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The hip in adults with classic bladder exstrophy: a biomechanical analysis
M M Jani1, P D Sponseller, J P Gearhart
1Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Journal of Pediatric Orthopedics
|May 24, 2000
Summary
Adults with bladder exstrophy experience higher hip joint force and stress due to pelvic deformity. This may lead to degenerative hip changes, impacting future treatment strategies.
Area of Science:
- Orthopedics
- Biomechanical Engineering
- Pediatric Surgery
Background:
- Bladder exstrophy often results in significant pelvic deformity.
- The biomechanical implications of untreated pelvic deformity on hip joint function in adults are not well understood.
Purpose of the Study:
- To investigate the relative hip-joint force and stress in adult patients with untreated bladder exstrophy.
- To assess the impact of these biomechanical changes on the clinical status and radiographic findings of the hip joint.
Main Methods:
- Biomechanical analysis of pelvic radiographs from 14 adult bladder exstrophy patients and age-matched controls.
- Calculation of relative joint force and stress (force/area) relative to partial body weight.
- Clinical evaluation using IOWA hip ratings and radiographic scoring for degenerative joint disease.
Main Results:
- Bladder exstrophy patients exhibited significantly higher mean relative joint force and stress (p < 0.001).
- Increased distance from body center to femoral head center (p < 0.001) and decreased center-edge angle (p < 0.05) were observed.
- Two patients had significant hip subluxation, one with associated degenerative hip disease.
Conclusions:
- Untreated pelvic deformity in adult bladder exstrophy patients leads to increased hip joint force and stress.
- These findings suggest a potential for clinically important degenerative hip changes.
- Further longitudinal studies are needed to confirm these effects and inform childhood treatment recommendations.