Hip Dysplasia in Adults: Surgical Correction vs. Conservative Treatment Options
DOI:
https://doi.org/10.12775/QS.2024.29.55566Keywords
hip joint, osteoarthritis, surgery, conservative therapy, hip, surgical correctionAbstract
Introduction: Developmental Dysplasia of the Hip (DDH) is an anatomical deformation resulting from abnormal formation of the structures that make up the hip joint. Due to abnormal biomechanics patients with hip dysplasia usually develop radiographic osteoarthritis. Aim of the study: Despite the introduction of screening tests in children, DDH remains an issue among adults. For this group of patients, it is essential to begin treatment as early as possible to prevent early-onset osteoarthritis of the hip joint. In adults it is often too late to implement non-invasive methods such as braces or orthoses. Therefore, in this study, we aim to describe other treatment options for adults with DDH, considering both surgical and non-surgical methods. In the following work, we present both the advantages and complications associated with these surgical methods. Additionally, we describe the non-surgical alternative method of progressive resistance training (PRT) and consider the possibilities of combining it with surgical techniques. We also discuss the potential for pharmacological treatment. Material and Methods: Review of studies available through open-access sources on PubMed, Google Scholar, and the National Library of Medicine. Conclusions: The decision to quickly implement an appropriate treatment plan is crucial for improving the patient's quality of life. The choice of treatment method should consider the patient's age and the severity of the disease. Adults with DDH are most often qualified for surgical procedures, which include periacetabular osteotomy (PAO) and total hip replacement (THR). However, for some patients, surgical procedures may be contraindicated or impossible, and in such cases, other non-invasive methods, such as resistance training or appropriate pharmacotherapy, should be considered. Keywords: hip joint, osteoarthritis, surgery, conservative therapy, hip, Surgical Correction
References
Gala L, Clohisy JC, Beaule PE. Hip Dysplasia in the Young Adult. J Bone Joint Surg Am. 2016;98(1):63-73.
Cooperman D. What is the evidence to support acetabular dysplasia as a cause of osteoarthritis? J Pediatr Orthop. 2013;33 Suppl 1:S2-7.
Nally AP, Galeano MA. [Screening and diagnostic recommendations in the developmental dysplasia of the hip]. Arch Argent Pediatr. 2021;119(4):S159-S8.
Goiano EO, Akkari M, Pupin JP, Santili C. The Epidemiology of Developmental Dysplasia of the Hip in Males. Acta Ortop Bras. 2020;28(1):26-30.
Pun S. Hip dysplasia in the young adult caused by residual childhood and adolescent-onset dysplasia. Curr Rev Musculoskelet Med. 2016;9(4):427-34.
Muddaluru V, Boughton O, Donnelly T, O'Byrne J, Cashman J, Green C. Developmental dysplasia of the hip is common in patients undergoing total hip arthroplasty under 50 years of age. SICOT J. 2023;9:25.
Hong KB, Lee WS, Kang K, Kang KT, Cho BW. Evaluation of lateral and anterior center-edge angles according to sex and anterior pelvic plane tilt angle: a three-dimensional quantitative analysis. J Orthop Surg Res. 2023;18(1):280.
Jawad MU, Scully SP. In brief: Crowe's classification: arthroplasty in developmental dysplasia of the hip. Clin Orthop Relat Res. 2011;469(1):306-8.
Thorborg K, Holmich P, Christensen R, Petersen J, Roos EM. The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist. Br J Sports Med. 2011;45(6):478-91.
O'Connor KP, Ince DJ, Clohisy JC, Willey MC. Hip Dysplasia Treated With Periacetabular Osteotomy in Patients Over 40 Years Old: A Systematic Review. Iowa Orthop J. 2024;44(1):105-12.
Tonning LU, O'Brien M, Semciw A, Stewart C, Kemp JL, Mechlenburg I. Periacetabular osteotomy to treat hip dysplasia: a systematic review of harms and benefits. Arch Orthop Trauma Surg. 2023;143(6):3637-48.
Jacobsen JS, Soballe K, Thorborg K, Bolvig L, Storgaard Jakobsen S, Holmich P, Mechlenburg I. Patient-reported outcome and muscle-tendon pain after periacetabular osteotomy are related: 1-year follow-up in 82 patients with hip dysplasia. Acta Orthop. 2019;90(1):40-5.
Jamil M, Dandachli W, Noordin S, Witt J. Hip arthroscopy: Indications, outcomes and complications. Int J Surg. 2018;54(Pt B):341-4.
