Incidence, trends, and associated risks of developmental hip dysplasia in patients with Early Onset and Adolescent Idiopathic Scoliosis

Frank A. Segreto, Dennis Vasquez-Montes, Avery E. Brown, Cole Bortz, Samantha R. Horn, Bassel G. Diebo, Peter L. Zhou, Shaleen Vira, Joseph F. Baker, Anthony M. Petrizzo, Renaud Lafage, Virginie Lafage, Thomas J. Errico, Peter G. Passias

Research output: Contribution to journalArticle

Abstract

Introduction: Early Onset and Adolescent Idiopathic Scoliosis, relatively common diagnoses (∼3% general population), have been associated with developmental dysplasia of the hip (DDH); a more rare spectrum of anomalies related to the abnormal development of acetabulum, proximal femur, and hip joint. To the best of our knowledge, no high powered investigations have been performed in an attempt to assess incidence and associated risks of DDH in scoliosis patients. Methods: The KID database was queried for ICD-9 codes from 2003 to 2012 pertaining to EOS (Congenital and Idiopathic <10y/o) and AIS patients. Descriptive analysis assessed patient demographics and yearly trends in hip dysplasia rates. EOS and AIS patients with hip dysplasia were isolated, and incidence of hospital admissions for associated anomalies (osteonecrosis, osteoarthritis, recurrent hip dislocation, hip ankylosis) and hip arthroplasty (total + partial) were investigated. Univariate analysis of hip pathology determined significant predictors of hip arthroplasty. Binary logistic regression analysis was used to determine the relationship between these predictors. Results: 111,827 scoliosis patients (EOS: 25,747; AIS: 77,183) were included. AIS patients were older (15.2 vs 4.3), more female (64.2% vs 52.1%), had a higher CCI (0.84 vs 0.64), and less racially diverse (all p < 0.001). The incidence of hip dysplasia was 1.4% for AIS patients and 3.9% for EOS patients (p < 0.001). Of the AIS (n = 1073) and EOS (n = 1005) patients with hip dysplasia, 0.3% (p > 0.05 between groups) developed hip osteonecrosis, 0% of patients were coded as having a hip labral tear, hip ankylosis, and 0.6% (EOS: 0.2%; AIS: 0.9%, p = 0.025) developed hip osteoarthritis. AIS patients were more likely to have recurrent hip dislocations (35.4% vs 17.0%, p < 0.001), and both groups had similar primary hip arthroplasty rates (6.7% vs 5.4%, p = 0.118) and revision hip arthroplasty rates (0% vs 0.4%, p = 0.053). Hip osteoarthritis (OR: 13.43[5.21–34.66], p=<0.001) and older age (OR: 1.039[1.007–1.073], p = 0.017) were the only significant predictors of hip arthroplasty (p=<.001). Conclusions: The incidence of hip dysplasia in EOS and AIS populations is higher than that of the general population. The rate of DDH was 3.9% and 1.8% for EOS and AIS, respectively. While the incidence of DDH is higher, associated anomalies of osteoarthritis, osteonecrosis, labral tears, and ankylosis appear to be a minimal risk for AIS and EOS patients with Hip Dysplasia.

Original languageEnglish (US)
Pages (from-to)874-877
Number of pages4
JournalJournal of Orthopaedics
Volume15
Issue number3
DOIs
StatePublished - Sep 2018
Externally publishedYes

Fingerprint

Hip Dislocation
Scoliosis
Hip
Incidence
Arthroplasty
Ankylosis
Hip Osteoarthritis
Osteonecrosis
International Classification of Diseases
Tears
Population
Acetabulum
Hip Joint
Osteoarthritis
Femur
Databases

Keywords

  • Adolescent idiopathic scoliosis
  • Degenerative dysplasia of the hip
  • Early onset scoliosis
  • Hip arthroplasty
  • Recurrent hip dislocations

