OBJECTIVE: Total hip arthroplasty (THA) improves function in patients with dysplastic hip osteoarthritis (DHOA). However, its effect on reducing fall risk remains unclear. This study aimed to evaluate fall risk following THA in patients with DHOA.
METHODS: This retrospective cohort study included 85 patients who had DHOA and underwent THA between September 2019 and September 2022 and were evaluated as having a preoperative fall risk (Fall Risk Index 5 items [FRI-5] ≥ 6). They were categorized into two groups according to the FRI-5 score 1 year postoperatively. Evaluation parameters included FRI-5 score, age, sex, body mass index (BMI), Harris hip score (HHS), perceived leg length discrepancy (P-LLD), and radiographic parameters. Logistic regression was used to assess risk factors for postoperative falls.
RESULTS: The FRI-5 score significantly decreased from 7.79 (6.0-13.0) preoperatively to 4.56 (0-13.0) postoperatively (p < 0.001). The number of falls during the year decreased from 36 (42.4%) to 18 (21.2%) after surgery (p = 0.005). The high-risk and low-risk groups comprised 33 and 52 individuals, respectively. The high-risk group was significantly older than the low-risk group (p = 0.006). Postoperative P-LLD was significantly large in the high-risk group compared to that in the low-risk group (p = 0.005). Preoperative and postoperative sagittal vertical axes (SVA) were significantly larger and preoperative lumbar lordosis (LL) was significantly lower in the high-risk group than in the low-risk group (p = 0.039, p = 0.034, and p = 0.021, respectively). Logistic regression analysis identified age (OR: 1.2, 95% CI: 1.05-1.36, p = 0.006), preoperative low LL (OR: 0.944, 95% CI: 0.892-0.999, p = 0.046), and postoperative P-LLD (OR: 5.81, 95% CI: 1.23-27.5, p = 0.026) as significant factors associated with fall risk.
CONCLUSION: THA for patients who have DHOA at high risk of falls reduces the likelihood for falls. Therefore, surgeons should plan surgeries considering the risk factors post-THA.
全髋关节置换术对跌倒风险的影响在本文中得到详细评估。研究纳入85例术前存在跌倒风险的髋关节发育不良骨关节炎患者，结果显示术后一年跌倒风险指数从7.79降至4.56，年跌倒发生率从42.4%降至21.2%，表明全髋关节置换能有效降低高风险患者的跌倒风险。然而多因素分析表明年龄增大、术前腰椎前凸减小及术后感知腿长差异仍与跌倒风险增加独立相关，其中术后感知腿长差异优势比达5.81，提示术中精确恢复肢体长度对患者安全的重要性。THA术前计划除关注髋关节功能恢复外，还应评估患者整体矢状位平衡和腰椎功能；术后应关注患者对腿长的主观感受，必要时通过鞋垫等补偿。老年患者术后应加强防跌倒指导。
BACKGROUND: Graf's introduction of hip ultrasonography (US) in the 1980s coincided with a major change in developmental hip dysplasia (DDH) screening and diagnostic practice, with a gradual reduction in reliance on examination- and radiograph-only strategies.
METHODS: A natural language processing pipeline and non-negative matrix factorization (NLP-NMF) were applied to Scopus-indexed DDH publications, extracting topics and weights across 4 epochs (pre-1980, 1980-1984, 1985-1989, 1980-2024) anchored to the 1980 US milestone. Topic co-occurrence networks, weight distributions, and segmented regression summarized thematic shifts and tested for a 1980 breakpoint.
RESULTS: In the post-1980 corpus, a distinct diagnostic imaging theme emerged and strengthened, while surgery declined and anatomy remained influential. In 1985-1989, joint anatomy dominated (39.1%), followed by diagnosis (18.6%), pediatric orthopedics (15.3%), surgery (13.7%), and conservative treatment (13.4%). Across 1980-2024, clinical evaluation accounted for 31.5% of publications, followed by anatomy (19.6%), genetic anomaly (16.7%), diagnostic imaging (16.6%), and surgery (15.6%). Within diagnostic imaging, US carried a high weight (0.948), underscoring its central role. Segmented regression identified a structural breakpoint around 1980, temporally coincident with the period in which hip US entered clinical practice and diffused across the field.
CONCLUSION: The NLP-NMF analysis of 4 decades of DDH literature shows a sustained pivot toward imagingsupported,n clinically anchored evaluation and growing attention to etiologic and syndromic/anomaly contexts alongside anatomical determinants, with potential implications for earlier detection, risk-aligned follow-up, and more targeted use of operative management. Cite this article as: Taşkin R, Yılar S, Budak İ, Uğur F. Ultrasonography and the reorientation of developmental hip dysplasia research: an NLP-NMF trend analysis (1980-2024). Eurasian J Med. 2026, 58 (2), 1249, doi:10.5152/eurasianjmed.2026.251249.
发育性髋关节发育不良的研究在过去四十多年间经历了重大转变。本研究通过自然语言处理技术对1980年以来的文献进行大数据分析，揭示了该领域的研究趋势变化。研究人员将文献按时间分为四个阶段进行分析，发现1980年超声技术的引入是一个重要分水岭——在此之前研究主要依赖临床体检和X线片，之后超声检查逐渐成为主流诊断工具，研究重心也从手术技术转向影像学诊断和早期筛查。在所有研究主题中，临床评估类文章占比最高（约31.5%），其次是解剖学研究（约19.6%）、遗传异常相关研究（约16.7%）、影像诊断（约16.6%）和手术相关（约15.6%）。在影像诊断领域，超声检查的权重最高（0.948），说明超声技术在发育性髋关节发育不良研究和临床实践中的核心地位从未动摇。这一趋势带来的启示是：随着超声筛查的普及和早诊早治理念的推广，需要手术矫形的严重病例可能会逐渐减少，而遗传因素和早期干预将成为未来研究的新热点。临床医生了解这些趋势有助于更好地把握学科发展方向，在日常诊疗中更加重视早期筛查和保守治疗，最大限度地减少严重畸形的发生。