[Reconstructions of the teratogenic hip dislocation in childrens with AMC]

Hip diclocation is the cause of the mobility impairment in children with arthrogryposis. Hip joint reconstruction is a commonly accepted treatment method in unilateral dislocations, but opinions are divided in bilateral.

Hip joint function assessment after reconstruction due to teratogenic dislocation in arthrogryposis.

In years 1988 to 2005 we performed 9 reconstructions of the teratogenic hip dislocation in 8 children with AMC (Arthrogryposis multiplex congenita). Mean age of children at the time of procedure was 3.5 years. Mean follow-up was 9.5 years. At final outcome the movement and the mobility were assessed according to modified Harris scale, as well as influence of other factor on ambulatory status. Radiological result was assessed according to Severin classification.

Mean ROM in hip joint after operation decreased in all children comparing to preoperative assessment in all planes, except for adduction. In all ROM of the hip remained functional. At the final check up there was mobility improvement in 7 patients. The knee flexion contracture ipsilateral to the dislocated hip was stated only in 1 patient. There was no isolated relation between ambulatory status and hip and knee extensor muscles strength, residual deformities of the lower extremities and involvement of the upper extremities. There was no relation between radiological result and mobility.

Decrease of hip ROM after the reconstruction in patients with AMC does not influence the mobility. The factor that influence that mobility ought to be considered altogether. Hip dislocation in patients with AMC may prevent occurrence of the knee flexion contracture deformity.