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Cook JL, Rucinski K, Wissman R, Crecelius C, DeFroda S, Crist BD. Outcomes following open acetabular labrum reconstruction: Comparing fresh-frozen tendon with fresh meniscus allograft transplantation. J Orthop 2024; 53:13-19. [PMID: 38450061 PMCID: PMC10912234 DOI: 10.1016/j.jor.2024.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 03/08/2024] Open
Abstract
Background Symptomatic acetabular labral insufficiency in young, active patients is often treated with labral repair or reconstruction using fresh-frozen allografts. However, fresh-frozen tendon allografts do not have tissue or material properties that closely mimic acetabular labral fibrocartilage. Recent studies suggest meniscal allografts may be a better biomechanical, geometric, and material alternative for acetabular labrum reconstruction (ALR). Hypothesis Patients undergoing open ALR using fresh meniscus allograft transplants (MAT) will have better outcomes than those using fresh-frozen tendon allografts transplants (TAT) when comparing initial treatment success, diagnostic imaging assessments, and patient-reported pain and function scores. Study design Cohort Study. Methods With IRB approval, patients undergoing ALR with either TAT or MAT were included when initial (>1-year) outcomes data related to treatment success, pain, and function were available. In addition, a subcohort of patients underwent magnetic resonance imaging at least 6-months after surgery to evaluate allograft healing. Results Initial success rate, defined as no need for ALR revision or conversion to total hip arthroplasty (THA), was 88.9% for the entire group (n = 27, TAT = 5, MAT = 22) with 1 (20%) patient in the TAT cohort and 2 patients (9.9%) in the MAT cohort undergoing THA. In the MAT cohort, significant improvements were documented for physical function and pain scores at 1 year and final follow-up (FFU)(mean 26.8 months). Improvements in pain and function were noted at 1-year, but not at FFU (mean 59.6 months) in the TAT group. MRIs completed at least 6 months after labrum reconstruction showed improved allograft integrity and integration in the MAT cohort over the TAT cohort. Conclusion For acetabular labrum reconstructions, MAT was associated with a higher initial success rate, superior patient reported outcomes, and subjectively better MRI findings when compared to TAT.
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Affiliation(s)
- James L. Cook
- Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, USA
| | - Kylee Rucinski
- Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, USA
| | - Robert Wissman
- Department of Radiology, University of Missouri, Columbia, MO, USA
| | - Cory Crecelius
- Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA
| | - Steven DeFroda
- Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, USA
| | - Brett D. Crist
- Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, USA
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Metz AK, Lewis DC, Froerer DL, Featherall J, Rosenthal RM, Khalil AZ, Aoki SK. Dysplastic Hips Have Decreased Iliofemoral Ligament Thickness on Coronal Sequences in Magnetic Resonance Imaging: A Matched Cohort Analysis. Arthroscopy 2024:S0749-8063(24)00417-1. [PMID: 38944323 DOI: 10.1016/j.arthro.2024.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/18/2024] [Accepted: 05/30/2024] [Indexed: 07/01/2024]
Abstract
PURPOSE To characterize hip capsule thickness on advanced imaging in patients with and without hip dysplasia and to also evaluate differences in capsular thickness between borderline and true dysplastic patients. METHODS Patients evaluated by the senior author for concerns of hip pathology from June 2020 to June 2021 were queried and images reviewed to determine dysplasia status by lateral center edge angle (LCEA) ≤ 25 degrees. A group of non-dysplastic patients was identified and matched for age, sex, and body mass index (BMI). Hip capsular thickness was quantified using MRI. A sub-analysis was conducted to compare true dysplastic patients (LCEA < 20°) to borderline dysplastic patients (LCEAs between 20 - 25°). Analysis included independent samples t-tests, Chi-square tests, and multivariable regression. RESULTS Eighty total patients were included, with a mean age of 31.8 ± 11.7 years, a mean BMI of 26.6 ± 6.5 points, and 70% (56) female patients. Dysplastic patients had a mean LCEA of 19.8 ± 4.3 degrees. Dysplastic individuals had decreased capsular thickness compared to their non-dysplastic controls (2.75 ± 0.96 vs 3.52 ± 1.22 mm, p = 0.003). Multivariable regression showed decreased capsular thickness associated with decreased LCEAs (β = 2.804, R = 0.432, p<0.001) and dysplasia (β = -0.709, R2 = 0.056, p = 0.004). Results of a sub-analysis of the dysplastic group examining differences between accepted definitions of borderline dysplasia and true dysplasia showed no significant differences in capsular thickness between the two groups (p = 0.379). CONCLUSIONS Patients with hip dysplasia were found to have thinner iliofemoral ligaments in the coronal plane on magnetic resonance imaging on magnetic resonance imaging. Further investigation is needed to evaluate any potential implications with hip instability given the thinner hip capsule demonstrated in this study.
