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Demographic Differences in Adolescent-diagnosed and Adult-diagnosed Acetabular Dysplasia Compared With Infantile Developmental Dysplasia of the Hip.
MedLine Citation:
PMID:  23389561     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: : Acetabular dysplasia is a common cause of hip pain that can lead to premature osteoarthritis. This study explores whether demographic characteristics of patients diagnosed with acetabular dysplasia in adolescence and adulthood [adult-diagnosed dysplasia (AD)] differ from those who are diagnosed with developmental dysplasia of the hip (DDH) in infancy.
METHODS: : Database review identified 633 patients undergoing periacetabular osteotomy for dysplasia from August 1991 to January 2008. Excluding patients with syndromal conditions and 80 lacking contact information, 421 patients received a questionnaire regarding birth and family history; 324 (70.3%) completed the survey. Thirteen were excluded because of unrelated hip conditions, leaving 311 patients for analysis.
RESULTS: : Respondents were divided into 2 groups according to whether they had a history of DDH in infancy (102 patients) or were diagnosed in adolescence/adulthood (209 patients). Statistically significant differences (P<0.05) were found in sex distribution (female: DDH=98.0%, AD=88.0%), affected limb (left hip: DDH=33.3%, AD=19.1%), bilaterality (DDH=45.1%, AD=61.2%), and breech presentation (DDH=25.3%, AD=9.4%). Over 50% of all the respondents had a family history of hip disease; over 40% were first-order relatives. First-order family members of patients with AD had a higher incidence of hip replacement by the age of 65 (50.0% vs. 22.7%). Patients with DDH were more likely to have first-order family members with DDH (59.0% vs. 15.8%).
CONCLUSIONS: : This study confirms demographic differences between patients diagnosed with hip dysplasia in infancy versus adolescence/adulthood and supports the hypothesis that these represent distinct forms of dysplasia. In both, there is a familial tendency toward hip disease with a higher incidence of arthroplasty in the AD group's family members and higher frequency of infantile dysplasia in the DDH group's family members.
CLINICAL RELEVANCE: : Infantile DDH is diagnosed with neonatal examination and patients are routinely followed into adolescence. Adolescent/adult AD is not detected until symptoms develop. Further study is needed to determine whether younger family members of patients with hip osteoarthritis should be screened to detect potentially at-risk hips.
Authors:
Cara Beth Lee; Ana Mata-Fink; Michael B Millis; Young-Jo Kim
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  33     ISSN:  1539-2570     ISO Abbreviation:  J Pediatr Orthop     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  107-11     Citation Subset:  IM    
Affiliation:
*Department of Orthopedics, Virginia Mason Medical Center, Seattle, WA †Department of Orthopedics, Darthmouth-Hitchcock Medical Center, Lebanon, NH ‡Department of Orthopedics, Children's Hospital, Boston, MA.
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