Top

Published in:

01-05-2016 | Review Article

Surgical treatment for young adult hip dysplasia: joint-preserving options

Authors: Min Chen, Xi-Fu Shang

Published in: International Orthopaedics | Issue 5/2016

Abstract

Developmental dysplasia of the hip (DDH) is a spectrum of disorders that results in anatomic abnormalities leading to increased contact stress in the joint and, eventually, secondary osteoarthritis. However, many patients with DDH become symptomatic before the severe degenerative changes of the hip because of abnormal hip biomechanics, mild hip instability, impingement, or associated intra-articular pathology. Early diagnosis and appropriate treatment for DDH are of the utmost importance. With the modification of techniques like pelvic osteotomy and capsular arthroplasty, and the introduction of intracapsular procedures such as arthroscopy and femoral head-neck junction osteochondroplasty, many young patients with symptomatic hip dysplasia may benefit from joint preservation procedures. We review the current development of these concepts and the associated surgical techniques.

Wenger DR (2013) Is there a role for acetabular dysplasia correction in an asymptomatic patient? J Pediatr Orthop 33(Suppl 1):S8–S12CrossRefPubMed

Papachristou G, Hatzigrigoris P, Panousis K, Plessas S, Sourlas J et al (2006) Total hip arthroplasty for developmental hip dysplasia. Int Orthop 30:21–25CrossRefPubMedPubMedCentral

Lachiewicz PF, McCaskill B, Inglis A, Ranawat CS, Rosenstein BD (1986) Total hip arthroplasty in juvenile rheumatoid arthritis. Two to eleven-year results. J Bone Joint Surg Am 68:502–508PubMed

Bessette BJ, Fassier F, Tanzer M, Brooks CE (2003) Total hip arthroplasty in patients younger than 21 years: a minimum, 10-year follow-up. Can J Surg 46:257–262PubMedPubMedCentral

Warth LC, Callaghan JJ, Liu SS, Klaassen AL, Goetz DD et al (2014) Thirty-five-year results after Charnley total hip arthroplasty in patients less than fifty years old: a concise follow-up of previous reports. J Bone Joint Surg Am 96:1814–1819CrossRefPubMed

Mast JW, Brunner RL, Zebrack J (2004) Recognizing acetabular version in the radiographic presentation of hip dysplasia. Clin Orthop Relat Res 48–53

Robertson DD, Essinger JR, Imura S, Kuroki Y, Sakamaki T et al (1996) Femoral deformity in adults with developmental hip dysplasia. Clin Orthop Relat Res 196–206

Steppacher SD, Tannast M, Werlen S, Siebenrock KA (2008) Femoral morphology differs between deficient and excessive acetabular coverage. Clin Orthop Relat Res 466:782–790CrossRefPubMedPubMedCentral

Sanchez-Sotelo J, Berry DJ, Trousdale RT, Cabanela ME (2002) Surgical treatment of developmental dysplasia of the hip in adults: II. Arthroplasty options. J Am Acad Orthop Surg 10:334–344CrossRefPubMed

10.

Sucato DJ (2006) Treatment of late dysplasia with Ganz osteotomy. Orthop Clin N Am 37(161–171):vi

11.

Notzli HP, Muller SM, Ganz R (2001) The relationship between fovea capitis femoris and weight bearing area in the normal and dysplastic hip in adults: a radiologic study. Z Orthop Ihre Grenzgeb 139:502–506CrossRefPubMed

12.

Haddad FS, Garbuz DS, Duncan CP, Janzen DL, Munk PL (2000) CT evaluation of periacetabular osteotomies. J Bone Joint Surg (Br) 82:526–531CrossRef

13.

Anda S, Svenningsen S, Dale LG, Benum P (1986) The acetabular sector angle of the adult hip determined by computed tomography. Acta Radiol Diagn (Stockh) 27:443–447

14.

Crowe JF, Mani VJ, Ranawat CS (1979) Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 61:15–23PubMed

15.

Hartofilakidis G, Stamos K, Ioannidis TT (1988) Low friction arthroplasty for old untreated congenital dislocation of the hip. J Bone Joint Surg (Br) 70:182–186

16.

Rogers BA, Garbedian S, Kuchinad RA, Backstein D, Safir O et al (2012) Total hip arthroplasty for adult hip dysplasia. J Bone Joint Surg Am 94:1809–1821CrossRefPubMed

17.

Hartofilakidis G, Yiannakopoulos CK, Babis GC (2008) The morphologic variations of low and high hip dislocation. Clin Orthop Relat Res 466:820–824CrossRefPubMedPubMedCentral

18.