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Affiliation(s)
- Allan K Metz
- University of Utah, Department of Orthopaedic Surgery, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Daniel C Lewis
- University of Utah, Department of Orthopaedic Surgery, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Devin L Froerer
- University of Utah, Department of Orthopaedic Surgery, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Joseph Featherall
- University of Utah, Department of Orthopaedic Surgery, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Reece M Rosenthal
- University of Utah, Department of Orthopaedic Surgery, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Ameen Z Khalil
- School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Stephen K Aoki
- University of Utah, Department of Orthopaedic Surgery, 590 Wakara Way, Salt Lake City, UT 84108, USA.
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Chen K, Wu J, Zhang X, Han X, Li T, Xia J, Shen C, Chen X. A Modified Approach to Measuring Femoro-Epiphyseal Acetabular Roof Index Has Better Intraobserver and Interobserver Reliability Compared With the Original Femoro-Epiphyseal Acetabular Roof Index. Arthroscopy 2024; 40:1807-1815. [PMID: 38056725 DOI: 10.1016/j.arthro.2023.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 10/29/2023] [Accepted: 11/19/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE To propose a modified approach to measuring the femoro-epiphyseal acetabular roof (FEAR) index while still abiding by its definition and biomechanical basis, and to compare the intra- and interobserver reliabilities of the original and the modified FEAR index. To propose a classification for medial sourcil edges. METHODS We retrospectively reviewed a consecutive series of patients treated with periacetabular osteotomy and/or hip arthroscopy at a single institute. Patients with unilateral or bilateral symptomatic borderline hip(s) were included. Hips with remarkable osteoarthritis, deformities, history of previous surgery, or without symptoms were excluded. A modified FEAR index was defined using a best-fit circle to determine the sourcil line and 2 ancillary lines connecting femoral head and sourcil edges to determine epiphyseal line. Lateral center-edge angle, Sharp angle, Tönnis angle on all hips, as well as FEAR index with original and modified approaches, were measured. Intra- and interobserver reliability were calculated as intraclass correlation coefficients (ICCs) for the FEAR index with both approaches and other alignments. A classification was proposed to categorize medial sourcil edges. ICCs for the 2 approaches across different sourcil groups also were calculated. RESULTS After we reviewed 411 patients, 49 were finally included. Thirty-two patients (40 hips) were identified as having borderline dysplasia defined by a lateral center-edge angle of 18 to 25°. Intraobserver ICCs for the modified method were good to excellent for borderline hips; poor to excellent for developmental dysplasia of the hip; and moderate to excellent for normal hips. As for interobserver reliability, the modified approach outperformed original approach with moderate-to-good interobserver reliability (developmental dysplasia of the hip group, ICC = 0.650; borderline dysplasia group, ICC = 0.813; normal hip group, ICC = 0.709). The medial sourcil edge was classified to 3 groups upon its morphology. Type II (39.0%) and III (43.9%) sourcil were the dominant patterns. The sourcil classification had substantial intraobserver agreement (observer 4, kappa = 0.68; observer 1, kappa = 0.799) and moderate interobserver agreement (kappa = 0.465). The modified approach to FEAR index possessed greater interobserver reliability in all medial sourcil edge patterns. CONCLUSIONS The modified FEAR index has better intra- and interobserver reliability compared with the original approach in all hip groups and sourcil groups. Type II and III sourcil types account for the majority, to which the modified approach is better. LEVEL OF EVIDENCE Level II, development of diagnostic criteria (consecutive patients with consistently applied reference standard and blinding).
