Clinical Orthopaedics and Related Research®

, Volume 472, Issue 2, pp 665–673

Hip Dysplasia Is More Severe in Charcot-Marie-Tooth Disease Than in Developmental Dysplasia of the Hip

  • Eduardo N. Novais
  • Sara D. Bixby
  • John Rennick
  • Patrick M. Carry
  • Young-Jo Kim
  • Michael B. Millis
Symposium: 2013 Hip Society Proceedings

DOI: 10.1007/s11999-013-3127-z

Cite this article as:
Novais, E.N., Bixby, S.D., Rennick, J. et al. Clin Orthop Relat Res (2014) 472: 665. doi:10.1007/s11999-013-3127-z

Abstract

Background

Patients with Charcot-Marie-Tooth disease may develop hip dysplasia. Hip geometry in these patients has not been well described in the literature.

Questions/purposes

We compared the hip morphometry in Charcot-Marie-Tooth hip dysplasia (CMTHD) and developmental dysplasia of the hip (DDH) in terms of extent of (1) acetabular dysplasia and subluxation, (2) acetabular anteversion and osseous support, (3) coxa valga and femoral version, and (4) osteoarthritis.

Methods

Fourteen patients with CMTHD (19 hips; mean age, 23 years) presenting for periacetabular osteotomy were matched to 45 patients with DDH (45 hips; mean age, 21 years) based on age, sex, and BMI. We assessed acetabular dysplasia and subluxation using lateral center-edge angle (LCEA), anterior center-edge angle (ACEA), and acetabular roof angle of Tönnis (TA) on plain pelvic radiographs and acetabular volume, area of femoral head covered by acetabulum, and percentage of femoral head covered by acetabulum on three-dimensional CT reconstruction models. Acetabular version and bony support, femoral version, and neck-shaft angle were measured on two-dimensional axial CT scans. Hip osteoarthritis was graded radiographically according to Tönnis criteria.

Results

Acetabular dysplasia was more severe in CMTHD, as measured by smaller LCEA (p < 0.001), ACEA (p < 0.001), and acetabular volume (p = 0.0178) and larger TA (p = 0.025). Hip subluxation was more pronounced in CMTHD, as demonstrated by lower area of femoral head covered by acetabulum (p = 0.034) and percentage of femoral head covered by acetabulum (p = 0.007). CMTHD was associated with higher acetabular anteversion (p < 0.001), lower anterior (p < 0.001) and posterior (p = 0.072) osseous support, and more severe coxa valga (p < 0.001). More (p = 0.006) arthritic hips were found in CMTHD.

Conclusions

The extent of acetabular dysplasia, hip subluxation, acetabular anteversion, coxa valga, and hip osteoarthritis was more severe in CMTHD. These findings are important in choosing the appropriate surgical strategy for patients affected by CMTHD.

Level of Evidence

Level IV, diagnostic study. See Instructions for Authors for a complete description of levels of evidence.

Copyright information

© The Association of Bone and Joint Surgeons® 2013

Authors and Affiliations

  • Eduardo N. Novais
    • 1
  • Sara D. Bixby
    • 2
  • John Rennick
    • 3
  • Patrick M. Carry
    • 1
  • Young-Jo Kim
    • 4
  • Michael B. Millis
    • 4
  1. 1.Department of Orthopedic Surgery, Children’s Hospital ColoradoUniversity of Colorado School of MedicineAuroraUSA
  2. 2.Department of RadiologyBoston Children’s HospitalBostonUSA
  3. 3.Northeastern UniversityBostonUSA
  4. 4.Department of Orthopedic SurgeryBoston Children’s HospitalBostonUSA

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