The fate of the hip in spondylo-epi-metaphyseal dysplasia: clinical and radiological evaluation of adults with SEMD Handigodu type

Abstract

Purpose

This study was undertaken to document the fate of the hip with reference to its structure and function in patients with spondylo-epi-metaphyseal dysplasia tarda Handigodu type (SEMDHG).

Material and methods

Radiographs of 271 adult patients with SEMDHG were studied to identify the pattern of long-term sequelae in the hips. Several measurements of the proximal femur and acetabulum were made to quantify morphological alterations in the hip. Fifty-four adult patients were examined and administered a questionnaire to evaluate the extent of disability attributable to the hips.

Results

Three patterns of changes in the hips were noted: 35% had acetabular protrusio, 33% had subluxation of the hip, and 32% had no protrusio or subluxation. Distinctly different anthropometric measurements and dimensional alterations around the hip were noted in these three patterns. Patients with protrusio were relatively tall while those with subluxation were the shortest. All the patients had developed degenerative arthritis of the hips by the fourth decade of life irrespective of the pattern of hip involvement. The reduction in the range of hip motion and fixed deformities were most severe in patients with protrusio. All the patients had significant disability and very low functional hip scores.

Conclusion

Degenerative arthritis of the hip develops in the majority of patients with SEMDHG; the symptoms are severe enough to warrant reconstructive surgery by the fourth decade of life. Protrusio or subluxation develops in a third of the patients each; both these complications will influence the surgical approach if total hip arthroplasty is planned.

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Acknowledgement

The study was funded by the Indian Council of Medical Research. The authors express their thanks to social workers H. M. Chandrshekhar Bhat and Mrs. K.R. Rajarathna for their invaluable help, Dr. S.S. Agarwal for making the radiographs available to us and for his guidance and Dr.Sreekumaran Nair and Mr Sanal, Department of Bio-Statistics, Manipal University, for analysis of the data.

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Correspondence to Benjamin Joseph.

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Siddesh, N.D., Shah, H. & Joseph, B. The fate of the hip in spondylo-epi-metaphyseal dysplasia: clinical and radiological evaluation of adults with SEMD Handigodu type. Skeletal Radiol 41, 939–945 (2012). https://doi.org/10.1007/s00256-011-1327-8

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Keywords

  • Spondylo-epi-metaphyseal dysplasia
  • Skeletal dysplasia
  • Hip
  • Arthritis
  • Subluxation
  • Protrusio