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Affiliation(s)
- Kangming Chen
- Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jinyan Wu
- Department of Orthopaedics, Xinhua Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, People's Republic of China
| | - Xinhai Zhang
- Department of Orthopaedics, Xinhua Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, People's Republic of China
| | - Xiuguo Han
- Department of Orthopaedics, Xinhua Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, People's Republic of China
| | - Tao Li
- Department of Orthopaedics, Xinhua Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, People's Republic of China
| | - Jun Xia
- Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Chao Shen
- Department of Orthopaedics, Xinhua Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, People's Republic of China
| | - Xiaodong Chen
- Department of Orthopaedics, Xinhua Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, People's Republic of China.
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Woodward RM, Lightfoot NJ, Vesey RM, van Dijck SA, Munro JT, Boyle MJ. Hip dysplasia hiding in plain sight: A retrospective analysis of radiology reports. J Med Imaging Radiat Oncol 2024; 68:26-32. [PMID: 37654031 DOI: 10.1111/1754-9485.13583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/19/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Timely recognition of dysplastic hip morphology is critical to facilitate appropriate management before significant joint damage has developed. It is likely that radiologist under reporting contributes to delays in diagnosis. This study aimed to assess how often adult hip dysplasia goes undetected in radiological reports and to identify clinical and radiological variables that impact the likelihood of detection of dysplasia by radiologists. METHODS Referral details and radiology reports of patients who underwent periacetabular osteotomy by a single surgeon for symptomatic hip dysplasia between 1 January 2016 and 30 June 2020 were reviewed. Four assessors measured the lateral centre edge angle from the pelvic radiograph performed at time of referral. Film quality and other radiographic parameters were also assessed. RESULTS Sixty-eight patients were included, 84% were female and the median age was 28.1 years. Dysplasia was not documented in the radiology report in 49% of cases. Dysplasia was more likely to be reported with no history of injury, an aspherical femoral head, lower lateral centre edge angle, higher acetabular index, increased femoral head shaft angle, higher femoro-epiphyseal acetabular roof index, or if there was disruption of Shenton's line, with the first three variables being independent predictors of radiologist detection. CONCLUSION Hip dysplasia should be considered in all adolescents/young adults presenting with hip pain. Causes of radiologist under reporting are likely multifactorial. Clinical information can cause cognitive biases and result in selective looking. A systematic approach to pelvis radiographs should include assessment of acetabular coverage and active search for evidence of femoral head migration.
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Affiliation(s)
- Rebecca M Woodward
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Auckland Radiology Group, Auckland, New Zealand
| | - Nicholas J Lightfoot
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Anaesthesia and Pain Medicine, Middlemore Hospital, Auckland, New Zealand
| | - Renuka M Vesey
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Stephanie A van Dijck
- Department of Orthopaedic Surgery, Starship Children's Hospital, Auckland, New Zealand
| | - Jacob T Munro
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Orthopaedic Surgery, Auckland City Hospital, Auckland, New Zealand
| | - Matthew J Boyle
- Department of Orthopaedic Surgery, Starship Children's Hospital, Auckland, New Zealand
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Kim JS, Agricola R, Kim YJ, Lane NE, Millis MB, Nelson AE, Runhaar J, Shefelbine SJ, Bostrom MP. Arthritis Foundation/HSS Workshop on Hip Osteoarthritis, Part 1: Epidemiology, Early Development, and Cohorts From Around the World. HSS J 2023; 19:395-401. [PMID: 37937080 PMCID: PMC10626936 DOI: 10.1177/15563316231189748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 11/09/2023]
Abstract
Far more publications are available for osteoarthritis of the knee than of the hip. Recognizing this research gap, the Arthritis Foundation, in partnership with the Hospital for Special Surgery, convened an in-person meeting of thought leaders to review the state of the science of and clinical approaches to hip osteoarthritis. This article summarizes the recommendations and clinical research gaps gleaned from 5 presentations given in the "how hip osteoarthritis begins" session of the 2023 Hip Osteoarthritis Clinical Studies Conference, which took place on February 17 and 18, 2023, in New York City.
