDH: 22.6˚, Control: 16.4˚, p  < 0.001). The surface area was similar between groups. 28% of hips had a global deficiency, 24% were anteriorly deficient, 19% were laterally deficient, 10% were anteverted (under covered anteriorly and over covered posteriorly), 3% were posteriorly deficient, and 15% of hips had borderline undercoverage. None of the hips in this cohort were found to be retroverted.
Conclusions: This is the first study to quantify the 3D acetabular deficiency in children with DDH compared to age- and sex-matched controls. We found wide variability in coverage patterns among dysplastic hips. It is imperative to define the specific acetabular deficiency for each individual patient prior to surgical correction.
Level of Evidence: III - Case-control study.
Competing Interests: Conflict of interestNo external funding was received for this study. This study was supported by the Rady Children’s Hospital, San Diego division of Orthopedics. Authors RB, MEJ, JDB, and SIA have nothing to disclose. Author ATP has the following disclosures: orthopediatrics: paid consultant. Author VVU has the following disclosures: DePuy, A Johnson & Johnson Company: paid consultant; EOS imaging: research support; Imagen: Stock or stock Options; nView: research support; Orthofix, Inc.: paid consultant; orthopediatrics: IP royalties; paid consultant; research support; Wolters Kluwer Health—Lippincott Williams & Wilkins: publishing royalties, financial or material support.
(© The Author(s) 2021.)
Databáze: MEDLINE
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