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Clinical and radiological outcomes following surgical hip dislocation for paediatric hip pathologies, a prospective
Shane Ahern1, Michael D O'Sullivan2, Kevin Clesham2
1Children's University Hospital, Temple St, Rotunda, Dublin 1, D01 XD99, Ireland.
Insights
Surgical Hip Dislocation (SHD) in pediatric patients shows improved pain, function, and stiffness with a low complication rate. This study confirms SHD
Area of Science:
- Pediatric Orthopedic Surgery
- Hip Preservation Surgery
Background:
- Surgical Hip Dislocation (SHD) is utilized for pediatric hip conditions like Legg-Calvé-Perthes disease and slipped capital femoral epiphysis.
- Assessing the surgical risks and clinical outcomes of SHD is crucial for patient management.
Approach:
- A prospective cohort study evaluated 18 pediatric patients (mean age 13.7 years) with symptomatic hip pathology.
- Patients underwent SHD with osteochondroplasty, osteotomy, or both.
- Clinical outcomes were measured using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index over a mean follow-up of 22 months.
Key Points:
- Significant improvements were observed in WOMAC scores for pain (10 to 3), function (33 to 10), and stiffness (4 to 2).
- Radiographic measures demonstrated significant postoperative improvement.
- No major complications such as osteonecrosis, infection, or nonunion were reported.
Conclusions:
- SHD demonstrates short-term efficacy in improving clinical and radiographic outcomes for pediatric hip conditions.
- The procedure is associated with a low rate of surgical complications.
Background:
Surgical Hip Dislocation (SHD) is a powerful tool in the armamentarium of any surgeon treating conditions affecting the hips of children presenting with sequelae of a number of common conditions including Legg-CalvéPerthes disease (LCPD) and slipped capital femoral epiphysis (SCFE). Risks associated with the procedure are well described. We investigated to assess if SHD is associated with significant surgical risk and if it improved clinical outcomes for patients.
Methods:
We conducted a prospective cohort study. We reviewed 18 (11 males and 7 females; mean age 13.7 years (6-17) with symptomatic hip pathology, secondary to femoroacetabular impingement (FAI) between 2017 and 2021. All patients underwent a surgical hip dislocation approach and femoral head-neck osteochondroplasty, Head Split osteotomy or both. Clinical improvement was assessed using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index. The minimum follow-up was 6 months (mean, 22 months; range, 6-42 months).
Results:
WOMAC scores improved at final follow-up from 10 to 3 for pain, 33 to 10 for function, and 4 to 2 for the stiffness subscales. All radiographic measures improved significantly of the postoperative X-rays. No patients developed osteonecrosis, implant failure, deep infection, or nonunion.
Conclusion:
Surgical Hip Dislocation, in the short term, we found improvement in WOMAC scores and radiographic indices with a low complication rate.
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