{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T06:02:09Z","timestamp":1779775329595,"version":"3.53.1"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01AR081881"],"award-info":[{"award-number":["R01AR081881"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["T32HD007434"],"award-info":[{"award-number":["T32HD007434"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Most patients with developmental dysplasia of the hip (DDH) have bilateral deformities, yet have asymmetric symptom development that is not well understood. This study aimed to identify relationships between deformity severity and symptom asymmetry in patients with bilateral DDH. Hip geometry from\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u2009230 patients was measured using lateral center\u2010edge angle (LCEA), acetabular inclination, neck\u2010shaft angle, alpha angle, and femoral version, and compared between initially symptomatic and contralateral hips. Patients were grouped into those with a \u201cmore dysplastic hip\u201d (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009133, based on &gt;3\u00b0 side\u2010to\u2010side LCEAs) or similar side\u2010to\u2010side deformities. Self\u2010reported activity levels were also compared between those whose symptomatic hips were more severely deformed and those whose contralateral hips were more severely deformed. Symptomatic hips had more severe acetabular deformities, based on the LCEA and acetabular inclination, in 80% of subjects (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). The only femoral measure to reveal differences between symptomatic and contralateral hips was neck\u2010shaft angle; most patients had more severe angles on their symptomatic side (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.003) though with a small effect (\n                    <jats:italic>d<\/jats:italic>\n                    \u2009=\u20090.14). Thus, acetabular deformities appear to drive asymmetric symptom development more than femoral deformities. Among the 20% of patients with more deformed contralateral hips, activity levels were not different from those with more deformed symptomatic hips. While self\u2010reported activity was not linked to symptom asymmetry, factors not captured, such as limb dominance and activity type, may contribute. These findings further understanding of disease progression and symptom onset in bilateral DDH and can inform anticipatory interventions to reduce pain and promote long\u2010term joint health.\n                  <\/jats:p>","DOI":"10.1002\/jor.70215","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T03:50:56Z","timestamp":1777348256000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does Deformity Severity Dictate Which Side Initially Develops Symptoms in Bilaterally Dysplastic Hips?"],"prefix":"10.1002","volume":"44","author":[{"given":"Madison M.","family":"Wissman","sequence":"first","affiliation":[{"name":"Program in Physical Therapy Washington University School of Medicine St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Washington University in St. Louis St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin E.","family":"Northrup","sequence":"additional","affiliation":[{"name":"Department of Radiology Washington University School of Medicine St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadreza","family":"Movahhedi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Medicine Boston Children's Hospital, Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ata M.","family":"Kiapour","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Medicine Boston Children's Hospital, Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Clohisy","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Washington University School of Medicine St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Harris","sequence":"additional","affiliation":[{"name":"Program in Physical Therapy Washington University School of Medicine St. Louis MO USA"},{"name":"Department of Biomedical Engineering Washington University in St. Louis St. Louis MO USA"},{"name":"Department of Orthopaedic Surgery Washington University School of Medicine St. Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-4815-2"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20886"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453673909149515"},{"key":"e_1_2_8_5_1","unstructured":"Congenital Dysplasia and Dislocation of the Hip in Children and Adults \u2010 Dietrich T\u00f6nnis \u2010 Google Books accessed April 22 2025 https:\/\/books.google.com\/books?hl=en&lr=&id=LW_tCAAAQBAJ&oi=fnd&pg=PA5&dq=tonnis+congenital+dysplasia&ots=9NyvNHQAJD&sig=kGNShDH8GUuiL4iTti8-k3InhpM#v=onepage&q&f=false."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.O.00109"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.80B4.0800711"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0481-3"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.01735"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00776-008-1252-4"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000201151.91206.50"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453690610046505"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00144"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198305000-00013"},{"issue":"7","key":"e_1_2_8_15_1","first-page":"985","article-title":"The Prognosis in Untreated Dysplasia of the Hip. 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B.","year":"1987","journal-title":"Journal of Bone & Joint Surgery"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.25865"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00756"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1754-1"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-015-2236-z"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620x.84b4.12014"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000003080"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.24.01472"},{"key":"e_1_2_8_27_1","doi-asserted-by":"crossref","unstructured":"T.LerchPrevalence of Femoral and Acetabular Version Abnormalities in Patients With Symptomatic Hip Disease: A Controlled Study of 538 Hips \u2010 Till D. Lerch Inga A.S. Todorski Simon D. Steppacher Florian Schmaranzer Stefan F. Werlen Klaus A. Siebenrock Moritz Tannast 2018 accessed April 14 2025 https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/0363546517726983.","DOI":"10.1177\/0363546517726983"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520914942"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2022.111023"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-15-00495"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2008.01.014"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000003076"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2025.106471"}],"container-title":["Journal of Orthopaedic Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.70215","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jor.70215","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.70215","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T05:02:22Z","timestamp":1779771742000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jor.70215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,27]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/jor.70215"],"URL":"https:\/\/doi.org\/10.1002\/jor.70215","archive":["Portico"],"relation":{},"ISSN":["0736-0266","1554-527X"],"issn-type":[{"value":"0736-0266","type":"print"},{"value":"1554-527X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,27]]},"assertion":[{"value":"2025-12-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70215"}}