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Prediction of time to prosthesis implantation as a function of joint anatomy in patients with developmental dysplasia of the hip
BACKGROUND: Developmental dysplasia of the hip (DDH) can lead to pain and premature secondary osteoarthritis at an early stage. Joint-preserving osteotomy is an established solution to this problem. In contrast, a conservative approach would result in pain persistence, ultimately raising the patient...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936128/ https://www.ncbi.nlm.nih.gov/pubmed/31888687 http://dx.doi.org/10.1186/s13018-019-1511-4 |
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author | Müller, Michael Rakow, Anasthasia Wassilew, Georgi I. Winkler, Tobias Perka, Carsten |
author_facet | Müller, Michael Rakow, Anasthasia Wassilew, Georgi I. Winkler, Tobias Perka, Carsten |
author_sort | Müller, Michael |
collection | PubMed |
description | BACKGROUND: Developmental dysplasia of the hip (DDH) can lead to pain and premature secondary osteoarthritis at an early stage. Joint-preserving osteotomy is an established solution to this problem. In contrast, a conservative approach would result in pain persistence, ultimately raising the patients question for a possible date of expected prosthesis implantation. The aim of the study was to identify the relationship between the dysplastic hip anatomy and the time of prosthesis implantation in order to enable prognostic predictions in younger patients with symptomatic DDH. MATERIALS AND METHODS: Data from 129 hips who received THA due to secondary DDH osteoarthritis were evaluated. The preoperative hip anatomy was evaluated for AI and LCE angle. Multiple linear regression analyses were then used to correlate the influence of these parameters with the patient’s age at the time of surgery. In addition, a graphical relationship was derived by the method of power least squares curve fitting with second-degree polynomials. RESULTS: The mean age for THA was 54.3 ± 11 years. The time of surgery correlated significantly with LCE (0.37) and AI (− 0.3) (p < 0.001). The mean age of patients with LCE angle ≤ 10° was 41.9 ± 14.0 years, for LCE 11–20° 52.7 ± 9.5 years, and for LCE 21–30° 57.0 ± 10.3 years. The following formula could then be determined for the calculation of the potential patient age at the time of THA as a function of LCE angle: age pTHA = 40.2 + 0.8 × LCE angle − 0.01 × (LCE angle)(2). CONCLUSION: A significant correlation between the extent of dysplasia and the time of prosthesis implantation was identified. In particular, the LCE and the AI correlated strongly with the time of implantation. The more dysplastic the angles were, the sooner the THA was necessary. Using the calculations presented in this study, the probable age of prosthesis implantation can be prognosticated and included in a counseling session about treatment options for DDH. |
format | Online Article Text |
id | pubmed-6936128 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-69361282019-12-31 Prediction of time to prosthesis implantation as a function of joint anatomy in patients with developmental dysplasia of the hip Müller, Michael Rakow, Anasthasia Wassilew, Georgi I. Winkler, Tobias Perka, Carsten J Orthop Surg Res Research Article BACKGROUND: Developmental dysplasia of the hip (DDH) can lead to pain and premature secondary osteoarthritis at an early stage. Joint-preserving osteotomy is an established solution to this problem. In contrast, a conservative approach would result in pain persistence, ultimately raising the patients question for a possible date of expected prosthesis implantation. The aim of the study was to identify the relationship between the dysplastic hip anatomy and the time of prosthesis implantation in order to enable prognostic predictions in younger patients with symptomatic DDH. MATERIALS AND METHODS: Data from 129 hips who received THA due to secondary DDH osteoarthritis were evaluated. The preoperative hip anatomy was evaluated for AI and LCE angle. Multiple linear regression analyses were then used to correlate the influence of these parameters with the patient’s age at the time of surgery. In addition, a graphical relationship was derived by the method of power least squares curve fitting with second-degree polynomials. RESULTS: The mean age for THA was 54.3 ± 11 years. The time of surgery correlated significantly with LCE (0.37) and AI (− 0.3) (p < 0.001). The mean age of patients with LCE angle ≤ 10° was 41.9 ± 14.0 years, for LCE 11–20° 52.7 ± 9.5 years, and for LCE 21–30° 57.0 ± 10.3 years. The following formula could then be determined for the calculation of the potential patient age at the time of THA as a function of LCE angle: age pTHA = 40.2 + 0.8 × LCE angle − 0.01 × (LCE angle)(2). CONCLUSION: A significant correlation between the extent of dysplasia and the time of prosthesis implantation was identified. In particular, the LCE and the AI correlated strongly with the time of implantation. The more dysplastic the angles were, the sooner the THA was necessary. Using the calculations presented in this study, the probable age of prosthesis implantation can be prognosticated and included in a counseling session about treatment options for DDH. BioMed Central 2019-12-30 /pmc/articles/PMC6936128/ /pubmed/31888687 http://dx.doi.org/10.1186/s13018-019-1511-4 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Müller, Michael Rakow, Anasthasia Wassilew, Georgi I. Winkler, Tobias Perka, Carsten Prediction of time to prosthesis implantation as a function of joint anatomy in patients with developmental dysplasia of the hip |
title | Prediction of time to prosthesis implantation as a function of joint anatomy in patients with developmental dysplasia of the hip |
title_full | Prediction of time to prosthesis implantation as a function of joint anatomy in patients with developmental dysplasia of the hip |
title_fullStr | Prediction of time to prosthesis implantation as a function of joint anatomy in patients with developmental dysplasia of the hip |
title_full_unstemmed | Prediction of time to prosthesis implantation as a function of joint anatomy in patients with developmental dysplasia of the hip |
title_short | Prediction of time to prosthesis implantation as a function of joint anatomy in patients with developmental dysplasia of the hip |
title_sort | prediction of time to prosthesis implantation as a function of joint anatomy in patients with developmental dysplasia of the hip |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936128/ https://www.ncbi.nlm.nih.gov/pubmed/31888687 http://dx.doi.org/10.1186/s13018-019-1511-4 |
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