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Morphological Changes and Concentricity of the Hip Joint During Gradual Reduction in Infants with Late-Detected Developmental Dysplasia of the Hip: A Retrospective Study

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Abstract

Background

The relationship between hip morphological changes and joint concentricity in infants with late-detected developmental dysplasia of the hip (DDH) treated with gradual reduction remains unclear. Therefore, we investigated hip morphological changes and concentricity in infants with late-detected unilateral DDH using magnetic resonance imaging (MRI) during gradual reduction.

Methods

We enrolled 20 infants aged ≥ 12 months with unilateral DDH. Treatment comprised continuous traction, a hip-spica cast, and an abduction brace. MRI was performed before treatment, immediately after hip-spica cast placement, after cast removal, and at the end of the brace. We evaluated the acetabulum and femoral head morphology and joint concentricity.

Results

The mean age was 25 months, and female sex and the left side were predominant. Before treatment, the acetabulum was small and shallow and the femoral head was spherically flat on the affected side. Immediately after the continuous traction, the affected acetabulum and femoral head were still smaller than the healthy/contralateral one. However, they improved to a deeper acetabulum and round femoral head. Intra-articular soft tissue (IAST) and femoral–acetabular distance (FAD) continuously decreased, indicating gradual improvement in joint concentricity. Deeper formation of the acetabulum and round shaping of the femoral head had occurred even in non-concentric reduction.

Conclusion

The shape and concentricity of the hip joint improved after treatment; however, the acetabulum and femoral head remained small. The deeper acetabulum and round femoral head were observed the non-concentric reduction before the concentric reduction was achieved. The continuous decrease in IAST and FAD indicates effective post-traction therapy.

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Data Availability

The datasets analyzed in this study are available from the corresponding author on reasonable request.

Code Availability

Not applicable.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Yaichiro Okuzu, Yutaka Kuroda, Toshiyuki Kawai, Yugo Morita & Shuichi Matsuda

  2. Department of Paediatric Orthopaedics, Shiga Medical Center for Children, 5-7-30, Moriyama, Moriyama-City, Shiga Pref., 524-0022, Japan

    Yaichiro Okuzu, Masako Tsukanaka & Tohru Futami

  3. Department of Orthopaedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osakasayama City, Osaka, 589-8511, Japan

    Koji Goto

Authors
  1. Yaichiro Okuzu
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  2. Masako Tsukanaka
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  3. Koji Goto
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  4. Yutaka Kuroda
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  5. Toshiyuki Kawai
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  6. Yugo Morita
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  7. Tohru Futami
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  8. Shuichi Matsuda
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Contributions

YO, MT, TF were involved in conceptualization, data curation, formal analysis, investigation, and methodology. KG, YK, TK, YM, and SM were involved in project administration, supervision, validation. YO and MT were major contributors in the writing the original draft. KG, YK, TK, YM, TF, and SM reviewed and edited the original draft. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yaichiro Okuzu.

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Conflict of interest

The authors declare that they have no relevant conflicts of interest.

Ethical Standards

This article does not contain any studies with human or animal subjects performed by the any of the authors.

Informed Consent in Studies with Human Subjects

This retrospective study was approved by the local institutional review board and conducted in accordance with the World Medical Association Declaration of Helsinki. Written informed consent was waived in this study.

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Okuzu, Y., Tsukanaka, M., Goto, K. et al. Morphological Changes and Concentricity of the Hip Joint During Gradual Reduction in Infants with Late-Detected Developmental Dysplasia of the Hip: A Retrospective Study. JOIO (2024). https://doi.org/10.1007/s43465-024-01184-6

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