Pediatric Hip Dysplasia Surgery Outcomes by Pediatric Versus Nonpediatric Orthopedists

Area of Science:

• Orthopedics
• Pediatric Surgery
• Hip Dysplasia Research

Background:

• Developmental dysplasia of the hip (DDH) involves immature hip abnormalities, often requiring surgical intervention when conservative methods fail.
• Despite an increasing number of pediatric orthopedic surgeons (POSs), a maldistribution persists, raising questions about surgical expertise and patient outcomes.
• This study addresses the outcomes of hip dysplasia surgery performed by POSs versus non-pediatric orthopedic surgeons.

Purpose of the Study:

• To compare surgical outcomes for hip dysplasia between pediatric orthopedic surgeons (POSs) and non-pediatric orthopedic surgeons.
• To analyze patient demographics, comorbidities, and postoperative complications based on surgeon specialty.
• To identify any disparities in care or outcomes related to surgeon training in pediatric hip conditions.

Main Methods:

• A large national database was utilized to identify pediatric patients who underwent hip dysplasia surgery between 2012 and 2019.
• Patient data, including demographics, comorbidities (e.g., cardiac, gastrointestinal, neurological), and postoperative complications, were collected and compared.
• Bivariate and multivariable regression analyses were performed to control for baseline patient characteristics and assess outcomes.

Main Results:

• Out of 10,780 patients, 94.7% were operated on by POSs and 5.3% by non-pediatric orthopedic surgeons.
• POSs were more likely to operate on patients with higher American Society of Anesthesiologists (ASA) class and more medical comorbidities.
• Multivariable regression analysis revealed no significant differences in postoperative complications between patients treated by POSs and non-pediatric orthopedic surgeons.

Conclusions:

• Pediatric orthopedic surgeons (POSs) tend to manage younger patients with more complex medical conditions for hip dysplasia.
• Surgical management of hip dysplasia yields comparable postoperative complication rates regardless of whether the surgeon is pediatric-trained or not.
• These findings suggest that non-pediatric orthopedic surgeons can achieve similar outcomes in treating hip dysplasia, despite a propensity for POSs to operate on higher-risk patients.