The natural history of congenital disease of the hip

Area of Science:

• Orthopedics
• Radiology
• Rheumatology

Background:

• Congenital hip disease can lead to significant long-term musculoskeletal issues.
• Untreated conditions present unique challenges for prognosis and management.
• Understanding the natural history of these conditions is crucial for patient care.

Purpose of the Study:

• To evaluate the long-term outcomes of untreated congenital hip disease.
• To assess the relationship between hip dislocation/subluxation and secondary conditions like osteoarthritis.
• To determine prognostic factors for affected hips, knees, and lumbar spines.

Main Methods:

• Retrospective review of 54 adult patients with 80 affected hips.
• Assessment of radiographic outcomes, including dislocation, subluxation, and false acetabulum development.
• Correlation analysis between hip joint status and ipsilateral knee and lumbar spine conditions.

Main Results:

• 59% of dislocated hips had fair or poor grading scores.
• Osteoarthritis incidence was significantly higher with a well-developed false acetabulum.
• Unilateral dislocation was associated with knee valgus deformity and degeneration in 7/22 patients.
• No correlation found between dislocated head height and prognosis or false acetabulum development.
• Congenital hip subluxation was linked to eventual hip osteoarthritis.

Conclusions:

• Untreated congenital hip dislocation and subluxation frequently lead to poor hip joint function and osteoarthritis.
• The presence of a false acetabulum is a key indicator for increased osteoarthritis risk.
• While hip issues can affect the knee, congenital hip dislocation does not appear to increase symptomatic lumbar spondylosis incidence.