Skip to main content
Erschienen in: International Orthopaedics 12/2018

03.03.2018 | Original Paper

Coronal plane alignment of the lower limbs in patients with unilateral developmental hip dislocation

verfasst von: Zhendong Zhang, Hong Zhang, Dianzhong Luo, Hui Cheng, Kai Xiao, Shuxun Hou

Erschienen in: International Orthopaedics | Ausgabe 12/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

We aimed to identify the coronal plane alignment of lower limbs in patients with unilateral developmental hip dislocation (UDHD) and observe the difference between Hartofilakidis type II and III.

Patients and methods

The radiographic data of 76 patients who met the inclusion criteria were retrospectively reviewed, including the hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), anatomical lateral distal femoral angle (aLDFA), mechanical proximal tibial angle (MPTA), and lateral distal tibial angle (LDTA).

Results

The valgus alignment on ipsilateral side was most frequently seen in both Hartofilakidis type II (51.3%) and type III groups (67.6%), whereas for the contralateral side, the neutral alignment in type II group (69.2%) and varus alignment in type III group (51.4%) were most commonly observed. Both the mLDFA and aLDFA of the ipsilateral side were significantly smaller than the contralateral side.

Conclusions

UDHD patients may present with lower limb malalignment on both sides. The ipsilateral valgus alignment is the most common deformity. On the contralateral side, Hartofilakidis type III patients may be more prone to be varus than type II patients. The lower limb malalignment and deformity of the ipsilateral distal femur should be considered during surgery involving hip, knee, or femur.
Literatur
1.
Zurück zum Zitat Hartofilakidis G, Stamos K, Karachalios T, Ioannidis TT, Zacharakis N (1996) Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty. J Bone Joint Surg Am 78(5):683–692CrossRefPubMed Hartofilakidis G, Stamos K, Karachalios T, Ioannidis TT, Zacharakis N (1996) Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty. J Bone Joint Surg Am 78(5):683–692CrossRefPubMed
6.
Zurück zum Zitat Crawford AH, Mehlman CT, Slovek RW (1999) The fate of untreated developmental dislocation of the hip: long-term follow-up of eleven patients. J Pediatr Orthop 19(5):641–644PubMed Crawford AH, Mehlman CT, Slovek RW (1999) The fate of untreated developmental dislocation of the hip: long-term follow-up of eleven patients. J Pediatr Orthop 19(5):641–644PubMed
7.
Zurück zum Zitat Wedge JH, Wasylenko MJ (1978) The natural history of congenital dislocation of the hip: a critical review. Clin Orthop Relat Res;(137):154–162 Wedge JH, Wasylenko MJ (1978) The natural history of congenital dislocation of the hip: a critical review. Clin Orthop Relat Res;(137):154–162
8.
Zurück zum Zitat Wedge JH, Wasylenko MJ (1979) The natural history of congenital disease of the hip. J Bone Joint Surg Br 61-B(3):334–338CrossRefPubMed Wedge JH, Wasylenko MJ (1979) The natural history of congenital disease of the hip. J Bone Joint Surg Br 61-B(3):334–338CrossRefPubMed
9.
Zurück zum Zitat Kandemir U, Yazici M, Alpaslan AM, Surat A (2002) Morphology of the knee in adult patients with neglected developmental dysplasia of the hip. J Bone Joint Surg Am 84-A(12):2249–2257CrossRefPubMed Kandemir U, Yazici M, Alpaslan AM, Surat A (2002) Morphology of the knee in adult patients with neglected developmental dysplasia of the hip. J Bone Joint Surg Am 84-A(12):2249–2257CrossRefPubMed
10.
Zurück zum Zitat Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD (2001) The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA 286(2):188–195CrossRefPubMed Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD (2001) The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA 286(2):188–195CrossRefPubMed
11.
Zurück zum Zitat Tetsworth K, Paley D (1994) Malalignment and degenerative arthropathy. Orthop Clin North Am 25:367–377PubMed Tetsworth K, Paley D (1994) Malalignment and degenerative arthropathy. Orthop Clin North Am 25:367–377PubMed
12.
Zurück zum Zitat McKellop HA, Llinas A, Sarmiento A (1994) Effects of tibial malalignment on the knee and ankle. Orthop Clin North Am 25:415–423PubMed McKellop HA, Llinas A, Sarmiento A (1994) Effects of tibial malalignment on the knee and ankle. Orthop Clin North Am 25:415–423PubMed
13.
Zurück zum Zitat Bruns J, Volkmer M, Luessenhop S (1993) Pressure distribution at the knee joint. Arch Orthop Trauma Surg 133:12–19CrossRef Bruns J, Volkmer M, Luessenhop S (1993) Pressure distribution at the knee joint. Arch Orthop Trauma Surg 133:12–19CrossRef
14.
