Objectives. There are several reports clarifying successful results following
open reduction using Ludloff’s medial approach for congenital (CDH)
or developmental dislocation of the hip (DDH). This study aimed
to reveal the long-term post-operative course until the period of
hip-joint maturity after the conventional surgical treatments. Methods. A long-term follow-up beyond the age of hip-joint maturity was
performed for 115 hips in 103 patients who underwent open reduction
using Ludloff’s medial approach in our hospital. The mean age at
surgery was 8.5 months (2 to 26) and the mean follow-up was 20.3
years (15 to 28). The radiological condition at full growth of the hip
joint was evaluated by Severin’s classification. Results. All 115 hips successfully attained reduction after surgery; however,
74 hips (64.3%) required corrective surgery at a mean age of 2.6
years (one to six). According to Severin’s classification, 69 hips
(60.0%) were classified as group I or II, which were considered
to represent acceptable results. A total of 39 hips (33.9%) were
group III and the remaining seven hips (6.1%) group IV. As to re-operation,
20 of 21 patients who underwent surgical reduction after 12 months
of age required additional corrective surgeries during the growth
period as the hip joint tended to subluxate gradually. Conclusion. Open reduction using Ludloff’s medial approach accomplished successful
joint reduction for persistent
This study was designed to develop a model for predicting bone mineral density (BMD) loss of the femur after total hip arthroplasty (THA) using artificial intelligence (AI), and to identify factors that influence the prediction. Additionally, we virtually examined the efficacy of administration of bisphosphonate for cases with severe BMD loss based on the predictive model. The study included 538 joints that underwent primary THA. The patients were divided into groups using unsupervised time series clustering for five-year BMD loss of Gruen zone 7 postoperatively, and a machine-learning model to predict the BMD loss was developed. Additionally, the predictor for BMD loss was extracted using SHapley Additive exPlanations (SHAP). The patient-specific efficacy of bisphosphonate, which is the most important categorical predictor for BMD loss, was examined by calculating the change in predictive probability when hypothetically switching between the inclusion and exclusion of bisphosphonate.Aims
Methods