Search

Residual acetabular dysplasia in children after reduction of hip dislocation is often treated using Salter innominate osteotomy to prevent future osteoarthritis. Preventive surgery for asymptomatic patients, which could result in overtreatment, should be carefully applied with consideration of patients' opinions. In this study, we aimed to describe opinions on Salter innominate osteotomy as preventive surgery for children among adult patients who had undergone periacetabular osteotomy for hip pain due to hip dysplasia. A mail-in questionnaire survey was conducted with 77 patients who underwent periacetabular osteotomy. Participants responded whether they would recommend Salter innominate osteotomy as preventive surgery for children and the reason for their opinion. We also performed a patient-based evaluation using the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire and assessed clinical outcome measures with the Japanese Orthopedic Association score. Their recommendations and reasons were evaluated, and associations between their opinions and demographic and clinical characteristics were analyzed. Forty-three patients (56%) responded to the questionnaire. Of these, 10 (23%) patients recommended undergoing Salter innominate osteotomy, 28 (65%) patients did not, and 5 (12%) patients responded they were undecided. No significant association was observed between their opinions and demographic/clinical characteristics evaluated in the survey. The most frequent reason for why they do not recommend Salter innominate osteotomy was related to uncertainty about future hip pain. In total, 65% of the study participants did not recommend Salter innominate osteotomy for children with risk of dysplasia in the future. Participants' preferences regarding preventive surgery were not influenced by demographic and clinical characteristics. [ABSTRACT FROM AUTHOR]

Purpose: Femoroacetabular impingement is a new disease concept for hip disorders in young adults suggested as a major cause of primary hip osteoarthritis in Western countries. However, significant controversy exists regarding the prevalence and contribution of impingement deformities to osteoarthritis in Japan, owing to the higher prevalence of developmental dysplasia of the hip. Therefore, the aims of this study were to: (1) determine the prevalence of structural abnormalities associated with hip disorders in patients undergoing total hip replacement and (2) analyse the contribution of impingement deformities to osteoarthritis. Methods: We analysed 250 patients from two different medical centres who underwent primary total hip replacement except those which were due to femoral head necrosis, posttraumatic osteoarthritis and systemic inflammatory disease. The average patient age at surgery was 64 years (range, 40-89 years), with 35 men and 215 women. Results: Radiographic abnormality related to developmental dysplasia of the hip was associated with the majority of osteoarthritic hips (62 %). Hips with femoroacetabular impingement deformities were present within the cases categorized as unknown etiology. Cam impingement deformity was present in 22 % of unknown aetiology cases when cases with reactive osteophytes were excluded from all cam deformity cases (pistol grip deformity and aspherical femoral heads). Conclusions: The prevalence of femoroacetabular impingement within primary osteoarthritis cases and gender predominance of impingement deformities are relatively similar to those reported previously in Western populations. This finding indicates that femoroacetabular impingement deformities are associated with osteoarthritis in the Japanese population, although it has a lower frequency among all hip failure patients. [ABSTRACT FROM AUTHOR]

Summary: Bone mineral density (BMD) of the lumbar spine, ultradistal radius, and calcaneus were significantly higher in the developmental dysplasia of the hip (DDH) patients than in the controls. Therefore, our data suggest that BMDs at different skeletal sites are greater in patients with DDH than in healthy women. Introduction: DDH has been acknowledged as a potentially preosteoarthritic condition that results in the development of hip osteoarthritis. Patients with DDH have been reported to have abnormal morphology of the pelvis and spine. Additional research, including that of bone quality, needs to be conducted to elucidate the pathogenetic mechanism of this disease. We therefore sought to determine whether BMD differs between healthy women and women with DDH. Methods: We measured BMD in 40 women who were scheduled to undergo pelvic osteotomy for DDH (average age, 45.3 years) and in 31 healthy women used as age-matched controls (average age, 47.5 years). BMDs of the lumbar spine, radius, and calcaneus were measured. Results: BMDs of the lumbar spine, ultradistal radius, and calcaneus were significantly higher in the DDH patients than in the controls. Conclusions: Therefore, our data suggest that BMDs at different skeletal sites are greater in patients with DDH than in healthy women. [ABSTRACT FROM AUTHOR]