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Segreto, F. A., Vasquez-Montes, D., Brown, A. E., Bortz, C., Horn, S. R., Diebo, B. G., ... Passias, P. G. (2018). Incidence, trends, and associated risks of developmental hip dysplasia in patients with Early Onset and Adolescent Idiopathic Scoliosis. Journal of Orthopaedics, 15(3), 874-877. https://doi.org/10.1016/j.jor.2018.08.015

Incidence, trends, and associated risks of developmental hip dysplasia in patients with Early Onset and Adolescent Idiopathic Scoliosis. / Segreto, Frank A.; Vasquez-Montes, Dennis; Brown, Avery E.; Bortz, Cole; Horn, Samantha R.; Diebo, Bassel G.; Zhou, Peter L.; Vira, Shaleen; Baker, Joseph F.; Petrizzo, Anthony M.; Lafage, Renaud; Lafage, Virginie; Errico, Thomas J.; Passias, Peter G.

In: Journal of Orthopaedics, Vol. 15, No. 3, 09.2018, p. 874-877.

Research output: Contribution to journalArticle

Segreto, FA, Vasquez-Montes, D, Brown, AE, Bortz, C, Horn, SR, Diebo, BG, Zhou, PL, Vira, S, Baker, JF, Petrizzo, AM, Lafage, R, Lafage, V, Errico, TJ & Passias, PG 2018, 'Incidence, trends, and associated risks of developmental hip dysplasia in patients with Early Onset and Adolescent Idiopathic Scoliosis', Journal of Orthopaedics, vol. 15, no. 3, pp. 874-877. https://doi.org/10.1016/j.jor.2018.08.015
Segreto, Frank A. ; Vasquez-Montes, Dennis ; Brown, Avery E. ; Bortz, Cole ; Horn, Samantha R. ; Diebo, Bassel G. ; Zhou, Peter L. ; Vira, Shaleen ; Baker, Joseph F. ; Petrizzo, Anthony M. ; Lafage, Renaud ; Lafage, Virginie ; Errico, Thomas J. ; Passias, Peter G. / Incidence, trends, and associated risks of developmental hip dysplasia in patients with Early Onset and Adolescent Idiopathic Scoliosis. In: Journal of Orthopaedics. 2018 ; Vol. 15, No. 3. pp. 874-877.
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abstract = "Introduction: Early Onset and Adolescent Idiopathic Scoliosis, relatively common diagnoses (∼3{\%} general population), have been associated with developmental dysplasia of the hip (DDH); a more rare spectrum of anomalies related to the abnormal development of acetabulum, proximal femur, and hip joint. To the best of our knowledge, no high powered investigations have been performed in an attempt to assess incidence and associated risks of DDH in scoliosis patients. Methods: The KID database was queried for ICD-9 codes from 2003 to 2012 pertaining to EOS (Congenital and Idiopathic <10y/o) and AIS patients. Descriptive analysis assessed patient demographics and yearly trends in hip dysplasia rates. EOS and AIS patients with hip dysplasia were isolated, and incidence of hospital admissions for associated anomalies (osteonecrosis, osteoarthritis, recurrent hip dislocation, hip ankylosis) and hip arthroplasty (total + partial) were investigated. Univariate analysis of hip pathology determined significant predictors of hip arthroplasty. Binary logistic regression analysis was used to determine the relationship between these predictors. Results: 111,827 scoliosis patients (EOS: 25,747; AIS: 77,183) were included. AIS patients were older (15.2 vs 4.3), more female (64.2{\%} vs 52.1{\%}), had a higher CCI (0.84 vs 0.64), and less racially diverse (all p < 0.001). The incidence of hip dysplasia was 1.4{\%} for AIS patients and 3.9{\%} for EOS patients (p < 0.001). Of the AIS (n = 1073) and EOS (n = 1005) patients with hip dysplasia, 0.3{\%} (p > 0.05 between groups) developed hip osteonecrosis, 0{\%} of patients were coded as having a hip labral tear, hip ankylosis, and 0.6{\%} (EOS: 0.2{\%}; AIS: 0.9{\%}, p = 0.025) developed hip osteoarthritis. AIS patients were more likely to have recurrent hip dislocations (35.4{\%} vs 17.0{\%}, p < 0.001), and both groups had similar primary hip arthroplasty rates (6.7{\%} vs 5.4{\%}, p = 0.118) and revision hip arthroplasty rates (0{\%} vs 0.4{\%}, p = 0.053). Hip osteoarthritis (OR: 13.43[5.21–34.66], p=<0.001) and older age (OR: 1.039[1.007–1.073], p = 0.017) were the only significant predictors of hip arthroplasty (p=<.001). Conclusions: The incidence of hip dysplasia in EOS and AIS populations is higher than that of the general population. The rate of DDH was 3.9{\%} and 1.8{\%} for EOS and AIS, respectively. While the incidence of DDH is higher, associated anomalies of osteoarthritis, osteonecrosis, labral tears, and ankylosis appear to be a minimal risk for AIS and EOS patients with Hip Dysplasia.",
keywords = "Adolescent idiopathic scoliosis, Degenerative dysplasia of the hip, Early onset scoliosis, Hip arthroplasty, Recurrent hip dislocations",
author = "Segreto, {Frank A.} and Dennis Vasquez-Montes and Brown, {Avery E.} and Cole Bortz and Horn, {Samantha R.} and Diebo, {Bassel G.} and Zhou, {Peter L.} and Shaleen Vira and Baker, {Joseph F.} and Petrizzo, {Anthony M.} and Renaud Lafage and Virginie Lafage and Errico, {Thomas J.} and Passias, {Peter G.}",
year = "2018",
month = "9",
doi = "10.1016/j.jor.2018.08.015",
language = "English (US)",
volume = "15",
pages = "874--877",
journal = "Journal of Orthopaedics",
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TY - JOUR

