The acetabulum in Perthes' disease: a prospective study of 123 children.
J Child Orthop
; 8(6): 457-65, 2014 Dec.
Article
em En
| MEDLINE
| ID: mdl-25409924
ABSTRACT
PURPOSE:
We assessed the radiographic changes of the acetabulum during the course of Perthes' disease and investigated whether they were associated with femoral head sphericity 5 years after diagnosis.METHODS:
We studied 123 children with unilateral Perthes' disease, femoral head necrosis more than 50 % and age at diagnosis 6 years or older. Pelvic radiographs were taken at onset, 1 year and 5 years after diagnosis. Sharp's angle, acetabular depth-to-width ratio (ADR) and lateral acetabular inclination were measured.RESULTS:
Compared to the unaffected hips, the Perthes' hips developed significantly higher Sharp's angles (p < 0.001) and a higher proportion with an upward-sloping lateral acetabular margin (Perthes' hips 49 %, unaffected hips 1 %). The mean ADR values were significantly lower on the affected side at all stages (p < 0.001). ADR values at diagnosis were associated with a more spherical femoral head at the 5-year follow-up [odds ratio (OR) 1.012, 95 % confidence interval (CI) 1.002-1.022, p = 0.016]. None of the other acetabular parameters were significantly associated with the femoral head shape 5 years after diagnosis.CONCLUSION:
The acetabulum developed an increasingly dysplastic shape in the course of Perthes' disease. Early dysplastic changes of the acetabulum were not associated with a poor radiological outcome 5 years after diagnosis. Routine measurement and monitoring of acetabular changes in plain radiographs were of little prognostic value and can, therefore, hardly be recommended in clinical practice.
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Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Child Orthop
Ano de publicação:
2014
Tipo de documento:
Article