The Journal of Bone and Joint Surgery, Vol 72, Issue 10 1510-1518, Copyright © 1990 by Journal of Bone and Joint Surgery, Inc
Osteoarthrosis and congenital dysplasia of the hip in family members of children who have congenital dysplasia of the hip
FT Hoaglund and JH Healey
Department of Orthopaedic Surgery, University of California, San Francisco 94143-0728.
Four hundred and eight siblings, parents, and grandparents of seventy-eight
children from the New England area who had congenital dysplasia of the hip
were evaluated, by clinical examination and by measurements of the
acetabulum on pelvic radiographs, for the signs and sequelae of congenital
dysplasia of the hip. Six siblings and four mothers (representing seven of
seventy-eight families) had been diagnosed with congenital dysplasia of the
hip during childhood. The other ninety-one siblings were asymptomatic and
had no radiographic evidence of dysplasia of the hip. In the adults in
these families, acetabular coverage (as measured by the center-edge angle
of Wiberg) was no different from that in the control subjects. There was no
difference between the study group and the control subjects in the
prevalence of osteoarthrosis of the hip or of osteoarthrosis that could be
considered secondary to congenital dysplasia of the hip. The results
indicate that children born to families that have a history of congenital
dysplasia of the hip have a greater prevalence of this problem compared
with the general population, but also that examinations of the hip in
newborns are effective in detecting congenital dysplasia of the hip in such
families. The greater prevalence of congenital disease of the hip among the
siblings and mothers in these families is consistent with a multifactorial
inheritance. The fact that acetabular development in the family members who
did not have congenital dysplasia of the hip was no different from that in
the control subjects suggests that acetabular dysplasia, rather than being
an inherited abnormality, is secondary to subluxation or dislocation.