Tacettin AYANOĞLU, Muhammet Baybars ATAOGLU, NİL TOKGÖZ, Elif ERSÖZ, HAKAN ATALAR, Sacit TURANLI

Assessing the risk of asymptomatic dysplasia in parents of children with developmental hip dysplasia

Objective: The aim of this study was to investigate whether being the parents of children with developmental hip dysplasia (DDH) is a risk factor for asymptomatic dysplasia. Methods: Asymptomatic parents of children who were diagnosed with DDH were assessed for presence of dysplasia by examining their anteroposterior pelvis radiographs at the neutral position. Eighty-six hips of 43 participants were included in the study group and 98 hips of 49 participants were included in the control group. Presence of hip dysplasia over the anteroposterior pelvis radiographs was analyzed for Wiberg's angle, acetabular index of the weight-bearing zone (the Tonnis angle), acetabular depth/width € index, femoral head coverage ratio (FHCR) and femoral neck/shaft angle. Results: The mean acetabular depth/width ratio was 44.3% in the study group and 53.5% in the control group. And, the mean FHCR was 80% in the study group and 82% in the control group. There was a statistically significant difference between the two groups in terms of mean acetabular depth/width ratio (p < 0.05) and FHCR (p < 0.05). In addition, 21 participants in the study group and 2 in the control group had a pathological acetabular depth/width ratio. And, the number of participants with a pathological FHCR was 22 in the study group and 13 in the control group. A statistically significant difference was found between the two groups regarding the number of pathological measurements of acetabular depth/ width ratio (p < 0.05) and FHCR (p < 0.05). Conclusion: Having a parent with DDH is a definitive risk factor for the development of hip dysplasia in childhood. In addition, being a parent of a child with DDH is a risk factor for asymptomatic dysplasia. These parents should be screened by roentgenogram.

___

1. Developmental dysplasia of the hip. In: Herring JA, ed. Tachdjian Pediatrics Orthopedics. 3rd ed. Philadelphia: WB Saunders Co.; 2002:513e704.

2. Rhodes AM, Clarke NM. A review of environmental factors implicated in human developmental dysplasia of the hip. J Child Orthop. 2014;8:375e379.

3. Coleman S. Congenital dysplasia of the hip in the Navajo infant. Clin Orthop Relat Res. 1968;56:179e193.

4. Ceylaner G, Ceylaner S, Ustünkan F, Inan M. Autosomal dominant inheritance of congenital dislocation of the hip in 16 members of a family. Acta Orthop Traumatol Turc. 2008;42:289e291 [Article in Turkish].

5. Oto M, Sarıkaya _ IA, Erdal OA, S¸ eker A. Surgical reconstruction of hip subluxation and dislocation in children with cerebral palsy. Eklem Hastalik Cerrahisi. 2018;29:8e12.

6. Sarıkaya B, Sipahioglu S, Sar ıkaya ZB, Altay MA, Is¸ ıkan UE. Early-term hip development following Pemberton osteotomy: a radiological follow-up. Eklem Hastalık Cerrahisi. 2016;27:81e86 [Article in Turkish].

7. Polat G, Sahin K, Arzu U, Kendirci AS¸ , Asik M. Prevalence of asymptomatic femoroacetabular impingement in Turkey; cross sectional study. Acta Orthopaedica et Traumatologica Turcica. 2018;52:49e53.

8. Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint with special references to the complication of osteoarthritis. Acta Chir Scand. 1939;83:53e68.

9. Tonnis D. Normal values of the hip joint for the evaluation of X-rays in children € and adults. Clin Orthop Relat Res. 1976;119:39e47.

10. Beltran LS, Rosenberg ZS, Mayo JD, et al. Imaging evaluation of developmental hip dysplasia in the young adult. AJR Am J Roentgenol. 2013;200:1077e1088.

11. Cooperman DR, Wallensten R, Stulberg SD. Acetabular dysplasia in the adult. Clin Orthop Relat Res. 1983;175:79e85.

12. Higuchi F. Genetic study on the congenital dislocation of the hip. Bull Tokyo Med Dent Univ. 1984;31:195e207.

13. Tachdjian MO. Treatment of hip dysplasia in the older child and adolescents: factors in decision making. In: Tachdjian MO, ed. Congenital Dislocation of the Hip. New York: Churchill Livingstone; 1982:625e646.

14. Basit S, Albalawi AM, Alharby E, Khoshhal KI. Exome sequencing identified rare variants in genes HSPG2 and ATP2B4 in a family segregating developmental dysplasia of the hip. BMC Med Genet. 2017;18:34e44.

15. Feldman GJ, Parvizi J, Levenstien M, et al. Developmental dysplasia of the hip: linkage mapping and whole exome sequencing identify a shared variant in CX3CR1 in all affected members of a large multigeneration family. J Bone Miner Res. 2013;28:2540e2549.

16. Matsushita M, Kitoh H, Kaneko H, et al. A novel SOX9 H169Q mutation in a family with overlapping phenotype of mild campomelic dysplasia and small patella syndrome. Am J Med Genet A. 2013;161A:2528e2534.

17. Tsuchiya K, Suzuki T, Okuyama S, et al. Genetic study on congenital dislocation of the hip. J Jpn Orthop Assoc. 1959;33:864e879.