MRI FINDINGS OF THE RESIDUAL SUBLUXATION AFTER REDUCTION OF DEVELOPMENTAL DYSPLASIA OF THE HIP

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After reduction of developmental dysplasia of the hip (DDH), not a few patients suffer from residual subluxation as well as acetabular dysplasia. Corrective surgery for these residual subluxations is sometimes performed before school-child age. it is occasionally difficult to determine whether the patient is candidate for the corrective surgery in the case with minor morphologic aberration. Therefore, we studied various MRI findings in residual subluxation, and examined if these MRI findings have an effect on natural courses such as growth or concentricity of the hip joint after reduction for DDH. The usefulness of MRI for determining the indication for the corrective surgery was also investigated. We studied 235 patients who underwent primary treatment for DDH during the past decade (between October, 1988 and September, 1998). Of the 235 patients, we studied 23 patients (23 cases ; all unilateral cases) who showed residual subluxation and whose MR images were taken when they were around 3 years old, and during a follow-up period was available. Corrective surgery is performed in 11 patients, whereas the remaining 12 patients were conservatively observed the course of the residual subluxation. We investigated the existence of high signal intensity area. (hereinafter referred to as HSIA) within the weight-bearing acetabular cartilage on T2-weighted MR coronal section images. Furthermore, conservatively observed patients were divided into two groups according to T2-weighted MR images. Based on simple X-ray images with time in both groups, the acetabular angle (1) and the CE angle (2) were measured. As results, many patients with residual subluxation showed localized HSIA in the weight-bearing acetabular cartilage on T2-weighted MR images. Although all patients who under-went corrective surgery showed HSIA, HSIA disappeared or decreased after the surgery. Of patients who were conservatively observed the course of the residual subluxation, patients showed HSIA on MR image had poor acetabular growth whereas patients showed no HSIA had favorable acetabular growth. The changes of HSIA in the weight-bearing acetabular cartilage on T 2-weighted MR im-ages could predict the poor or favorable course of acetabular growth, which is considered to be useful in determining the indication for the corrective surgery.
名古屋市立大学の論文
2007-02-28

MRI FINDINGS OF THE RESIDUAL SUBLUXATION AFTER REDUCTION OF DEVELOPMENTAL DYSPLASIA OF THE HIP

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