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Adolescents after pemberton's osteotomy for developmental dysplasia of the hip displayed greater joint loading than healthy controls in affected and unaffected limbs during gait
Author(s) -
Chang ChuFen,
Wang TingMing,
Wang JyhHorng,
Huang ShierChieg,
Lu TungWu
Publication year - 2011
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.21377
Subject(s) - medicine , avascular necrosis , femoral head , osteoarthritis , osteotomy , ankle , heel , gait , hip dysplasia , orthopedic surgery , dysplasia , surgery , physical therapy , radiography , anatomy , alternative medicine , pathology
Patients after reduced developmental dysplasia of the hip (DDH) are at higher than normal risk of developing avascular necrosis (AVN) of the femoral head and degenerative hip osteoarthritis (OA) that are closely related to abnormal loadings. We aimed to determine the lower limb loadings in adolescents after Pemberton's osteotomy for unilateral DDH. Eleven females (age: 10.6 ± 1.0 years), who had received Pemberton's osteotomy for unilateral DDH at 1.6 ± 0.5 years of age, and 12 age‐matched healthy controls were studied using gait analysis. Compared to the normal controls, the patients were displayed greater peak axial forces at the hip, knee, and ankle in both limbs, with greater loading rates in the ground reaction force (GRF) and at the hips ( p < 0.05 for all comparisons). The increased rates of repetitive loading around heel strike in both hips suggest that patients treated for unilateral DDH using Pemberton's osteotomy may be at higher risk of premature hip OA. The increased axial forces at the affected hip may be a contributing factor to the development of AVN of the femoral head in these patients, especially when incomplete coverage, insufficient congruency, and/or damaged articular surfaces remain after the osteotomy. Therefore, monitoring the loading condition at the hip is necessary for a more accurate assessment of the risk of developing joint pathology in patients after reduced DDH. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 29: 1034–1041, 2011