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. 2023 Nov 27;12(23):7347.
doi: 10.3390/jcm12237347.

Total Hip Arthroplasty for Low-Grade Developmental Hip Dysplasia Changes the Ipsilateral Knee Alignment on the Axial and Coronal Planes

Stefano Lucchini  1 , Francesco Castagnini  1   2 , Francesco Perdisa  3 , Giuseppe Filardo  4 , Francesco Pardo  1 , Francesco Traina  1   2
Affiliations

Total Hip Arthroplasty for Low-Grade Developmental Hip Dysplasia Changes the Ipsilateral Knee Alignment on the Axial and Coronal Planes

Stefano Lucchini et al. J Clin Med. .

Abstract

Background: There is a paucity of data regarding the post-operative influence of total hip arthroplasty (THA) on the axial and coronal alignments of the ipsilateral knee. A CT study was designed to assess the post-THA changes in axial and coronal knee alignments in low-grade dysplastic hips.

Methods: Forty Crowe I-II dysplastic hips in 37 patients were assessed: a pre-operative CT scan from the fourth lumbar vertebra to the tibial plateaus was compared to a similar post-operative CT scan performed after a minimum of 2 years after THA.

Results: THA implantation caused significant post-operative changes in terms of the rotation height (2 mm lowering; p = 0.003); center of rotation medialization (10 mm medialization; p < 0.001); femoral offset (11 mm increase; p < 0.001); femoral antetorsion (22° internal rotation; p < 0.001), and hip internal rotation (9° internal rotation; p < 0.001). The femoral axis angle deviated in the valgus (5.5° ± 1.1°, p < 0.001) and the mechanical lateral distal femoral angle deviated in the varus (86° ± 2.7°, p = 0.001). The pelvic-tibial alignment changed from 88.2° ± 11.7° to 96° ± 9.3° (p < 0.001). Patellar alignment was not influenced.

Conclusions: In conclusion, THA imposes significant changes in low-grade dysplastic hips: all the modifications tend to neutralize the coronal alignment and, mostly, the rotational alignment, without substantial and durable variations of the patellofemoral joint. Large clinical trials should confirm whether radiological changes impact anterior knee pain and patellar stability.

Keywords: femoral anteversion; hip internal rotation; patellar tilt; total hip arthroplasty; trochlea.

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Conflict of interest statement

On behalf of all the authors, the corresponding author states that there are no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of patient enrollments.
Figure 2
Figure 2
Pre-operative and post-operative X-rays of a patient treated with THA (conical stem) for hip dysplasia.
Figure 3
Figure 3
Pre-operative and post-operative X-rays of a patient treated with THA (anatomical stem) for hip dysplasia.
See this image and copyright information in PMC

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References

    1. Li H., Qu X., Wang Y., Dai K., Zhu Z. Morphological Analysis of the Knee Joint in Patients with Hip Dysplasia. Knee Surg. Sport. Traumatol. Arthrosc. Off. J. ESSKA. 2013;21:2081–2088. doi: 10.1007/s00167-012-2242-9. - DOI - PubMed
    1. Li Q., Kadhim M., Zhang L., Cheng X., Zhao Q., Li L. Knee Joint Changes in Patients with Neglected Developmental Hip Dysplasia: A Prospective Case-Control Study. Knee. 2014;21:1072–1076. doi: 10.1016/j.knee.2014.08.012. - DOI - PubMed
    1. Hu B., Sang L., Gao D., Wu Y., Zhang H., Luo D. Patella Alignment Abnormality in Patients with Developmental Dysplasia of the Hip. J. Orthop. Surg. Hong Kong. 2019;27:2309499019854039. doi: 10.1177/2309499019854039. - DOI - PubMed
    1. Zhang Z., Zhang H., Luo D., Cheng H., Xiao K., Hou S. Coronal Plane Alignment of the Lower Limbs in Patients with Unilateral Developmental Hip Dislocation. Int. Orthop. 2018;42:2761–2769. doi: 10.1007/s00264-018-3813-2. - DOI - PubMed
    1. Imai N., Miyasaka D., Hirano Y., Suzuki H., Tsuchiya K., Endo N. Tibiofemoral Rotation Is Related to Differences in the Lateral Femoral Condyle Configuration in Both Normal Subjects and Women with Hip Dysplasia: A Three-Dimensional Analysis. BMC Musculoskelet. Disord. 2019;20:353. doi: 10.1186/s12891-019-2737-3. - DOI - PMC - PubMed

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