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Journal of Pediatric Orthopaedics:
Hip

Natural History of Hips With Borderline Acetabular Index and Acetabular Dysplasia in Infants

Mladenov, Kiril M.D.; Dora, Claudio M.D.; Wicart, Philippe M.D.; Seringe, Raphaël M.D.

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Abstract

Management of clinically stable hips with an increased age-related acetabular index (AI) remains controversial. The authors' purpose was to document the natural history of such hips. Sixty-eight clinically stable hips with an increased age-related AI were followed up for a mean of 9.5 years. Four patterns of evolution were observed: type 1 (25 hips) had rapid progression to normal range in the first 2 years; type 2 (19 hips) had slow improvement, with AI values reaching the normal range between 4 and 11 years; type 3 (20 hips) had improved hip morphology with persistence of minor deviations from the normal values; and type 4 (4 hips) showed no improvement. Initially, none of the hips with type 1, 2, or 3 pattern showed radiologic signs of displacement; in contrast, all our type 4 hips were radiologically eccentered. Clinically stable and radiologically well-centered hips with an increased age-related AI improved spontaneously without treatment. For these cases, clinical and radiologic follow-up is all that is needed.

© 2002 Lippincott Williams & Wilkins, Inc.

The Pediatric Orthopaedic Society of North America (POSNA)
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