[Unreduced congenital hip dislocation in adults]

Area of Science:

• Orthopedics
• Pediatric Orthopedics
• Adult Hip Reconstruction

Background:

• Unreduced congenital dislocation of the hip (CDH) is a complex condition where the femoral head is not properly seated in the acetabulum.
• In these cases, the femoral head rides high, supported by surrounding muscles rather than a developed acetabulum.
• This malformation can lead to secondary musculoskeletal issues over time.

Purpose of the Study:

• To review cases of unreduced congenital hip dislocation.
• To evaluate the functional outcomes and associated musculoskeletal problems.
• To identify long-term complications in patients with untreated CDH.

Main Methods:

• Retrospective review of 34 cases with unreduced congenital hip dislocation.
• Assessment of hip function using the Harris hip score.
• Clinical evaluation for associated low back pain, spinal deformities, and knee joint dysfunction.

Main Results:

• The mean Harris hip score was 64, indicating significant hip dysfunction.
• Low backache (mild to severe) was reported in 80% of patients, often linked to increased lumbar lordosis or functional scoliosis.
• Knee joint valgus malalignment and dysfunction were present in 20% of patients.
• Older patients (>50 years) exhibited a higher prevalence of hip, lumbar spine, and knee problems.

Conclusions:

• Unreduced congenital hip dislocation is associated with substantial long-term morbidity, including debilitating low back pain and knee dysfunction.
• The condition can lead to progressive degenerative changes affecting the hip, lumbar spine, and knees.
• Management strategies should address not only the hip itself but also the associated spinal and lower extremity complications, especially in adult patients.