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International variance in the treatment of developmental dysplasia of the hip

I H Feeley1, C J Green, F E Rowan

  • 1Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland, iainfeeley@rcsi.ie.

Journal of Children'S Orthopaedics
|October 30, 2014
PubMed

Insights

Surgical management for developmental dysplasia of the hip (DDH) lacks global consensus. This study reveals significant international variation in the timing and type of osteotomy for treating DDH.

Area of Science:

  • Orthopedics
  • Pediatric Surgery
  • Musculoskeletal Abnormalities

Background:

  • Developmental dysplasia of the hip (DDH) is the most prevalent congenital musculoskeletal disorder.
  • Surgical intervention for DDH is typically delayed until 18-24 months of age.
  • Existing literature lacks international consensus on surgical timing, indications, and osteotomy techniques for DDH.

Purpose of the Study:

  • To investigate global variations in the timing and type of osteotomy used for persistent DDH.
  • To identify differences in surgical practices among international orthopedic surgeons specializing in hip dysplasia.

Main Methods:

  • Survey of senior authors from recent hip dysplasia publications.
  • Assessment of participants' practices regarding age and radiological indications for surgical osteotomy.

Main Results:

  • Responses were received from 32 surgeons across five geographical regions.
  • No inter-regional consensus was found on investigations for osteotomy necessity, preferred osteotomy type, or optimal surgical age.
  • Significant variation exists in the surgical management of DDH worldwide.

Conclusions:

  • There is a lack of international agreement on the surgical management of DDH.
  • The high prevalence of DDH necessitates the development of a standardized treatment algorithm.
  • Further research is needed to establish evidence-based guidelines for DDH surgical treatment.
Abstract

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