Long-term Follow-up of Open Reduction Surgery for Developmental Dislocation of the Hip

Holman, Joel; Carroll, Kristen L.; Murray, Kathleen A.; MacLeod, Lynne M.; Roach, James W.

doi:10.1097/bpo.0b013e3182471aad

Cited by 53 publications

(57 citation statements)

References 12 publications

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“…Our results are in accordance with previous studies of open reduction using the anterior approach with Severin Grade I/II in 96% of the hips at skeletal maturity [26] and in 92% at a mean followup of 6 years [2]. However, considerably worse results after open reduction were reported by Holman et al [7] with only 33% Severin I/II hips after a mean followup of almost 30 years.…”

Section: Discussionsupporting

confidence: 82%

“…We found no significant difference in the proportions of AVN between the two treatment groups. Our rate of AVN Groups II to IV was within the range of 5% to 43% in previous studies on open reduction [1,7,14,26]. AVN occurred more frequently after open reduction than after closed reduction in Group B, but most were Group II and had a good prognosis.…”

Section: Discussionmentioning

confidence: 64%

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Have Changes in Treatment of Late-detected Developmental Dysplasia of the Hip During the Last Decades Led to Better Radiographic Outcome?

Terjesen

Horn

2016

Clinical Orthopaedics &Amp; Related Research

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Background Despite considerable changes in the treatment of of late-detected congenital or developmental hip dislocation (DDH) during the last 50 years, it is unclear whether and to what degree these changes have led to better long-term outcome for the patients. Questions/purposes The aims of this study were to see whether decreasing use of skin traction and instead a more aggressive approach to open reduction resulted in (1) reduced use of secondary procedures; (2) improved radiographic appearance of the hips at long-term followup; and (3) changes in the proportion of patients developing avascular necrosis. Methods Two groups of patients were compared retrospectively. Inclusion criteria were patient age older than 3 months and younger than 5 years at the initiation of treatment, no associated anomaly, no previous treatment in other hospitals, and available radiographs from the time of diagnosis to skeletal maturity.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 64%

Have Changes in Treatment of Late-detected Developmental Dysplasia of the Hip During the Last Decades Led to Better Radiographic Outcome?

Terjesen

Horn

2016

Clinical Orthopaedics &Amp; Related Research

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“…The third limitation is the lack of a control series. However, none of the previously reported long-term followup series after medial open reduction has a control series [33,39,50,78]. The fourth limitation is the lack of homogeneity between the three age groups, with the third group including almost 30% less cases than the other two.…”

Section: Discussionmentioning

confidence: 87%

“…It is known that the final result of DDH after open reduction can be evaluated only when musculoskeletal growth is completed [81], but to our knowledge, there is a paucity of studies including skeletally mature patients [5,18,30,33,39,52,71,[78][79][80].…”

Section: Introductionmentioning

confidence: 99%

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

Farsetti

Caterini

Potenza

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background During the last 35 years, the medial approach has been reported more frequently than the anterior approach for open reduction of developmental dislocation of the hip (DDH), however, few studies have followed children treated by medial open reduction to adulthood. Questions/purposes The purposes of our study were: (1) to assess the development of 71 completely dislocated hips after medial open reduction, the incidence of additional surgery and avascular necrosis during the followup period, and the long-term radiographic and functional results; and (2) to compare our results with those obtained by others who performed open reduction either by the medial or anterior approach. Patients and Methods We retrospectively evaluated, after the end of growth, 71 hips in 52 patients who underwent open reduction by the medial approach. The mean age of the patients was 16 months (range, 3-36 months). After surgery, the hips were immobilized in 100°flexion, 60°a bduction, and neutral rotation for an average of 6 months. All patients had staged clinical and radiographic followups until skeletal maturity. The length of followup averaged 22 years (range, 13-32 years). Results In all the surgically treated hips, the acetabular index normalized by the end of growth, the incidence of avascular necrosis was 18%, and additional surgery was required in 15% of our cases. At the last followup, 93% of the hips were classified as Severin Classes I or II and 7% as Class III; 76% of the hips had an excellent result, 17% had a good result, and 7% had a fair result according to the McKay scale as modified by Barrett and colleagues. Conclusions Open reduction of DDH through a medial approach provided good long-term radiographic and functional results in patients 3 to 36 months old and it was the only surgery performed in 85% of our cases. Future comparative studies are needed to confirm our results, especially in older children. Level of evidence Level IV, therapeutic study.

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“…Ideally, patients should be identified and treated in infancy. Failing this, treatment should be instituted as soon as possible, preferably before 4 years of age [4,74,76] . The goals of treatment in older children with persistent acetabular dysplasia are to delay or prevent the development of osteoarthritis and to obviate the need for arthroplasty at a relatively young age [74] .…”

Section: Treatmentmentioning

confidence: 99%

Developmental dysplasia of the hip: What has changed in the last 20 years?

Kotlarsky

Reuben

Bialik

et al. 2015

WJO

236

244

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Long-term Follow-up of Open Reduction Surgery for Developmental Dislocation of the Hip

Abstract: Level IV--case series.

Cited by 53 publications

References 12 publications

Have Changes in Treatment of Late-detected Developmental Dysplasia of the Hip During the Last Decades Led to Better Radiographic Outcome?

Have Changes in Treatment of Late-detected Developmental Dysplasia of the Hip During the Last Decades Led to Better Radiographic Outcome?

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

Developmental dysplasia of the hip: What has changed in the last 20 years?

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