The Journal of Bone and Joint Surgery, Vol 62, Issue 7 1073-1082, Copyright © 1980 by Journal of Bone and Joint Surgery, Inc
Morphological variants in the human fetal hip joint. Their significance in congenital hip disease
JM Walker
In a study of 280 hips in 140 normal fetuses, sixty-five of the ninety-two
hips of forty-six fetuses between the ages of twelve weeks and term showed
morphological variants, yet they were neither subluxated nor dislocated and
showed no statistically significant morphological differences from normal
joints. The vazriants observed included flattening (fourteen hips) or
rounding-off of the rim of the labrum (nine hips), localized dips in the
labrum (twenty hips), folding of the labrum (six hips), capsular folds
(four hips), extension of the pulvinar pad between the joint surfaces (six
hips), and kinking of the ligament of the head of the femur (seven hips).
The localization of these variants in the anterosuperior quadrant of the
acetabulum was highly significant (p < 0.001), but there was no
significant relationship to sex or side of involvement. A significant
relationship to age, on the other hand, was evident since the frequency of
these minor morphological variations in the fetal hip joint appeared to
increase with age. Considering all 140 fetuses, the ones with variant hips
formed 55 per cent of all of those older than twenty-eight weeks and only
23 per cent of those younger than twenty-eight weeks (p = 0.007). I suggest
that some of these variants are subclinical manifestations of congenital
hip disease.
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