Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: The risk of ischemic complications of the hip joint with congenital hip dislocation remains a relevant issue. The incidence of avascular necrosis (AVN) of the femoral head ranges from 5.4% to 27% according to various authors. Doppler ultrasonography of the hip joint is an inexpensive and non-invasive diagnostic method for monitoring changes of blood flow. Assessment and analysis of Doppler parameters in early childhood may facilitate early detection of impaired blood flow and help evaluate the risk of its subsequent development. Objective: To identify significant ultrasound parameters of blood flow in children with congenital hip dislocation. Materials and methods: This was a retrospective study. A total of 58 patients were examined, including 9 (16%) boys and 49 (84%) girls aged 6 months to 8 years. The study included children with Grade II–IV dysplasia according to the IHDI (International Hip Dysplasia Institute). Doppler ultrasonography of the hip joint was performed using color Doppler imaging and pulsed-wave Doppler. The following quantitative parameters were assessed: peak systolic blood flow velocity and resistive index. Doppler parameters were analyzed in 12 patients with radiographically confirmed manifestations of post-reduction avascular necrosis of the femoral head. Results: A statistically significant increase in the resistive index was observed in Grade III dysplasia according to the IHDI classification compared with the contralateral non-dysplastic hip: the median values with interquartile ranges were 0.87 [0.80–0.88] versus 0.79 [0.73–0.80], respectively ( p = 0.022). In Grade IV dysplasia according to the IHDI classifications, blood flow velocity was significantly lower, while the resistive index was significantly higher, compared to the contralateral non-dysplastic hip: 18.50 [15.90–23.10] cm/s versus 23.40 [20.30–26.40] cm/s, p = 0.013, and 0.88 [0.84–0.88] versus 0.80 [0.78–0.82] p < 0.001. In patients with post-reduction avascular necrosis of the femoral head, the resistive index was the most consistent and informative parameter, with values of 0.88 [0.87–0.89] on the right and 0.81 [0.79–0.83] on the left. Conclusion: Doppler ultrasonography of the hip joint enables an objective assessment of blood flow characteristics in children with congenital hip dislocation. Comparative analysis with the contralateral joint, particularly in unilateral disease, combined with dynamic monitoring, enables the assessment of blood flow changes and contribute to risk stratification and the early detection of signs of post-reduction avascular necrosis of the femoral head.
Source: Innovative medicine of Kuban
Language: English
Topic: Hip disorders and treatments
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7225754595