Developmental dysplasia of the hip: is acetabular retroversion a crucial factor?

OBJECTIVE: The objective of this study was to investigate a possible relation between congenital hip dysplasia and acetabular retroversion and to explore the eventual influence of the latter in the surgical decision for periacetabular osteotomy. MATERIALS AND METHODS: We assessed the classical morphological characteristics of both hips, with an additional newly described retroversion index. The study was conducted in 174 patients with uni- or bilateral congenital hip dysplasia having undergone unilateral (153 patients) or bilateral (21 patients) periacetabular osteotomy when respectively one or both dysplastic hips remained symptomatic. RESULTS: In the group of operated hips (195 hips in total), 53% of the acetabuli were anteverted, 42% retroverted, and 5% neutral orientations. The group of nonoperated hips (153 hips) included 24% normal hips, 22% hips with normal coverage but retroverted, 35% dysplastic hips with anteverted or neutral orientation, and 19% dysplastic retroverted hips. Comparing the two hips in the subgroup of patients in whom the operated and nonoperated sides were both dysplastic failed to demonstrate statistically significant difference in the mean retroversion index. However, all the other variables measured were significantly different; with the operated side more dysplastic. Comparing the two hips in the other subgroups showed that acetabular retroversion was nearly always bilateral and symmetrical, even in presence of unilateral congenital dysplasia. DISCUSSION: Our data suggest that the presence of acetabular retroversion is probably independent of the congenital hip dysplasia and that this abnormality seems at best a secondary factor in the appearance of dysplastic hip symptoms. LEVEL OF EVIDENCE: Level IV, retrospective diagnostic study.

[Stomatologic and maxillofacial pathology in a medieval population (10th-12th centuries) of southwestern France]. / Etude de la pathologie stomatologique et maxillo-faciale dans une population médiévale (Xe-XIIe siècles) du sud-ouest de la France.

We present an assessment of the dental and maxillofacial pathology in a medieval population in southwestern France. One hundred and ninety eight mandibles and 29 craniofacial complexes were analysed. Dental and periodontal infectious pathology predominated. Third molar agenesia was quite frequent, concerning 25% of the mandibles. Third molar eruption was almost constant and in a normal position. Condylar process degeneration concerned 6% of the population. Three cases of traumatic pathology were observed, one case of long mandible was noted, and two cases of hypertrophic inferior alveolar process. Dento-mandibular maladjustment was uncommon. No unwedging of the maxillo-mandibular bone basis was observed.

[Sports activity and body composition. Study by whole body osteodensitometry of 269 men between 17 and 21 years of age]. / Activité sportive et composition corporelle. Etude par ostéodensitométrie "corps entier" de 269 hommes de 17 à 21 ans.

Two hundred and sixty one men aged between 17 and 21 were questioned concerning their sports activities and underwent "whole body" osteodensitometry. Values found in terms of bone density rose harmoniously and proportionally from the ages of 17 to 21. Studied in terms of sports activities claimed, figures were higher in athletes and this essentially concerning the lower limbs and pelvis. These data contrast a "growth" effect with a "physical activity" effect, the first being of a systemic nature involving total bone mass and the second of a locoregional nature concerning only those bone segments involved in a particular activity. Our study failed to reveal any arguments in favour of spinal bone steal to the advantage of the lower limbs in athletes. The authors feel that "whole body" osteodensitometry by simultaneous and prospective study of bone segments involved or not involved in exercise should enable a distinction to be drawn between the systemic and locoregional effects of physical activity and thus, in the context of primary prevention, to define the optimal calcium intake and physical activity leading to acquisition of maximum bone capital and to maintain it to the best possible extent.