Nawabi DH, Degen RM, Fields KG, McLawhorn A, Ranawat AS, Sink EL, Kelly BT. Outcomes After Arthroscopic Treatment of Femoroacetabular Impingement for Patients With Borderline Hip Dysplasia. Am J Sports Med. 2016;44(4):1017-23.
Slullitel PA, Onativia JI, Garcia-Mansilla A, Diaz-Dilernia F, Buttaro MA, Zanotti G, et al. Is hip arthroscopy useful in the treatment of borderline dysplasia?: a case-control study. Rev Esp Cir Ortop Traumatol (Engl Ed). 2020;64(5):326-34.
Clarke MT, Arora A, Villar RN. Hip arthroscopy: complications in 1054 cases. Clin Orthop Relat Res. 2003(406):84-8.
Griffin DR, Villar RN. Complications of arthroscopy of the hip. J Bone Joint Surg Br. 1999;81(4):604-6.
Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet. 2007;370(9597):1508-19.
Alp NB, Akdag G, Erdogan F. Long-term results of total hip arthroplasty in developmental dysplasia of hip patients. Jt Dis Relat Surg. 2020;31(2):298-305.
Bobak P, Wroblewski BM, Siney PD, Fleming PA, Hall R. Charnley low-friction arthroplasty with an autograft of the femoral head for developmental dysplasia of the hip. The 10- to 15-year results. J Bone Joint Surg Br. 2000;82(4):508-11.
Papachristou GC, Pappa E, Chytas D, Masouros PT, Nikolaou VS. Total Hip Replacement in Developmental Hip Dysplasia: A Narrative Review. Cureus. 2021;13(4):e14763.
Engesaeter LB, Furnes O, Havelin LI. Developmental dysplasia of the hip--good results of later total hip arthroplasty: 7135 primary total hip arthroplasties after developmental dysplasia of the hip compared with 59774 total hip arthroplasties in idiopathic coxarthrosis followed for 0 to 15 years in the Norwegian Arthroplasty Register. J Arthroplasty. 2008;23(2):235-40.
Reimer LCU, Jakobsen SS, Mortensen L, Dalgas U, Jacobsen JS, Soballe K, et al. Efficacy of periacetabular osteotomy followed by progressive resistance training compared to progressive resistance training as non-surgical treatment in patients with hip dysplasia (PreserveHip) - a protocol for a randomised controlled trial. BMJ Open. 2019;9(12):e032782.
Mortensen L, Schultz J, Elsner A, Jakobsen SS, Soballe K, Jacobsen JS, et al. Progressive resistance training in patients with hip dysplasia: A feasibility study. J Rehabil Med. 2018;50(8):751-8.
Ahuja V, Thapa D, Patial S, Chander A, Ahuja A. Chronic hip pain in adults: Current knowledge and future prospective. J Anaesthesiol Clin Pharmacol. 2020;36(4):450-7.
Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64(4):465-74.
Jevsevar DS. Treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition. J Am Acad Orthop Surg. 2013;21(9):571-6.
da Costa BR, Pereira TV, Saadat P, Rudnicki M, Iskander SM, Bodmer NS, et al. Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis. BMJ. 2021;375:n2321.
Richard MJ, Driban JB, McAlindon TE. Pharmaceutical treatment of osteoarthritis. Osteoarthritis Cartilage. 2023;31(4):458-66.
Weng Q, Goh SL, Wu J, Persson MSM, Wei J, Sarmanova A, et al. Comparative efficacy of exercise therapy and oral non-steroidal anti-inflammatory drugs and paracetamol for knee or hip osteoarthritis: a network meta-analysis of randomised controlled trials. Br J Sports Med. 2023;57(15):990-6.
Hermann A, Holsgaard-Larsen A, Zerahn B, Mejdahl S, Overgaard S. Preoperative progressive explosive-type resistance training is feasible and effective in patients with hip osteoarthritis scheduled for total hip arthroplasty--a randomized controlled trial. Osteoarthritis Cartilage. 2016;24(1):91-8.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Iga Wiak, Filip Banyś, Filip Czyżewski, Konrad Bochen, Stanisław Dudek, Filip Jasiński, Artur Łukawski, Karolina Pasierb, Julia Szałajska, Klaudia Wojtach
![Creative Commons License](http://i.creativecommons.org/l/by-nc-sa/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 210
Number of citations: 0