Arthroscopic-assisted surgical treatment for developmental dislocation of the hip before the age of 18 months

The purpose of this study is to evaluate the results of arthroscopy assisted surgical treatment of developmental dislocation of the hip (DDH).

Arthroscopic assisted surgical treatment was performed on nine hips of nine female children with DDH using our method, published previously, between January 2001 and December 2005. Their ages ranged from 9 to 16 months. Percutaneous adductor tenotomies were performed in seven cases. A spica cast and abduction splint were used for 11-17 weeks postoperatively. Acetabular index and Shenton line were used for preoperative and postoperative radiologic evaluation. Also, the cases were evaluated postoperatively with respect to range of motion restriction, and the leg length discrepancy.

The average follow-up was 47.7 months (range 22-79 months). Acetabular index measurements of cases in the preoperative/postoperative periods were as follows: preoperative mean angle 39.9° (range 34°-52°)/postoperative mean angle 26° (range 22°-34°). Hip joint restriction and leg length discrepancy were not observed postoperatively. However, two patients had acetabular dysplasia. Acetabular dysplasia was completely resolved in one patient in the third year of follow-up, whereas Salter innominate osteotomy, required in another patient, was in the second year of follow-up. The latter patient was the oldest case (16-month-old) in our series.

Based on the results of this study, treatment of developmental hip dysplasia with arthroscopic-assisted surgical treatment technique may be safe and effective method. Further clinical studies will be required to confirm this study.