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Affiliation(s)
| | - Rintje Agricola
- Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Young-Jo Kim
- Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Nancy E Lane
- Department of Medicine and Rheumatology, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Michael B Millis
- Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Amanda E Nelson
- Division of Rheumatology, Allergy, and Immunology, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jos Runhaar
- Department of General Practice, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sandra J Shefelbine
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, USA
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DeFroda SF, Crist B, Cook JL. Arthroscopic Hip Labral Reconstruction With Fresh Meniscal Allograft. Arthrosc Tech 2023; 12:e813-e821. [PMID: 37424660 PMCID: PMC10323673 DOI: 10.1016/j.eats.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/11/2023] [Indexed: 07/11/2023] Open
Abstract
The acetabular labrum is essential to maintaining the functional health of the hip joint through contributions to joint congruity, stability, and the negative pressure suction seal. Injury, overuse, long-standing developmental disorders, or failed primary labral repair can eventually lead to functional labral insufficiency requiring management via labral reconstruction. While numerous graft options exist for hip labral reconstruction, there is no current gold standard. The optimal graft should best mimic the native labrum with regard to geometry, structure, mechanical properties, and durability. This has led to the development of an arthroscopic technique for labral reconstruction with fresh meniscal allograft tissue.
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Affiliation(s)
- Steven F. DeFroda
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri, U.S.A
| | - Brett Crist
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri, U.S.A
| | - James L. Cook
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri, U.S.A
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7
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Wen Z, Wu YY, Kuang GY, Wen J, Lu M. Effects of different pelvic osteotomies on acetabular morphology in developmental dysplasia of hip in children. World J Orthop 2023; 14:186-196. [PMID: 37155509 PMCID: PMC10122774 DOI: 10.5312/wjo.v14.i4.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/19/2023] [Accepted: 03/30/2023] [Indexed: 04/18/2023] Open
Abstract
Developmental dysplasia of hip seriously affects the health of children, and pelvic osteotomy is an important part of surgical treatment. Improving the shape of the acetabulum, preventing or delaying the progression of osteoarthritis is the ultimate goal of pelvic osteotomies. Re-directional osteotomies, reshaping osteotomies and salvage osteotomies are the three most common types of pelvic osteotomy. The influence of different pelvic osteotomy on acetabular morphology is different, and the acetabular morphology after osteotomy is closely related to the prognosis of the patients. But there lacks comparison of acetabular morphology between different pelvic osteotomies, on the basis of retrospective analysis and measurable imaging indicators, this study predicted the acetabular shape after developmental dysplasia of the hip pelvic osteotomy in order to help clinicians make reasonable and correct decisions and improve the planning and performance of pelvic osteotomy.
