The effects of contact pressure elevations and aseptic necrosis on the long-term outcome of congenital hip dislocation.
J Orthop Res
; 8(4): 504-13, 1990 Jul.
Article
en En
| MEDLINE
| ID: mdl-2355290
ABSTRACT
The relationship between excessive articular contact pressure, aseptic necrosis, and the long-term outcome with unilateral congenital dislocation of the hip (CDH) was studied in a series of 84 patients treated by closed reduction and followed for an average of 29.2 years. Contact stress was estimated from archived radiographs taken at the time of maturity and at several follow-up visits. At a recent review, each patient was rated both clinically for pain and function and radiographically for deformity, degeneration, and aseptic necrosis. For each of 431 archived films, articular contact stress (force/area) was estimated mathematically, based upon a frontal plane equilibrium (force) analysis and a landmark-based inference of three-dimensional head surface (area). Good correlation with final deformity (Spearman rho = 0.78) was obtained when the hips were ranked in terms of a new cumulative overpressure index Pc, defined as a time-pressure product involving years of pressure exposure beyond a 2 MPa pressure damage level. An unsatisfactory outcome occurred in 90.4% of the hips experiencing Pc greater than 10 MPa-years (most of which had aseptic necrosis involvement), whereas the outcome was satisfactory in 80.9% of hips with Pc less than 10 MPa-years.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Necrosis de la Cabeza Femoral
/
Luxación Congénita de la Cadera
Tipo de estudio:
Prognostic_studies
Límite:
Adolescent
/
Adult
/
Humans
/
Middle aged
Idioma:
En
Revista:
J Orthop Res
Año:
1990
Tipo del documento:
Article