T1 - Incidence, trends, and associated risks of developmental hip dysplasia in patients with Early Onset and Adolescent Idiopathic Scoliosis

AU - Segreto, Frank A.

AU - Vasquez-Montes, Dennis

AU - Brown, Avery E.

AU - Bortz, Cole

AU - Horn, Samantha R.

AU - Diebo, Bassel G.

AU - Zhou, Peter L.

AU - Vira, Shaleen

AU - Baker, Joseph F.

AU - Petrizzo, Anthony M.

AU - Lafage, Renaud

AU - Lafage, Virginie

AU - Errico, Thomas J.

AU - Passias, Peter G.

PY - 2018/9

Y1 - 2018/9

N2 - Introduction: Early Onset and Adolescent Idiopathic Scoliosis, relatively common diagnoses (∼3% general population), have been associated with developmental dysplasia of the hip (DDH); a more rare spectrum of anomalies related to the abnormal development of acetabulum, proximal femur, and hip joint. To the best of our knowledge, no high powered investigations have been performed in an attempt to assess incidence and associated risks of DDH in scoliosis patients. Methods: The KID database was queried for ICD-9 codes from 2003 to 2012 pertaining to EOS (Congenital and Idiopathic <10y/o) and AIS patients. Descriptive analysis assessed patient demographics and yearly trends in hip dysplasia rates. EOS and AIS patients with hip dysplasia were isolated, and incidence of hospital admissions for associated anomalies (osteonecrosis, osteoarthritis, recurrent hip dislocation, hip ankylosis) and hip arthroplasty (total + partial) were investigated. Univariate analysis of hip pathology determined significant predictors of hip arthroplasty. Binary logistic regression analysis was used to determine the relationship between these predictors. Results: 111,827 scoliosis patients (EOS: 25,747; AIS: 77,183) were included. AIS patients were older (15.2 vs 4.3), more female (64.2% vs 52.1%), had a higher CCI (0.84 vs 0.64), and less racially diverse (all p < 0.001). The incidence of hip dysplasia was 1.4% for AIS patients and 3.9% for EOS patients (p < 0.001). Of the AIS (n = 1073) and EOS (n = 1005) patients with hip dysplasia, 0.3% (p > 0.05 between groups) developed hip osteonecrosis, 0% of patients were coded as having a hip labral tear, hip ankylosis, and 0.6% (EOS: 0.2%; AIS: 0.9%, p = 0.025) developed hip osteoarthritis. AIS patients were more likely to have recurrent hip dislocations (35.4% vs 17.0%, p < 0.001), and both groups had similar primary hip arthroplasty rates (6.7% vs 5.4%, p = 0.118) and revision hip arthroplasty rates (0% vs 0.4%, p = 0.053). Hip osteoarthritis (OR: 13.43[5.21–34.66], p=<0.001) and older age (OR: 1.039[1.007–1.073], p = 0.017) were the only significant predictors of hip arthroplasty (p=<.001). Conclusions: The incidence of hip dysplasia in EOS and AIS populations is higher than that of the general population. The rate of DDH was 3.9% and 1.8% for EOS and AIS, respectively. While the incidence of DDH is higher, associated anomalies of osteoarthritis, osteonecrosis, labral tears, and ankylosis appear to be a minimal risk for AIS and EOS patients with Hip Dysplasia.