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Affiliation(s)
- Zhi Wen
- Graduate School, Hunan University of Chinese Medicine, Changsha 410007, Hunan Province, China
- Department of Joint Orthopedics, The First Hospital of Hunan University of Chinese Medicine, Changsha 410007, Hunan Province, China
| | - Yu-Yuan Wu
- Department of Pediatric Orthopedics, Traditional Chinese Medicine Hospital in Huaihua, Huaihua 418000, Hunan Province, China
| | - Gao-Yan Kuang
- Department of Joint Orthopedics, The First Hospital of Hunan University of Chinese Medicine, Changsha 410007, Hunan Province, China
| | - Jie Wen
- Department of Pediatric Orthopedics, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha 410013, Hunan Province, China
| | - Min Lu
- Department of Joint Orthopedics, The First Hospital of Hunan University of Chinese Medicine, Changsha 410007, Hunan Province, China
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8
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Muacevic A, Adler JR, Flemming DP, Ellis TJ, Kollmorgen RC. Addition of Pericapsular Nerve Group and Transversus Abdominis Plane Blocks Significantly Reduces Opioid Use in Patients Undergoing Concomitant Hip Arthroscopy and Periacetabular Osteotomy. Cureus 2023; 15:e33277. [PMID: 36741622 PMCID: PMC9892016 DOI: 10.7759/cureus.33277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Previous studies have evaluated the effect of the pericapsular nerve group block for hip arthroscopy and the transverse abdominis plane block for periacetabular osteotomy and have shown decreased narcotic consumption in both groups. No published study has evaluated the effectiveness of combining the blocks when performing hip arthroscopy and periacetabular osteotomy under the same general anesthesia. It was hypothesized that patients treated for hip dysplasia with hip arthroscopy and concomitant periacetabular osteotomy using a pericapsular nerve group block, transverse abdominis plane block, and general anesthesia would have decreased postoperative pain and require less narcotic consumption than those undergoing the procedure with general anesthetic alone. Methods: A single surgeon performed a retrospective analysis of consecutive patients undergoing concomitant hip arthroscopy and periacetabular osteotomy between 11/2020 and 6/2021. Fifteen consecutive patients undergoing the procedure with a general anesthetic alone (no-block group) were compared to 15 patients undergoing the same procedure with a combined pericapsular nerve group block, transverse abdominis plane block, and general anesthetic (block group). Hip arthroscopy was performed utilizing a post-free technique, and a rectus sparing approach was used for the periacetabular osteotomy. The nerve blocks were performed by multiple anesthesiologists using previously published methods. Operating room time, length of stay, visual analog scale pain scores, and total narcotic consumption in morphine milliequivalents were analyzed. Groups were compared using the chi-squared test for non-continuous demographic variables and a two-tailed t-test for continuous variables utilizing Microsoft Excel (Microsoft, Redmond, WA, USA), p-value set at 0.05 for significance. Results: The no-block group consisted of 14 females and one male, while the block group was all females. No significant differences were observed between age, sex, BMI, surgery time, length of stay, or procedures performed, p>0.05. The maximal visual analog scale score in the post-anesthesia care unit was 8 ± 1.3 vs. 7 ± 1.9 in the no-block vs. block groups, respectively, p=0.15. The average hospital floor visual analog scale score was 5.7 ± 1.3 vs. 4.8 ± 1.3 in the no-block vs. block groups, respectively, p=0.07. Total pain medications required were 217.6 ± 54.6 vs. 154 ± 41.9 morphine milliequivalents in the no-block vs. block groups, respectively, p=0.001. No complications were reported in either group, and no patient in the block group demonstrated motor nerve palsy or postoperative fall. CONCLUSION This study demonstrated that patients undergoing combined hip arthroscopy and periacetabular osteotomy for symptomatic acetabular dysplasia who had pericapsular nerve group, transverse abdominal plane block, and general anesthesia required fewer narcotics in the first 24 hours after surgery compared to those who had general anesthesia alone.