Zurück zum Zitat Someya S, Sonohata M, Ide S, Nagamine S, Tajima T, Mawatari M (2016) Lower limbs alignment in patients with a unilateral completely dislocated hip. Open Orthop J 10:448–456 eCollection 2016CrossRefPubMedPubMedCentral Someya S, Sonohata M, Ide S, Nagamine S, Tajima T, Mawatari M (2016) Lower limbs alignment in patients with a unilateral completely dislocated hip. Open Orthop J 10:448–456 eCollection 2016CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Zampogna B, Vasta S, Amendola A, Uribe-Echevarria Marbach B, Gao Y, Papalia R, Denaro V (2015) Assessing lower limb alignment: comparison of standard knee X-ray vs long leg view. Assessing lower limb alignment: comparison of standard knee X-ray vs long leg view. Iowa Orthop J 35:49–54PubMedPubMedCentral Zampogna B, Vasta S, Amendola A, Uribe-Echevarria Marbach B, Gao Y, Papalia R, Denaro V (2015) Assessing lower limb alignment: comparison of standard knee X-ray vs long leg view. Assessing lower limb alignment: comparison of standard knee X-ray vs long leg view. Iowa Orthop J 35:49–54PubMedPubMedCentral
16.
Zurück zum Zitat Cooke TD, Sled EA, Scudamore RA (2007) Frontal plane knee alignment: a call for standardized measurement. J Rheumatol 34(9):1796–1801PubMed Cooke TD, Sled EA, Scudamore RA (2007) Frontal plane knee alignment: a call for standardized measurement. J Rheumatol 34(9):1796–1801PubMed
20.
Zurück zum Zitat Moreland JR, Bassett LW, Hanker GJ (1987) Radiographic analysis of the axial alignment of the lower extremity. J Bone Joint Surg Am 69:745–749CrossRefPubMed Moreland JR, Bassett LW, Hanker GJ (1987) Radiographic analysis of the axial alignment of the lower extremity. J Bone Joint Surg Am 69:745–749CrossRefPubMed
21.
Zurück zum Zitat Cooke TD, Scudamore RA, Bryant JT, Sorbie C, Siu D, Fisher B (1991) A quantitative approach to radiography of the lower limb. Principles and applications. J Bone Joint Surg Br 73(5):715–720CrossRefPubMed Cooke TD, Scudamore RA, Bryant JT, Sorbie C, Siu D, Fisher B (1991) A quantitative approach to radiography of the lower limb. Principles and applications. J Bone Joint Surg Br 73(5):715–720CrossRefPubMed
23.
Zurück zum Zitat Cooke TD, Li J, Scudamore RA (1994) Radiographic assessment of bony contributions to knee deformity. Orthop Clin North Am 25:387–393PubMed Cooke TD, Li J, Scudamore RA (1994) Radiographic assessment of bony contributions to knee deformity. Orthop Clin North Am 25:387–393PubMed
24.
Zurück zum Zitat Paley D (2003) Principles of deformity correction. Springer, New York Paley D (2003) Principles of deformity correction. Springer, New York
25.
Zurück zum Zitat Cooke TDV, Scudamore A (2003) Healthy knee alignment and mechanics. In: Callaghan JJ, Rosenberg AG, Rubash HE et al (eds) The adult knee. Lippincott Williams & Wilkins, Philadelphia, pp 175–186 Cooke TDV, Scudamore A (2003) Healthy knee alignment and mechanics. In: Callaghan JJ, Rosenberg AG, Rubash HE et al (eds) The adult knee. Lippincott Williams & Wilkins, Philadelphia, pp 175–186
26.
Zurück zum Zitat Hsu RW, Himeno S, Coventry MB, Chao EY (1990) Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res;(255):215–227 Hsu RW, Himeno S, Coventry MB, Chao EY (1990) Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res;(255):215–227
28.
Zurück zum Zitat Chao EY, Neluheni EV, Hsu RW, Paley D (1994) Biomechanics of malalignment. Orthop Clin North Am 25:379–386PubMed Chao EY, Neluheni EV, Hsu RW, Paley D (1994) Biomechanics of malalignment. Orthop Clin North Am 25:379–386PubMed
29.
Zurück zum Zitat Cooke D, Scudamore A, Li J, Wyss U, Bryant T, Costigan P (1997) Axial lower-limb alignment: comparison of knee geometry in normal volunteers and osteoarthritis patients. Osteoarthr Cartil 5:39–47CrossRefPubMed Cooke D, Scudamore A, Li J, Wyss U, Bryant T, Costigan P (1997) Axial lower-limb alignment: comparison of knee geometry in normal volunteers and osteoarthritis patients. Osteoarthr Cartil 5:39–47CrossRefPubMed
30.
Zurück zum Zitat Murphy SB, Simon SR, Kijewski PK, Wilkinson RH, Griscom NT (1987) Femoral anteversion. J Bone Joint Surg Am 69(8):1169–1176CrossRefPubMed Murphy SB, Simon SR, Kijewski PK, Wilkinson RH, Griscom NT (1987) Femoral anteversion. J Bone Joint Surg Am 69(8):1169–1176CrossRefPubMed
31.
Zurück zum Zitat Kuklo TR, Potter BK, O'Brien MF, Schroeder TM, Lenke LG, Polly DW Jr, Spinal Deformity Study Group (2005) Reliability analysis for digital adolescent idiopathic scoliosis measurements. J Spinal Disord Tech 18:152–159CrossRefPubMed Kuklo TR, Potter BK, O'Brien MF, Schroeder TM, Lenke LG, Polly DW Jr, Spinal Deformity Study Group (2005) Reliability analysis for digital adolescent idiopathic scoliosis measurements. J Spinal Disord Tech 18:152–159CrossRefPubMed
36.
Zurück zum Zitat Teitge RA (2012) Does lower limb torsion matter? Tech Knee Surg 11(3):137–146CrossRef Teitge RA (2012) Does lower limb torsion matter? Tech Knee Surg 11(3):137–146CrossRef
Metadaten
Titel
Coronal plane alignment of the lower limbs in patients with unilateral developmental hip dislocation
verfasst von
Zhendong Zhang
Hong Zhang
Dianzhong Luo
Hui Cheng
Kai Xiao
Shuxun Hou
Publikationsdatum
03.03.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 12/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-3813-2

Weitere Artikel der Ausgabe 12/2018

International Orthopaedics 12/2018 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.