AB - Introduction: Early Onset and Adolescent Idiopathic Scoliosis, relatively common diagnoses (∼3% general population), have been associated with developmental dysplasia of the hip (DDH); a more rare spectrum of anomalies related to the abnormal development of acetabulum, proximal femur, and hip joint. To the best of our knowledge, no high powered investigations have been performed in an attempt to assess incidence and associated risks of DDH in scoliosis patients. Methods: The KID database was queried for ICD-9 codes from 2003 to 2012 pertaining to EOS (Congenital and Idiopathic <10y/o) and AIS patients. Descriptive analysis assessed patient demographics and yearly trends in hip dysplasia rates. EOS and AIS patients with hip dysplasia were isolated, and incidence of hospital admissions for associated anomalies (osteonecrosis, osteoarthritis, recurrent hip dislocation, hip ankylosis) and hip arthroplasty (total + partial) were investigated. Univariate analysis of hip pathology determined significant predictors of hip arthroplasty. Binary logistic regression analysis was used to determine the relationship between these predictors. Results: 111,827 scoliosis patients (EOS: 25,747; AIS: 77,183) were included. AIS patients were older (15.2 vs 4.3), more female (64.2% vs 52.1%), had a higher CCI (0.84 vs 0.64), and less racially diverse (all p < 0.001). The incidence of hip dysplasia was 1.4% for AIS patients and 3.9% for EOS patients (p < 0.001). Of the AIS (n = 1073) and EOS (n = 1005) patients with hip dysplasia, 0.3% (p > 0.05 between groups) developed hip osteonecrosis, 0% of patients were coded as having a hip labral tear, hip ankylosis, and 0.6% (EOS: 0.2%; AIS: 0.9%, p = 0.025) developed hip osteoarthritis. AIS patients were more likely to have recurrent hip dislocations (35.4% vs 17.0%, p < 0.001), and both groups had similar primary hip arthroplasty rates (6.7% vs 5.4%, p = 0.118) and revision hip arthroplasty rates (0% vs 0.4%, p = 0.053). Hip osteoarthritis (OR: 13.43[5.21–34.66], p=<0.001) and older age (OR: 1.039[1.007–1.073], p = 0.017) were the only significant predictors of hip arthroplasty (p=<.001). Conclusions: The incidence of hip dysplasia in EOS and AIS populations is higher than that of the general population. The rate of DDH was 3.9% and 1.8% for EOS and AIS, respectively. While the incidence of DDH is higher, associated anomalies of osteoarthritis, osteonecrosis, labral tears, and ankylosis appear to be a minimal risk for AIS and EOS patients with Hip Dysplasia.

KW - Adolescent idiopathic scoliosis

KW - Degenerative dysplasia of the hip

KW - Early onset scoliosis

KW - Hip arthroplasty

KW - Recurrent hip dislocations

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