Identifying Risk Factors for Disease Progression in Developmental Dysplasia of the Hip Using a Contralateral Hip...

Area of Science:

• Orthopedic Surgery
• Hip Dysplasia Research
• Clinical Outcomes Analysis

Background:

• Developmental dysplasia of the hip (DDH) can lead to pain and early osteoarthritis.
• Risk factors and disease progression timing in young adults with DDH require further definition.
• This study investigates contralateral hip issues following periacetabular osteotomy (PAO) for hip dysplasia.

Purpose of the Study:

• To determine the prevalence of contralateral hip pain and surgery after unilateral PAO for DDH.
• To identify risk factors associated with the development of contralateral hip pain and the need for surgery.

Main Methods:

• Prospective follow-up of 184 patients for at least 2 years post-unilateral PAO for DDH.
• Categorization into contralateral pain/no-pain and surgery/no-surgery groups.
• Statistical analysis including univariate, Kaplan-Meier survival, and multivariable regression, with secondary assessment based on dysplasia severity (LCEA, AI).

Main Results:

• After a mean follow-up of 4.6 years, 51% reported contralateral hip pain and 33% underwent contralateral surgery.
• Kaplan-Meier analysis predicted 5-year risks of 49% for contralateral pain and 66% for contralateral surgery.
• More severe dysplasia (lower LCEA, higher AI) predicted contralateral pain and surgery; higher AI was a sole predictor of pain, increasing risk by 11% per degree.

Conclusions:

• Approximately 50% of contralateral hips develop pain and 35% require surgery within 5 years post-PAO.
• Increased dysplasia severity, particularly acetabular inclination (AI), significantly elevates the risk of contralateral hip pain and surgery.
• Findings aid in patient counseling and treatment planning for individuals with hip dysplasia undergoing PAO.