{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T19:19:00Z","timestamp":1770059940741,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T00:00:00Z","timestamp":1660780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>It is unclear whether idiopathic osteonecrosis of the femoral head (ONFH) is associated with borderline developmental dysplasia of the hip (BDDH). This study aimed to compare the incidence of BDDH between patients with idiopathic ONFH and matched control subjects and determine the influence of BDDH on poor prognosis after core decompression (CD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively examined 78 consecutive patients (111 hips) with idiopathic ONFH undergoing CD and 1:2 matched with 156 control subjects (222 hips). The anteroposterior pelvic radiographs were used to measure the acetabular anatomical parameters and divide included subjects into BDDH or non\u2010BDDH group. The incidence of BDDH and acetabular anatomical parameters were compared between patients with idiopathic ONFH and matched controls. Clinical outcomes, such as Harris Hip Score (HHS), progression of collapse, and conversion to total hip arthroplasty (THA), were compared between patients with BDDH and without BDDH in the idiopathic ONFH group, with a mean follow\u2010up of 72.1\u2009\u00b1\u200936.6\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with idiopathic ONFH had a significantly higher incidence of BDDH than matched controls (29.7% <jats:italic>vs<\/jats:italic> 12.2%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Less acetabular coverage was also found in patients with idiopathic ONFH than in matched controls as demonstrated by lower CEA (28.5\u00b0\u2009\u00b1\u20094.7\u00b0 <jats:italic>vs<\/jats:italic> 33.1\u00b0\u2009\u00b1\u20095.7\u00b0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), AHI (82.4\u2009\u00b1\u20095.0 <jats:italic>vs<\/jats:italic> 86.3\u2009\u00b1\u20095.4, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), ADR (299.6\u2009\u00b1\u200928.4 <jats:italic>vs<\/jats:italic> 318.8\u2009\u00b1\u200931.3, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and a higher sharp angle (40.0\u00b0\u2009\u00b1\u20093.4\u00b0 <jats:italic>vs<\/jats:italic> 37.4\u00b0\u2009\u00b1\u20093.7\u00b0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In patients with idiopathic ONFH, the BDDH group had a significantly lower mean HHS at the last follow\u2010up (83.5\u2009\u00b1\u200917.4 <jats:italic>vs<\/jats:italic> 91.6\u2009\u00b1\u20099.7, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.015) with a different score distribution (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.004), and a lower 5\u2010year survival rate with both clinical failure (66.7%, 95% CI 52.4%\u201384.9% <jats:italic>vs<\/jats:italic> 83.7%, 95% CI 75.2%\u201393.1%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.028) and conversion to THA (74.6%, 95% CI 60.7%\u201391.6% <jats:italic>vs<\/jats:italic> 92.1%, 95% CI 85.6%\u201399.0%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.008) as the endpoints than the non\u2010BDDH group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The incidence of BDDH was significantly higher in patients with idiopathic ONFH than matched controls, and idiopathic ONFH patients who underwent CD with BDDH had lower mean HHS as well as 5\u2010year survival rate than those without BDDH. Therefore, BDDH should be considered a risk factor predicting the development of idiopathic ONFH as well as poor prognosis after CD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13442","type":"journal-article","created":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T20:39:17Z","timestamp":1660855157000},"page":"2427-2435","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Borderline Developmental Dysplasia of the Hip: A Risk Factor Predicting the Development and Poor Prognosis after Core Decompression for Idiopathic Osteonecrosis of the Femoral Head"],"prefix":"10.1111","volume":"14","author":[{"given":"Kai","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics, West China Hospital Sichuan University  Chengdu China"},{"name":"Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital Sichuan University and Collaborative Innovation Center of Biotherapy  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing\u2010Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics, West China Hospital Sichuan University  Chengdu China"},{"name":"Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital Sichuan University and Collaborative Innovation Center of Biotherapy  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui\u2010Yu","family":"He","sequence":"additional","affiliation":[{"name":"West China School of Public Health Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen\u2010Xiang","family":"Gao","sequence":"additional","affiliation":[{"name":"West China School of Stomatology Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics, West China Hospital Sichuan University  Chengdu China"},{"name":"Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital Sichuan University and Collaborative Innovation Center of Biotherapy  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics, West China Hospital Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui\u2010Qi","family":"Xie","sequence":"additional","affiliation":[{"name":"Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital Sichuan University and Collaborative Innovation Center of Biotherapy  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1650-8020","authenticated-orcid":false,"given":"Yi","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics, West China Hospital Sichuan University  Chengdu China"},{"name":"Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital Sichuan 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