Ganz R, Klaue K, Vinh TS, Mast JW (1988) A new periacetabular osteotomy for the treatment of hip dysplasias. Technique and preliminary results. Clin Orthop Relat Res 26–36

19.

Ganz R, Slongo T, Siebenrock KA, Turchetto L, Leunig M (2012) Surgical technique: the capsular arthroplasty: a useful but abandoned procedure for young patients with developmental dysplasia of the hip. Clin Orthop Relat Res 470:2957–2967CrossRefPubMedPubMedCentral

20.

Ganz R, Gill TJ, Gautier E, Ganz K, Krugel N et al (2001) Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg (Br) 83:1119–1124CrossRef

21.

Ganz R, Parvizi J, Beck M, Leunig M, Notzli H et al (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 112–120

22.

Kim KI, Cho YJ, Ramteke AA, Yoo MC (2011) Peri-acetabular rotational osteotomy with concomitant hip arthroscopy for treatment of hip dysplasia. J Bone Joint Surg (Br) 93:732–737CrossRef

23.

Albers CE, Steppacher SD, Ganz R, Tannast M, Siebenrock KA (2013) Impingement adversely affects 10-year survivorship after periacetabular osteotomy for DDH. Clin Orthop Relat Res 471:1602–1614CrossRefPubMedPubMedCentral

24.

Parvizi J, Bican O, Bender B, Mortazavi SM, Purtill JJ et al (2009) Arthroscopy for labral tears in patients with developmental dysplasia of the hip: a cautionary note. J Arthroplasty 24:110–113CrossRefPubMed

25.

Wenger DE, Kendell KR, Miner MR, Trousdale RT (2004) Acetabular labral tears rarely occur in the absence of bony abnormalities. Clin Orthop Relat Res (426):145–150

26.

Clohisy JC, Beaule PE, O’Malley A, Safran MR, Schoenecker P (2008) AOA symposium. Hip disease in the young adult: current concepts of etiology and surgical treatment. J Bone Joint Surg Am 90:2267–2281CrossRefPubMed

27.

Kain MS, Novais EN, Vallim C, Millis MB, Kim YJ (2011) Periacetabular osteotomy after failed hip arthroscopy for labral tears in patients with acetabular dysplasia. J Bone Joint Surg Am 93(Suppl 2):57–61CrossRefPubMed

28.

Lian Y, Lian X, Lu D, Zhou Y, Wang K et al (2011) Treatment of adult developmental dysplasia of the hip by rotational acetabular osteotomy combined with debridement under arthroscope. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 25:821–825PubMed

29.

Perry KI, Trousdale RT, Sierra RJ (2013) Hip dysplasia in the young adult: an osteotomy solution. Bone Joint J 95-b:21–25CrossRefPubMed

30.

Clohisy JC, Barrett SE, Gordon JE, Delgado ED, Schoenecker PL (2006) Periacetabular osteotomy in the treatment of severe acetabular dysplasia. Surgical technique. J Bone Joint Surg Am 88(Suppl 1 Pt 1):65–83PubMed

31.

Hussell JG, Rodriguez JA, Ganz R (1999) Technical complications of the Bernese periacetabular osteotomy. Clin Orthop Relat Res 81–92

32.

Matheney T, Kim YJ, Zurakowski D, Matero C, Millis M (2009) Intermediate to long-term results following the Bernese periacetabular osteotomy and predictors of clinical outcome. J Bone Joint Surg Am 91:2113–2123CrossRefPubMed

33.

Tonnis D (1976) Normal values of the hip joint for the evaluation of X-rays in children and adults. Clin Orthop Relat Res 39–47

34.

Leunig M, Siebenrock KA, Ganz R (2001) Rationale of periacetabular osteotomy and background work. Instr Course Lect 50:229–238PubMed

35.

Loder RT, Karol LA, Johnson S (1993) Influence of pelvic osteotomy on birth canal size. Arch Orthop Trauma Surg 112:210–214CrossRefPubMed

36.

Trousdale RT, Cabanela ME, Berry DJ, Wenger DE (2002) Magnetic resonance imaging pelvimetry before and after a periacetabular osteotomy. J Bone Joint Surg Am 84-a:552–556PubMed

37.

Beck M, Leunig M, Ellis T, Sledge JB, Ganz R (2003) The acetabular blood supply: implications for periacetabular osteotomies. Surg Radiol Anat 25:361–367CrossRefPubMed

38.

