Association of Hip Dysplasia With Trochlear Dysplasia in Skeletally Mature Patients.

Background

Developmental dysplasia of the hip (DDH) and trochlear dysplasia (TD) are distinct pathologies with several important features in common. In addition to shared risk factors, both forms of dysplasia cause abnormal joint kinematics and force transmission, predisposing patients to pain, injuries to cartilage and soft tissue stabilizers, and ultimately arthritis.

Purpose

To evaluate for an association between hip dysplasia and TD in skeletally mature patients with symptomatic hip dysplasia.

Study Design

Cross-sectional study; Level of evidence, 3.

Methods

A total of 48 patients with DDH who underwent periacetabular osteotomy were compared with 48 sex-matched patients who underwent hip arthroscopy for femoroacetabular impingement (FAI) between July 2014 and February 2021. All patients were skeletally mature. The Tönnis angle and lateral center-edge angle were measured on preoperative pelvis radiographs. Femoral version, trochlear depth, lateral trochlear inclination (LTI), tibial tubercle-trochlear groove distance (TTTG-d), and posterior lateral condylar angle (PLCA) were measured on preoperative magnetic resonance imaging scans of the symptomatic hip and ipsilateral knee. Continuous variables were compared between the patient groups using 2-sample

Results

Patients with DDH demonstrated a reduced trochlear depth compared with patients with FAI (3.6 vs 4.6 mm;

Conclusion

Patients with DDH had reduced trochlear depth compared with patients with FAI, demonstrating a higher incidence of dysplastic trochlear features that may predispose patients to patellofemoral joint disease. Further research is needed to determine whether screening at-risk patients and treating TD will help to prevent symptomatic patellofemoral disease.

Informations de copyright

© The Author(s) 2023.

Déclaration de conflit d'intérêts

One or more of the authors has declared the following potential conflict of interest or source of funding: A.T.F. has received education payments from Evolution Surgical. S.L.S. has received education payments from Evolution Surgical and Elite Orthopedics; consulting fees from Bioventus, DJO, Kinamed, Linvatec, Olympus America, Ceterix Orthopaedics, Pacira Therapeutics, Smith & Nephew, Vericel, JRF Ortho, LifeNet Health, and Flexion Therapeutics; nonconsulting fees from Arthrex, Linvatec, Smith & Nephew, and Synthes GmbH; royalties from Linvatec and ConMed; hospitality payments from Aesculap Biologics; and honoraria from Flexion Therapeutics, JRF Ortho, and Vericel. K.G.S. has received education payments from Evolution Surgical and hospitality payments from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from Stanford University (No. 5136).