A Study on Thickening of the Acetobular Floor in Congenital Dislocation of the Hip Joint

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  • KONNO HIDEO
    Department of Orthopedic Surgery, Juntendo University, School of Medicine

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  • 先天性股関節脱臼に於ける臼蓋底肥厚に関する研究
  • センテンセイ コカンセツ ダッキュウ ニ オケル キュウブタ テイヒコウ ニカ

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Abstract

At the preaent time diagnosis and treatment of congenital dislocation of the hip joint have achieved a remarkable progress. However the management of refractory cases is still remained as a serious problem. In refractory cases causes of the difficulties in management should be elucidated and then adequate measurement should be done. In the present study the acetabular floor in severe cases was roentgenologically measured and histologically investigated in cases in in which surgical treatment was required. The following results were obtained. Measurements in roentgenograms showed that the acetabular floor was frequently more thickened on the dislocated side than on the normal side. This finding coincided with actually meaeued values in operation. The cases with shallower acetabulum more frequently required some surgical treatment on an overall basis. According to the shape of the acetabulum the course after operation was most favorable in the angular concave type, followed by the angular flat type. The cases having rounded convex type, or totally defective convex acetabulum to be intractable to treatment. Although on definitive treatment is actually aveilable, early diagnosis, of course, is of therapeutic importance, because the acetabular floor becomes thickened with age. The significant histopathological findings of the acetabular floor in this disease include proliferation of the fibrous tissue and changes in the cartilaginous tissue. The proliferation of the fibrous tissue seems to be not primary but secondary in nature. Histological examination of the thickened portion of the acetabular floor unusually thin layers of cells with distinct irregularity of cellular arrangement. There was also evidence of suppressed proliferatian of cells in the collumnar layer and in this situation proliferation of chondrocytes, whether primary or secondary, were quite unlikely to occur. It might beconsidered that these changes, with secondary proliferation of connective tissue in the acetabular floor, led to hypoplasia of the hip joint.

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