2019, Number 5
<< Back Next >>
Cir Cir 2019; 87 (5)
Volumetric measurement of the acetabular cavity in patients with unilateral neglected developmental dysplasia of the dislocated hip operated in a single time
Araujo-Monsalvo B, Trujillo-Satow A, Araujo-Monsalvo VM, Cuevas-Olivo R, Hernández-Simón LM, Domínguez-Hernández VM
Language: Spanish
References: 24
Page: 490-495
PDF size: 369.53 Kb.
ABSTRACT
Background: Plain radiography is the most often imaging method used for postoperative assessment of inveterate developmental
dysplasia of the hip. This technique does not permit to achieve an accurate diagnose of intra-articular changes, specifically
articular congruity.
Objective: analyze the morphological changes of the acetabular volume by computed tomography,
in patients operated by medium adductor myotomy, psoas tenotomy, open hip reduction, diaphysectomy, varus osteotomy and
derotating and Dega-type acetabuloplasty.
Method: A pilot clinical trial was conducted including six patients with unilateral
inveterate dysplasia admitted to the Rehabilitation National Institute. Computed tomography were analyzed using an engineering
design software.
Results: It was found that in all cases analyzed, operated acetabular volume was greater than the
contralateral (8 to 48%), however, no significant difference between the volumes was found (p = 2.46). Significant difference
between the volume and the age of patients, in multifactorial ANOVA tests (p = 0.006), Cochran’s (p = 0.00019) and Kruskal-
Wallis (p = 2.925 × 10−8) was found.
Conclusion: It is clear that the proposed measurement technique is able to identify
differences between volumes (operated and contralateral). The clinical monitoring of these patients can validate the results
obtained by this measurement technique, and it will serve to estimate the effectiveness of the surgical technique applied in
patients.
REFERENCES
Carol LA. Developmental dysplasia of the hip. En: Song KM, editor. Orthopaedic knowledge update: pediatrics 4. Rosemont, IL: AAOS; 2011. p. 159-67.
Duncan ST, Bogunovic L, Baca G, Schoenecker PL, Clohisy JC. Are there sex-dependent differences in acetabular dysplasia characteristics? Clin Orthop Relat Res. 2015;473:1432-9.
Dobashi ET, Kiyohara RT, Matsuda MM, Milani C, Kuwajima SS, Ishida A. Inveterate dysplasic hip – a surgical treatment. Acta Ortop Bras. 2006;14:183-9.
Dega W. Schwierigkeiten in der chirurgischen reposition der veraltetenkongenitalen subluxation des hüftgelenkesbei Kindern. Beitr Orthop Traumatol. 1964;11:642-7.
Dega W. Selection of surgical methods in the treatment of congenital dislocation of the hip in children. Chir Narzadow Ruchu Ortop Pol. 1969;34:357-66.
Dega W. Transiliac osteotomy in the treatment of congenital hip dysplasia. Chir Narzadow Ruchu Ortop Pol. 1974;39:601-3.
Ozgur AF, Aksoy MC, Kandemir U, Karcaaltncaba M, Aydingoz U, Yazici M, et al. Does Dega osteotomy increase acetabular volume in developmental dysplasia of the hip? J Pediatr Orthop B. 2006;15:83-6.
Lepistö J, Armand M, Armiger RS. Periacetabular osteotomy in adult hip dysplasia-developing a computer aided real-time biomechanical guiding system (BGS). Suom Ortoped Traumatol. 2008;31:186-90.
Park MS, Chung CY, Lee SH, Cho TJ, Yoo WJ, Choi IH. Two-dimensional computed tomographic measurement of acetabulum reliability, validity, and limitation. J Pediatr Orthop. 2008;28:812-8.
Öhman C, Baleani M, Pani C, Taddei F, Alberghini M, Viceconti M, et al. Compressive behaviour of child and adult cortical bone. Bone. 2011; 49:769-76.
Smet MH, Marchal GJ, Baert AL, Van Hoe L, Van Cleynenbreugel J, Daniels H, et al. Three-dimensional imaging of acetabular dysplasia: diagnostic value and impact on surgical type classification. Eur J Radiol. 2000;34:26-31.
Dandachli W, Islam SU, Liu M, Richards R, Hall-Craggs M, Witt J. Three-dimensional CT analysis to determine acetabular retroversion and the implications for the management of femoro-acetabular impingement. J Bone Joint Surg (Br). 2009;91:1031-6.
Jia J, Li L, Zhang L, Zhao Q, Liu X. Three dimensional-CT evaluation of femoral neck anteversion, acetabular anteversion and combined anteversion in unilateral DDH in an early walking age group. Int Orthop. 2012;36:119-24.
Pinoit Y, May O, Girard J, Laffargue P, Ala Eddine T, Migaud H. Low accuracy of the anterior pelvic plane to guide the position of the cup with imageless computer assistance: variation of position in 106 patients. Rev Chir Orthop Reparatrice Appar Mot. 2007;93:455-60.
Humbert L, Carlioz H, Baudoin A, Skalli W, Mitton D. 3D Evaluation of the acetabular coverage assessed by biplanar X-rays or single anteroposterior X-ray compared with CT-scan. Comput Methods Biomech Biomed Engin. 2008;11:257-62.
Li L, Zhang L, Zhao Q, Wang E. Measurement of acetabular anteversion in developmental dysplasia of the hip in children by two- and three-dimensional computed tomography. J Int Med Res. 2009;37:567-75.
Jóźwiak M, Rychlik M, Musielak B, Chen BP, Idzio RM, Grzegorzewski A. An accurate method of radiological assessment of acetabular volume and orientation in computed tomography spatial reconstruction. BMC Musculoskelet Disord. 2015;16:42.
Larson CM, Moreau-Gaudry A, Kelly BT, Byrd JW, Tonetti J, Lavallee S, et al. Are normal hips being labeled as pathologic? A CT-based method for defining normal acetabular coverage. Clin Orthop Relat Res. 2015; 473:1247-54.
Zhao L, Zhao DY, Wang Z, Zhao L, Zhang JS, Huan Y, et al. 3D-CT for skeletal abnormality in developmental dislocation of the hip with a particular reference to surgical indications. World J Pediatr. 2006; 2:125-32.
Tannast M, Hanke M, Zheng G, Steppacher S, Siebenrock K. What are the radiographic reference values for acetabular under- and overcoverage? Clin Orthop Relat Res. 2015;473:1234-46.
Hansen BJ, Harris MD, Anderson LA, Peters CL, Weiss JA, Anderson AE. Correlation between radiographic measures of acetabular morphology with 3D femoral head coverage in patients with acetabular retroversion. Acta Orthop. 2012;83:233-9.
Akgül T, Göksan SB, Bilgili F, Valiyev N, Hürmeydan ÖM. Radiological results of modified Dega osteotomy in Tönnis grade 3 and 4 developmental dysplasia of the hip. J Pediatr Orthop B. 2014;23:333-8.
Rampal V, Klein C, Arellano E, Boubakeur Y, Seringe R, Glorion C, et al. Outcomes of modified Dega acetabuloplasty in acetabular dysplasia related to developmental dislocation of the hip. Orthop Traumatol Surg Res. 2014;100:203-7.
Chung CY, Park MS, Choi IH, Cho TJ, Yoo WJ, Lee KM. Morphometric analysis of acetabular dysplasia in cerebral palsy. J Bone Joint Surg (Br). 2006;88:243-7.