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Gao G, Dong H, Wu R, Wang J, Ao Y, Xu Y. 3D-printed regenerative polycaprolactone/silk fibroin osteogenic and chondrogenic implant for treatment of hip dysplasia. Biochem Biophys Res Commun 2022; 636:96-104. [DOI: 10.1016/j.bbrc.2022.10.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 09/15/2022] [Accepted: 10/12/2022] [Indexed: 11/02/2022]
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Mendez-Dominguez N, Alvarez-Baeza A, Estrella-Castillo D, Lugo R, Villasuso-Alcocer V, Azcorra H. Ethnic and sociodemographic correlates of developmental dysplasia of the hip in newborns from Yucatan, Mexico. Am J Hum Biol 2022; 34:e23724. [PMID: 35092106 DOI: 10.1002/ajhb.23724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To provide an insight of the incidence of congenital developmental dysplasia of the hip in newborns from Yucatan born between 2015 and 2019 and analyze its association with maternal sociodemographic characteristics and neonatal, pregnancy and delivery related aspects. METHODS Retrospective, population-based study from Birth Registries database in Yucatan, Mexico between 2015 and 2019. Presence of hip dysplasia was described and analyzed considering three aspects (I) Maternal information (II) Pregnancy and birth (III) Neonatal examination. We obtained incidence rates from each year and the complete studied period. Association between hip dysplasia and maternal, neonatal and pregnancy/delivery variables was analyzed using logistic regression, unadjusted odds ratio and an adjusted model. RESULTS Hip dysplasia occurred in 13 per 10 000 live births. Significant associations were found between hip dysplasia and maternal place of residence in a city <50 000 inhabitants, without a local clinic. Propensity to give birth to a neonate with hip dysplasia increased with maternal age and ethnicity, in female newborns and when total number of pregnancy consultations summed <5. Newborns with hip dysplasia were heavier and less susceptible to be delivered vaginally. Congenital developmental hip dysplasia was comparatively more frequent among offspring of Mayan women and suboptimal access to medical care during pregnancy. Female neonates were affected the most, those first-borns. Neonates with hip dysplasia were heavier and more susceptible to be born by cesarean section. CONCLUSION Maternal, neonatal, and perinatal factors are associated with DDH in Yucatecan infants born during 2015-2019. Factors that describe living conditions seems to have a more important effect on the presence of this condition.
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Affiliation(s)
- Nina Mendez-Dominguez
- Subdirección de Enseñanza e Investigación, Hospital Regional de Alta Especialidad de la Península de Yucatán, 7 # 433 x 20 & 22 Fracc. Altabrisa, Merida, Yucatan, 97130, Mexico
| | - Alberto Alvarez-Baeza
- Subdirección de Enseñanza e Investigación, Hospital Regional de Alta Especialidad de la Península de Yucatán, 7 # 433 x 20 & 22 Fracc. Altabrisa, Merida, Yucatan, 97130, Mexico.,School of Medicine, Universidad Marista de Merida, Periférico Norte; Tablaje catastral 13941. Carretera Mérida-Progreso, Merida, Yucatan, 97300, Mexico
| | - Damaris Estrella-Castillo
- School of Medicine, Universidad Autónoma de Yucatán, Avenida Itzáes No. 498 x 59 y 59A Col. Centro, Merida, Yucatan, 97000, Mexico
| | - Roberto Lugo
- Subdirección de Enseñanza e Investigación, Hospital Regional de Alta Especialidad de la Península de Yucatán, 7 # 433 x 20 & 22 Fracc. Altabrisa, Merida, Yucatan, 97130, Mexico
| | - Víctor Villasuso-Alcocer
- Subdirección de Enseñanza e Investigación, Hospital Regional de Alta Especialidad de la Península de Yucatán, 7 # 433 x 20 & 22 Fracc. Altabrisa, Merida, Yucatan, 97130, Mexico.,School of Medicine, Universidad Marista de Merida, Periférico Norte; Tablaje catastral 13941. Carretera Mérida-Progreso, Merida, Yucatan, 97300, Mexico.,Scholar at Direccion General de Calidad y Educacion en Salud, Secretaria de Salud, Av. Marina Nacional 60, Torre B, piso 8 Col. Tacuba, D.T. Miguel Hidalgo, Ciudad de México, 11410, Mexico
| | - Hugo Azcorra
- Centro de Investigaciones Silvio Zavala, Universidad Modelo, Carretera a Cholul, 200 mts. después del periférico, Merida, Yucatan, Mexico
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