Hip arthrography under general anesthesia to refine the definition of hinge abduction in Legg-Calvé-Perthes disease

Journal of Pediatric Orthopedics
Junichi NakamuraYoshitada Harada

Abstract

Hinge abduction is widely accepted as a poor prognostic factor in Legg-Calvé-Perthes disease (LCPD), whereas the exact definition of hinge abduction remains ill defined. The purpose of this diagnostic study was to refine the definition of hinge abduction in LCPD using conventional hip arthrography under general anesthesia. Among 350 hips in 332 LCPD patients, we reviewed 92 hips in 90 patients (75 boys and 15 girls) who consecutively underwent arthrography under general anesthesia because of an expected poor prognosis. The mean age at LCPD onset was 8.2 years (range, 4-13 years). With respect to lateral pillar classification, 25 hips were classified as group B, 27 as B/C border, and 40 as C. Subluxation (>or=3-mm difference from unaffected side) was present in 81 (88%) of the 92 hips. The modified Waldenström classification was used for evaluating the radiographic stage of disease at the time of arthrography: 80 hips were classified as fragmentation stage and 12 as reossification stage. Hinge abduction was defined as an increased subluxation index in maximum abduction and/or a positive impingement sign. Under this definition, 11% (10 hips) of the study group had hinge abduction. The range of abduction under general anesthesia (...Continue Reading

References

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Citations

Jul 12, 2011·The Orthopedic Clinics of North America·In Ho ChoiHyuk Ju Moon
Mar 4, 2009·The Journal of Bone and Joint Surgery. American Volume·Young-Jo Kim, Kenneth J Noonan
Apr 13, 2011·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Harish S HosalkarKlaus Siebenrock
Jun 26, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Jennifer C LaineDerek M Kelly
Dec 9, 2017·Journal of Pediatric Orthopedics·Benjamin J ShoreWudbhav N Sankar
Jul 1, 2014·Journal of Pediatric Orthopedics·Junichi NakamuraKazuhisa Takahashi
Jul 27, 2014·The Journal of the American Academy of Orthopaedic Surgeons·Philip D Nowicki, Ryan Duhn
Sep 8, 2012·Journal of Pediatric Orthopedics·Patrick B WrightJonathan H Phillips
May 4, 2021·Interactive Journal of Medical Research·Arash MalekiMohammad Nabi Bahrami
Jul 12, 2011·The Orthopedic Clinics of North America·Kent A Reinker

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