Developmental Dysplasia Of The Hip In Older Children; Prospects Of Functional And Radiological Outcome Following A...

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Hip Dysplasia Research

Background:

• Developmental dysplasia of the hip (DDH) encompasses a spectrum of conditions from mild acetabular dysplasia to complete hip dislocation.
• Limited data exists on the safety and efficacy of the one-stage triple procedure for DDH.
• This study evaluates the mid-term outcomes of this procedure in children who have started walking.

Purpose of the Study:

• To analyze the mid-term functional and radiological outcomes of the single-stage triple procedure in children with developmental dysplasia of the hip (DDH) who are of walking age.
• To assess the safety and efficacy of open reduction combined with femoral and pelvic osteotomy in this patient group.

Main Methods:

• A prospective case series included 23 patients (26 hips) diagnosed with DDH, aged 20 months and above.
• Patients underwent a single-stage triple procedure: open reduction, femoral osteotomy, and pelvic osteotomy.
• Functional outcomes were assessed using McKay's grading, and radiological outcomes using Severin's grading.

Main Results:

• The mean preoperative acetabular index (AI) improved significantly from 40.3° to 23.4° post-procedure.
• Over 70% of patients achieved excellent or good functional outcomes (McKay Grade I or II).
• One case of avascular necrosis of the femoral head was noted.

Conclusions:

• The single-stage triple procedure demonstrates excellent functional and radiological results for treating developmental dysplasia of the hip (DDH) in walking-age children.
• Potential adverse events include avascular necrosis of the femoral head, redislocation, and long-term osteoarthritis.
• This surgical approach offers a viable option for DDH management, though careful monitoring for complications is essential.