10 of 12 Top Hip Papers of 2024 | The ALPHA Alert for adult acetabular dyplasia
It's day 10 of my 12 Top Hip Papers series of miniblogs for 2024! If you missed Day 9, you'll find a link at the bottom of this page to take you back. For day 10 we'll be looking at a paper that helped identify the signs and symptoms that people living with acetabular dysplasia describe and to provide an aid for translating the findings into practice.
10 of 12 Top Hip Papers of 2024: The ALPHA Alert: An aid to detect adult acetabular dyplasia1
Background:
- Acetabular dysplasia, often referred to as hip dysplasia, refers to an insufficient acetabulum (socket), leaving the femoral head undercovered and the hip at risk of instability, pain and early osteoarthritis.
- The diagnosis of acetabular dysplasia in adults has been previously reported to take, on average, more than 5 years!
- We need better techniques to identify this impactful condition earlier.
Study Aim:
- To identify the signs and symptoms that people living with acetabular dysplasia describe and to provide an aid for translating the findings into practice.
What was done:
- A three-phased mixed methods study, using patient reports from an online survey of people with acetabular dysplasia.
PHASE 1:
n = 98 (2 males) Mean age: 36.7 years (16–61)
- An online survey of adults with acetabular dysplasia, allowing open responses to questions around demographic profile, earliest memories of the condition, signs & symptoms, and diagnosis.
- Responses were grouped into themes.
PHASE 2:
n = 62 (2 males) Mean age: 35.7 years (16–60)
Themes were tested to see how common they were.
PHASE 3:
A mnemonic was created around the themes.
The study generated 5 common themes and 19 common signs and symptoms from survey responses from 96 individuals with acetabular dysplasia. The survey questions were developed from a systematic review of the literature around signs and symptoms of acetabular dysplasia. The ALPHA mnemonic was developed from the themes and most common experiences of survey respondents.
Key Findings:
- 5 key themes that may increase the chances of acetabular dysplasia were identified:
- Demographic and diagnostic profile,
- Posture and gait characteristics,
- Pain,
- Childhood hip and family history, and
- Hip joint characteristics.
- 19 common sign and symptoms of acetabular dysplasia were reported across these 5 themes.
- The ALPHA mnemonic below helps as a reminder of those 5 themes and the associated characteristics of those with hip dysplasia in each theme.
Clinical Implications:
- Clinicians should suspect acetabular dysplasia in patients presenting with a concurrence of the above signs and symptoms, and consider referral for further evaluation +/- x-ray.
An insufficient acetabulum has meaningful implications for the long term health of the hip joint, due to substantially increased risks of developing hip pain and osteoarthritis. Healthcare professionals need to ensure they are picking up this diagnosis early, so that appropriate steps can be taken to mitigate these risks.
Clinicians should suspect acetabular dysplasia in patients presenting with a concurrence of ALPHA signs and symptoms and consider referral for x-ray and/or further evaluation.
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