Authors: Rath E., Levy O., Liberman N., Atar D.
Institution: Faculty of Health Sciences, Ben Gurion University of the Negeve, Beer-Sheva, Israel.
Title: Bilateral dislocation of the hip during convulsion: a case report. [Review] [6 refs]
Source: Journal of Bone & Joint Surgery - British Volume. 79(2):304-6, 1997 Mar.
Abstract: Simultaneous bilateral posterior dislocation of the hip is very uncommon and most cases are caused by road accidents. Simultaneous bilateral posterior dislocation of the hip due to convulsions is extremely rare. We report the case of a man who was diagnosed late and operated on 15 weeks after the injury. We discuss the treatment of chronic dislocation of the hip and review the literature.

Authors: Turra S., Gigante C., Iacobellis C.
Institution: Divisione di Ortopedia Ospedale Civile di Treviso.
Title: Voluntary hip dislocation in Down's syndrome: report of two cases.
Source: Chirurgia Degli Organi di Movemento. 80(2):245-8, 1995 Apr-Jun.
Abstract: Two cases of monolateral voluntary hip dislocation in Down's syndrome are reported. No surgical procedure was permitted by the family in either case, thus showing the natural evolution of the joint morphology. In the case observed a year after the onset of hip dislocation CT Scan already showed an initial smoothing of the posterior acetabular wall. In the other case, after a 9 year follow-up, the voluntary hip dislocation was followed by progressive subluxation and fixed dislocation at the end. This suggests that only early surgical treatment can prevent this outcome.

Authors: Hresko MT, McCarthy JC, Goldberg MJ.
Institution: Tufts University School of Medicine, Boston, Massachusetts 02111.
Title: Hip disease in adults with Down syndrome.
Source: Journal of Bone & Joint Surgery - British Volume. 75(4):604-7, 1993 Jul.
Abstract: The life expectancy of patients with Down syndrome has increased significantly in recent years. Hip abnormalities occur in children with this syndrome but little is known about their natural history in later life. In 65 adults with Down syndrome we found hip abnormalities in 28%, and this was statistically correlated with walking ability. A subgroup of 18 patients was followed by serial examination; this showed that hip instability occurred in adulthood and became worse with time. In some patients, hip instability started after skeletal maturity.

Authors: Shaw ED, Beals RK.
Institution: Oregon Health Sciences University, Portland 97201.
Title: The hip joint in Down's syndrome. A study of its structure and associated disease.
Source: Clinical Orthopaedics & Related Research. (278): 101-7, 1992 May.
Abstract: Clinical and roentgenographic examination of the hip was performed in 114 patients with Down's syndrome to study range of motion, roentgenographic anatomy, and incidence of hip pathology. The study found increased external rotation of the hip. Roentgenographic studies demonstrate that, in comparison with a normal acetabulum, the acetabulum of a patient with Down's syndrome is deep, more horizontally placed, and has increased anteversion. The proximal femur of a patient with Down's syndrome has a normal neck-shaft angle and a moderate increase in anteversion. Of the patients, 7.9% had some hip abnormality, including dysplasia, dislocation, avascular necrosis, or slipped capital femoral epiphysis.

Authors: Skoff HD, Keggi K.
Title: Total hip replacement in Down's syndrome.
Source: Orthopedics. 10(3):485-9, 1987 Mar.
Abstract: Hip subluxation occurs in 4% to 5% of Down's patients; adulthood coxarthrosis may result. Eight total hip replacements were performed in five Down's patients (ages 37 to 64 years) for painful coxarthrosis. The patients were followed for a mean of 4.3 years. The hip scores improved from an average of fair preoperatively to excellent postoperatively, with a Harris hip score of 92. All of the patients demonstrated clinical improvement and were cared for more easily by virtue of the procedure. There were no major complications. Total hip replacement should be considered a useful surgical option for the treatment of hip osteoarthritis in patients with Down's syndrome.

Authors: Livingstone B., Hirst P.
Title: Orthopedic disorders in school children with Down's syndrome with special reference to the incidence of joint laxity.
Source: Clinical Orthopaedics & Related Research. (207):74-6, 1986 Jun.
Abstract: Thirty-nine school-age children with Down's syndrome (trisomy 21) were examined for orthopedic problems and evidence of joint laxity. Of these, 10.3% had required orthopedic surgery for feet and hip problems, and 13% had disorders not yet requiring surgery. Only two children could be regarded as showing unequivocally abnormal generalized joint laxity. Twenty-three of the children had one or more lax joints, and one had a dislocated hip without laxity of other joints. Six children had hypermobility of the patells, but this did not correlate with joint laxity. Fiften children had no evidence of joint laxity. Laxity does not appear to be a major etiological factor in joint problems occurring in Down's syndrome.

Authors: Aprin H., Zink WP, Hall JE
Title: Management of dislocation of the hip in Down syndrome.
Source: Journal of Pediatric Orthopedics. 5(4):428-31, 1985 Jul-Aug.
Abstract: Six patients with Down syndrome were treated for dislocation of the hip (10 hips). Follow-up averaged 49 months. Group I consisted of three patients (six hips) with dislocatable hips and normal acetabula treated with capsular plication and/or proximal femoral osteotomy. Group II consisted of three patients (four hips) with dislocatable hips and dysplastic and insufficient acetabula treated with capsular plication, Salter osteotomy, and proximal femoral osteotomy. Results were rated as satisfactory in four patients (seven hips) and unsatisfactory in two patients (three hips).