Clohisy JC, Schutz AL, St John L, Schoenecker PL, Wright RW (2009) Periacetabular osteotomy: a systematic literature review. Clin Orthop Relat Res 467:2041–2052CrossRefPubMedPubMedCentral

39.

Trousdale RT, Ekkernkamp A, Ganz R, Wallrichs SL (1995) Periacetabular and intertrochanteric osteotomy for the treatment of osteoarthrosis in dysplastic hips. J Bone Joint Surg Am 77:73–85PubMed

40.

Troelsen A, Elmengaard B, Soballe K (2009) Medium-term outcome of periacetabular osteotomy and predictors of conversion to total hip replacement. J Bone Joint Surg Am 91:2169–2179CrossRefPubMed

41.

Zhu J, Chen X, Cui Y, Shen C, Cai G (2013) Mid-term results of Bernese periacetabular osteotomy for developmental dysplasia of hip in middle aged patients. Int Orthop 37:589–594CrossRefPubMedPubMedCentral

42.

Beaule PE, Dowding C, Parker G, Ryu JJ (2015) What factors predict improvements in outcomes scores and reoperations after the Bernese periacetabular osteotomy? Clin Orthop Relat Res 473:615-622

43.

Steppacher SD, Tannast M, Ganz R, Siebenrock KA (2008) Mean 20-year followup of Bernese periacetabular osteotomy. Clin Orthop Relat Res 466:1633–1644CrossRefPubMedPubMedCentral

44.

Sucato DJ, Tulchin K, Shrader MW, DeLaRocha A, Gist T et al (2010) Gait, hip strength and functional outcomes after a Ganz periacetabular osteotomy for adolescent hip dysplasia. J Pediatr Orthop 30:344–350CrossRefPubMed

45.

Matheney T, Kim YJ, Zurakowski D, Matero C, Millis M (2010) Intermediate to long-term results following the Bernese periacetabular osteotomy and predictors of clinical outcome: surgical technique. J Bone Joint Surg Am 92(Suppl 1 Pt 2):115–129PubMed

46.

Garras DN, Crowder TT, Olson SA (2007) Medium-term results of the Bernese periacetabular osteotomy in the treatment of symptomatic developmental dysplasia of the hip. J Bone Joint Surg (Br) 89:721–724CrossRef

47.

Matta JM, Stover MD, Siebenrock K (1999) Periacetabular osteotomy through the Smith-Petersen approach. Clin Orthop Relat Res 21–32

48.

Siebenrock KA, Scholl E, Lottenbach M, Ganz R (1999) Bernese periacetabular osteotomy. Clin Orthop Relat Res (363):9–20

49.

Trumble SJ, Mayo KA, Mast JW (1999) The periacetabular osteotomy. Minimum 2 year followup in more than 100 hips. Clin Orthop Relat Res (363):54–63

50.

Clohisy JC, Barrett SE, Gordon JE, Delgado ED, Schoenecker PL (2005) Periacetabular osteotomy for the treatment of severe acetabular dysplasia. J Bone Joint Surg Am 87:254–259CrossRefPubMed

51.

Cunningham T, Jessel R, Zurakowski D, Millis MB, Kim YJ (2006) Delayed gadolinium-enhanced magnetic resonance imaging of cartilage to predict early failure of Bernese periacetabular osteotomy for hip dysplasia. J Bone Joint Surg Am 88:1540–1548CrossRefPubMed

52.

Peters CL, Erickson JA, Hines JL (2006) Early results of the Bernese periacetabular osteotomy: the learning curve at an academic medical center. J Bone Joint Surg Am 88:1920–1926CrossRefPubMed

53.

Beck M, Kalhor M, Leunig M, Ganz R (2005) Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg (Br) 87:1012–1018CrossRef

54.

Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K et al (2002) The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg (Br) 84:556–560CrossRef

55.

Beaule PE, Harvey N, Zaragoza E, Le Duff MJ, Dorey FJ (2007) The femoral head/neck offset and hip resurfacing. J Bone Joint Surg (Br) 89:9–15CrossRef

56.

Nassif NA, Schoenecker PL, Thorsness R, Clohisy JC (2012) Periacetabular osteotomy and combined femoral head-neck junction osteochondroplasty: a minimum two-year follow-up cohort study. J Bone Joint Surg Am 94:1959–1966CrossRefPubMed

57.

Ida T, Nakamura Y, Hagio T, Naito M (2014) Prevalence and characteristics of cam-type femoroacetabular deformity in 100 hips with symptomatic acetabular dysplasia: a case control study. J Orthop Surg Res 9:93CrossRefPubMedPubMedCentral

58.

