Bilateral hip dysplasia in a South African male: A case study from the 17-18th century

Chelsey Voegt; Geney Gunston; Marc Nortje; Judith C Sealy; Letian He; Petrus le Roux; Catherine Namayega; Victoria E Gibbon

doi:10.1016/j.ijpp.2023.07.002

Bilateral hip dysplasia in a South African male: A case study from the 17-18th century

Int J Paleopathol. 2023 Sep:42:27-33. doi: 10.1016/j.ijpp.2023.07.002. Epub 2023 Jul 30.

Authors

Chelsey Voegt¹, Geney Gunston¹, Marc Nortje², Judith C Sealy³, Letian He⁴, Petrus le Roux⁵, Catherine Namayega⁶, Victoria E Gibbon⁷

Affiliations

¹ Division of Clinical Anatomy and Biological Anthropology, Department of Human Biology, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa.
² Department of Orthopaedic Surgery, University of Cape Town, Vincent Pallotti and Kingsbury Hospitals, Cape Town, South Africa.
³ Department of Archaeology, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa.
⁴ School of History and Culture, Department of Archaeology and Museology, Lanzhou University, Lanzhou, Gansu 730000, China.
⁵ Department of Geological Sciences, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa.
⁶ Medical Imaging Inferencing and Distributed Diagnostics laboratory (Mi2d2), Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa.
⁷ Division of Clinical Anatomy and Biological Anthropology, Department of Human Biology, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa. Electronic address: victoria.gibbon@uct.ac.za.

PMID: 37527585
DOI: 10.1016/j.ijpp.2023.07.002

Abstract

Objective: To identify, critically analyse and describe severe bilateral skeletal pathology involving the ossa coxae of an individual from historic era Cape Town.

Materials: A single individual from the University of Cape Town's Human Skeletal Repository was analysed under research approval (HREC# 035/2021).

Methods: An osteobiography was constructed, radiocarbon dating and isotopic analyses were conducted. Pathological description and contextualised disability analyses followed, along with differential diagnosis. The pelvis and femora were visualised macroscopically and radiographically.

Results: This individual was a non-European middle-aged adult male who lived in the 17-18th centuries CE. Morphological changes showed hypoplastic hips with collapsed femoral heads and neoacetabulae. A diagnosis of developmental dysplasia of the hips (DDH) was made. Then a contextualised disability analysis including consideration of the clinical and functional impacts of the condition were applied. No signs of maltreatment, physiological stress or persistent infections were present. His bones were well developed, illustrating mobility and use.

Conclusions: He developed DDH early in life and lived through adulthood, and his strong, healthy bones suggest resilience, some mobility and contribution to society through less physically demanding tasks.

Significance: Value for palaepathological analyses to inform and understand disability and culturally significant health mediation to offer a more objective interpretation and improve understanding of past people. It expands our understanding of the presence of DDH globally and in Africa and provides insight into disease impact for individuals with bilateral expression.

Suggestions for future research: Further contextual research is required.

Limitations: Poor scene recovery hindered in-depth care analysis and interpretation of the condition.

Keywords: Acetabular hypoplasia; Bilateral hip dislocation; Congenital hip dysplasia; Neoacetabulum; Proximal femoral hypoplasia.

Publication types

Case Reports

MeSH terms

Adult
Femur / pathology
Femur Head / pathology
Hip Dislocation* / pathology
Hip Dislocation, Congenital*
Humans
Male
Middle Aged
South Africa