Okano Kunihiko, Yamaguchi Kazumasa, Ninomiya Yoshikazu, Matsubayashi Shohei, Aoyagi Kiyoshi, Osaki Makoto, Enomoto Hiroshi, Takahashi Katsuro
Department of Orthopaedic Surgery, Nagasaki Prefectural Center of Medicine and Welfare for Children, Isahaya, Japan (KO, KY, YN, SM); Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (KA); Department of Orthopedic Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan (MO); Enomoto Orthopaedic Clinic, Nagasaki, Japan (HE); and Takahashi Orthopedic Clinic, Nagasaki, Japan (KT).
Medicine (Baltimore). 2015 Jan;94(1):e268. doi: 10.1097/MD.0000000000000268.
Previous reports demonstrated 8-60% patients treated for developmental dislocation of hip (DDH) in infancy have residual acetabular dysplasia (AD) at skeletal maturity. AD patients reportedly exhibit abnormal morphology of the pelvis, high rates of comorbid spinal congenital anomalies and high bone mineral density. These physical findings suggest that AD patients have genetic background. We examined the percentage of AD patients with hip pain at skeletal maturity having a history of DDH in infancy and the correlation between the severity of AD at skeletal maturity and history of DDH treatment to investigate the relationship between AD and DDH.A total of 245 patients were radiographically examined for any history of DDH treatment in infancy. The study included 226 women and 19 men with a mean age at examination of 40.7 years (range 17-59 years).Eighty-eight patients (36%) had a history of DDH treatment (DDH group) and the remaining 157 patients (64%) had no history of DDH treatment (non-DDH group). The average age was lower and acetabular angle was larger in the DDH group. There was a significant increasing trend of the percentage of DDH patients associated with the severity of AD classified with CE, acetabular angle, and acetabular roof angle.Our data suggest that there are several AD patients without a history of DDH in Japan, and AD in patients without a history of DDH has different characteristics from AD in patients with a history of DDH.
既往报道显示,婴儿期接受发育性髋关节脱位(DDH)治疗的患者中,8%-60%在骨骼成熟时存在髋臼发育不良(AD)。据报道,AD患者表现出骨盆形态异常、脊柱先天性畸形合并率高以及骨密度高。这些体格检查结果表明AD患者具有遗传背景。我们检查了骨骼成熟时存在髋关节疼痛且婴儿期有DDH病史的AD患者的比例,以及骨骼成熟时AD的严重程度与DDH治疗史之间的相关性,以研究AD与DDH之间的关系。共有245例患者接受了婴儿期DDH治疗史的影像学检查。该研究包括226名女性和19名男性,检查时的平均年龄为40.7岁(范围17-59岁)。88例患者(36%)有DDH治疗史(DDH组),其余157例患者(64%)无DDH治疗史(非DDH组)。DDH组的平均年龄较低,髋臼角较大。根据CE、髋臼角和髋臼顶角分类,与AD严重程度相关的DDH患者百分比有显著增加趋势。我们的数据表明,在日本有几名AD患者没有DDH病史,没有DDH病史的患者的AD与有DDH病史的患者的AD具有不同的特征。