title: Adolescents after Pemberton's osteotomy for developmental dysplasia of the hip displayed greater joint loading than healthy controls in affected and unaffected limbs during gait.
abstract: Patients after reduced developmental dysplasia of the hip (DDH) are at higher than normal risk of developing avascular necrosis (AVN) of the femoral head and degenerative hip osteoarthritis (OA) that are closely related to abnormal loadings. We aimed to determine the lower limb loadings in adolescents after Pemberton's osteotomy for unilateral DDH. Eleven females (age: 10.6 ± 1.0 years), who had received Pemberton's osteotomy for unilateral DDH at 1.6 ± 0.5 years of age, and 12 age-matched healthy controls were studied using gait analysis. Compared to the normal controls, the patients were displayed greater peak axial forces at the hip, knee, and ankle in both limbs, with greater loading rates in the ground reaction force (GRF) and at the hips (p < 0.05 for all comparisons). The increased rates of repetitive loading around heel strike in both hips suggest that patients treated for unilateral DDH using Pemberton's osteotomy may be at higher risk of premature hip OA. The increased axial forces at the affected hip may be a contributing factor to the development of AVN of the femoral head in these patients, especially when incomplete coverage, insufficient congruency, and/or damaged articular surfaces remain after the osteotomy. Therefore, monitoring the loading condition at the hip is necessary for a more accurate assessment of the risk of developing joint pathology in patients after reduced DDH.
authors.affiliation: Institute of Biomedical Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei 100, Taiwan.
authors.forename: Chu-Fen
authors.initials: CF
authors.lastname: Chang
authors.forename: Ting-Ming
authors.initials: TM
authors.lastname: Wang
authors.forename: Jyh-Horng
authors.initials: JH
authors.lastname: Wang
authors.forename: Shier-Chieg
authors.initials: SC
authors.lastname: Huang
authors.forename: Tung-Wu
authors.initials: TW
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000843:Ankle Joint / Q000502:physiology; D002648:Child; D005260:Female; D005684:Gait / Q000502:physiology*; D006618:Hip Dislocation, Congenital / Q000503:physiopathology*; D006621:Hip Joint / Q000502:physiology* / Q000601:surgery; D006801:Humans; D007223:Infant; D007719:Knee Joint / Q000502:physiology; D010027:Osteotomy; D011183:Postoperative Complications / Q000503:physiopathology* / Q000517:prevention & control; D016474:Weight-Bearing / Q000502:physiology*