Clohisy JC, Nunley RM, Carlisle JC, Schoenecker PL (2009) Incidence and characteristics of femoral deformities in the dysplastic hip. Clin Orthop Relat Res 467:128–134CrossRefPubMedPubMedCentral

59.

Myers SR, Eijer H, Ganz R (1999) Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res (363):93–99

60.

Espinosa N, Rothenfluh DA, Beck M, Ganz R, Leunig M (2006) Treatment of femoro-acetabular impingement: preliminary results of labral refixation. J Bone Joint Surg Am 88:925–935CrossRefPubMed

61.

Turgeon TR, Phillips W, Kantor SR, Santore RF (2005) The role of acetabular and femoral osteotomies in reconstructive surgery of the hip. Clin Orthop Relat Res 441:188–199CrossRefPubMed

62.

Ansari A, Jones S, Hashemi-Nejad A, Catterall A (2008) Varus proximal femoral osteotomy for hip dysplasia in adults. Hip Int 18:200–206PubMed

63.

Koulouvaris P, Stafylas K, Aznaoutoglou C, Zacharis K, Xenakis T (2007) Isolated varus intertrochanteric osteotomy for hip dysplasia in 52 patients: long-term results. Int Orthop 31:193–198CrossRefPubMedPubMedCentral

64.

Ito H, Matsuno T, Minami A (2005) Intertrochanteric varus osteotomy for osteoarthritis in patients with hip dysplasia: 6 to 28 years followup. Clin Orthop Relat Res 124–128

65.

Boos N, Krushell R, Ganz R, Muller ME (1997) Total hip arthroplasty after previous proximal femoral osteotomy. J Bone Joint Surg (Br) 79:247–253CrossRef

66.

Haverkamp D, de Jong PT, Marti RK (2006) Intertrochanteric osteotomies do not impair long-term outcome of subsequent cemented total hip arthroplasties. Clin Orthop Relat Res 444:154–160CrossRefPubMed

67.

Roposch A, Liu LQ, Hefti F, Clarke NM, Wedge JH (2011) Standardized diagnostic criteria for developmental dysplasia of the hip in early infancy. Clin Orthop Relat Res 469:3451–3461CrossRefPubMedPubMedCentral

68.

Karmazyn BK, Gunderman RB, Coley BD, Blatt ER, Bulas D et al (2009) ACR Appropriateness Criteria on developmental dysplasia of the hip—child. J Am Coll Radiol 6:551–557CrossRefPubMed

69.

Graf R (2007) Hip sonography: 20 years experience and results. Hip Int 17(Suppl 5):S8–S14PubMed

70.

Edwards BN, Tullos HS, Noble PC (1987) Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty. Clin Orthop Relat Res (218):136–141

71.

Chung SM, Scholl HW Jr, Ralston EL, Pendergrass EP (1971) The colonna capsular arthroplasty. A long-term follow-up study of fifty-six patients. J Bone Joint Surg Am 53:1511–1527PubMed

72.

Glass A, Dunningham TH (1980) Capsular arthroplasty of the hip for congenital dislocation. Isr J Med Sci 16:328–332PubMed

73.

Ganz R, Huff TW, Leunig M (2009) Extended retinacular soft-tissue flap for intra-articular hip surgery: surgical technique, indications, and results of application. Instr Course Lect 58:241–255PubMed

74.

Pogliacomi F, Stark A, Wallensten R (2005) Periacetabular osteotomy. Good pain relief in symptomatic hip dysplasia, 32 patients followed for 4 years. Acta Orthop 76:67–74CrossRefPubMed

75.

Leunig M, Ganz R (2014) The evolution and concepts of joint-preserving surgery of the hip. Bone Joint J 96-B:5–18CrossRefPubMed

Title: Surgical treatment for young adult hip dysplasia: joint-preserving options
Authors: Min Chen
Xi-Fu Shang
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 5/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-015-2927-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical treatment for young adult hip dysplasia: joint-preserving options

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2016

Infectious risk for suicide bomber attack victims: management of penetrative wounds in French Army personnel

Assessment of fixation in cementless femoral revision of total hip arthroplasty: comparison of the Engh score versus radiolucent line measurement

Reverse shoulder prosthesis in patients with rheumatoid arthritis: a systematic review

Transection of the deep metatarsal transverse ligament in Morton’s neuroma surgery does not increase risk of splayfoot development

The Vienna and German heritage of orthopaedics from the first half of the twentieth century: Adolf Lorenz, Lorenz Böhler, Friedrich Pauwels, Gerhard Küntscher

One-stage revision of infected hip arthroplasty: outcome of 39 consecutive hips