One-stage bilateral open reduction through a medial approach in developmental dysplasia of the hip

Zamzam, Mohammed M.; Khosshal, K. I.; Abak, Alshahid A.; Bakarman, Khalid A.; Alsiddiky, Abdul Monem M.; Alzain, Kholoud O.; Kremli, Mamoun K.

doi:10.1302/0301-620x.91b1.21429

Cited by 32 publications

(40 citation statements)

References 22 publications

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“…Sufficient subject-level data were available to exclude the following ineligible cases: four dislocations of the hip secondary to neuromuscular or teratologic causes [15,67], 188 hips treated by open reduction with concomitant pelvic osteotomy [8,10,19,20,29,31,33,38,46,59,69,74,95,96], and 280 hips treated by other ineligible interventions [23,64,85,94]. Additionally, one study [13] included 12 hips treated by medial open reduction that at least partly overlapped with a more recently published article [49].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Thirty-nine studies [1, 4, 6-8, 11, 13, 14, 16, 18-20, 23, 27, 29, 30, 34, 38, 40, 41, 45, 53, 54, 56, 61, 64, 67, 69, 72, 74, 77, 79, 81, 83-85, 89, 94, 96] [54], older than 6 months [5], between 6 and 18 months old [95], younger than 18 months [43], and younger than 24 months [87]; an anterior approach for patients 12 months or older [57,69]; and no operative treatment at all before 9 months of age [7].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Sixteen studies [1,4,5,11,14,27,49,53,56,61,62,65,69,88,94,95] statistically analyzed the relationship between age at reduction and the occurrence of osteonecrosis. The analyses of five studies [56,62,69,94,95] were based partly on data that did not reflect our definition of index reduction.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The analyses of five studies [56,62,69,94,95] were based partly on data that did not reflect our definition of index reduction. Significance levels were not published in three studies [14,27,61] and were reported as 0.05 in all other reviewed studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The same is true for DDH treatment by open reduction. Although a correlation between increased age at reduction and osteonecrosis has been reported [49,55,56,62,65], others have found no such association [4,5,11,27,95].…”

Section: Introductionmentioning

confidence: 95%

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Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis

Novais

Hill

Carry

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Osteonecrosis of the femoral head is a major complication that negatively impacts the clinical and radiographic long-term outcome after treatment of developmental hip dysplasia (DDH). There are conflicting results in the literature whether age at the time of closed or open reduction and a specific surgical approach are associated with osteonecrosis. Better understanding of the impact of age at reduction and surgical approach is important to reduce the risk of osteonecrosis in patients with DDH. Questions/purposes We aimed to evaluate the association between occurrence of osteonecrosis and (1) age at closed reduction; (2) age at open reduction; and (3) medial versus anterior operative approaches.Methods A systematic review identified studies reporting osteonecrosis occurrence after treatment of DDH and at least 2 years of followup. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Methodologic quality was assessed using the methodologic index for nonrandomized studies. Generalized logistic models were used to estimate pooled odds ratios (ORs) in the meta-analysis. Sixty-six studies were included in the systematic review and 24 in the meta-analysis. Data on 481 hips treated by closed reduction and 584 hips treated by open reduction were available to evaluate the association between osteonecrosis and age. The association between osteonecrosis and operative approach was assessed using data on 364 hips treated by medial open reduction and 220 hips treated by anterior open reduction. Results Age at reduction ([ 12 months versus B 12 months) was not associated with osteonecrosis after closed reduction (OR, 1.1; 95% confidence interval [CI], 0.4-3.2; p = 0.9) or open reduction (OR, 1.1; 95% CI, 0.7-1.9; p = 0.66). The overall, adjusted incidence of osteonecrosis (C Grade II) was 8.0% (95% CI, 2.8%-20.6%) among patients treated with closed reduction at or before 12 months of age and 8.4% (95% CI, 3.0%-21.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

See 3 more Smart Citations

Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis

Novais

Hill

Carry

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

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Risk factor analysis of femoral avascular necrosis after operation for Tönnis grade IV developmental dysplasia of the hip

Wu,

Li,

Lin

et al. 2023

International Orthopaedics (SICOT)

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Long-term outcome following medial open reduction in developmental dysplasia of the hip: A retrospective cohort study

Gardner¹,

Bradley

Sharma

et al. 2016

Journal of Children's Orthopaedics

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IntroductionAvascular necrosis (AVN) is a serious complication of treatment for developmental dysplasia of the hip. There is ongoing controversy regarding AVN and its influence on hip development following medial open reduction (MOR).PurposeThe aim of our study was to (1) determine the long-term prevalence of AVN following MOR, (2) evaluate hip development after MOR, and (3) identify predictors of AVN and radiographic outcome at skeletal maturity after MOR.MethodsA retrospective cohort analysis of 60 patients (70 hips) who underwent MOR with a mean follow-up of 10.83 years (5.23–16.74) was conducted. AVN was recorded according to Bucholz and Ogden classification and radiographic outcome based on Severin grading. AVN and hip morphology related to length of follow-up were evaluated. Chi-squared and t-tests were used to identify relationships between AVN and other variables. Logistic regression was used to assess predictors of AVN and Severin outcome.ResultsThe rate of clinically significant AVN (types 2–4) following MOR was 32.9 % with type 2 accounting for 82.6 % of these cases. While early acetabular development was satisfactory, long-term outcome was unsatisfactory in 26 % of cases with AVN (vs 8.7 % of cases without AVN). A higher rate of AVN was identified when hips were immobilized in ≥60° of abduction postoperatively. A higher rate of poor Severin outcome was identified in hips with AVN.ConclusionsOur findings suggest that there is a high rate of AVN and unsatisfactory long-term outcome following MOR. AVN remains a significant concern following MOR surgery for developmental dysplasia of the hip that may not be apparent until long-term evaluation.

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One-stage bilateral open reduction through a medial approach in developmental dysplasia of the hip

Cited by 32 publications

References 22 publications

Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis

Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis

Risk factor analysis of femoral avascular necrosis after operation for Tönnis grade IV developmental dysplasia of the hip

Long-term outcome following medial open reduction in developmental dysplasia of the hip: A retrospective cohort study

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