Open reduction for congenital dislocation of the hip: comparison of the long-term results of the wide exposure method and Ludloff’s method

Matsushita, Tomohiro; Miyake, Yoshihiro; Akazawa, Hirofumi; Eguchi, Satoru; Takahashi, Yūzō

doi:10.1007/s007760050113

Cited by 36 publications

(40 citation statements)

References 12 publications

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“…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%

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%

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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“…After a postoperative follow-up period of 8 − 12 years, they reported femoral head necrosis in 10 − 43%, need for an additional operation in 11 − 46%, Severin class I or II in 40 − 73% [14][15][16][17][18], and factors that indicated poor results, such as surgery after the initiation of walking. Matsushita et al [13] compared the medial approach (Ludloff's approach) as the conventional method versus the extensive anterolateral approach. They reported bone necrosis in 21.9% and need for an additional operation for redislocation/subluxation in 34.4% using the conventional approach.…”

Section: Discussionmentioning

confidence: 99%

“…Akazawa et al [12] and Matsushita et al [13] used the extensive anterolateral approach in patients with a mean age of 18 months at the time of surgery and followed them for 11 − 17 years. They reported femoral head necrosis in 3 − 5%, need for an additional operation in 0 − 16%, and Severin class I or II in 81 − 84%.…”

Section: Discussionmentioning

confidence: 99%

Radiological results of treatment using an extensive anterolateral approach for developmental dysplasia of the hip: minimum 5-year follow-up

Sugawara

Watanabe²,

Hagiwara³

et al. 2016

Journal of Pediatric Orthopaedics B

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To investigate the radiological results using the extensive anterolateral approach in patients with developmental dysplasia of the hip. A total of 16 hips with developmental dysplasia of the hip treated by the extensive anterolateral approach were retrospectively reviewed after a minimum follow-up of 5 years. For evaluation, we considered the Severin classification and postoperative complications. At the final follow-up (mean 75.6 months), 14 hips (87.5%) were satisfactory in the Severin classification. Reoperation was performed in only one hip (6.3%) because of redislocation. No femoral head necrosis was observed. Our results were more favorable than those using conventional surgical methods.

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“…The medial approach for open reduction is a minimally invasive method for correcting DDH; however, satisfactory or unsatisfactory long-term results have been reported, and many patients needing additional surgery after this approach were included at the time of followup [10,13,16,27]. Satisfactory long-term results of periacetabular osteotomy for residual dysplasia after open reduction have been reported [18,20,25,26].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the mechanism of enlargement of the femoral head may differ from that of deformation of the femoral head. Matsushita et al compared the radiographic results at skeletal maturity between open reduction using the wide exposure method [13], which is more invasive, and the medial approach; femoral head enlargement was observed more frequently with the wide exposure method than with the medial approach. Increased blood supply to the femoral head caused by invasion during surgery may influence subsequent enlargement of the femoral head [4,6].…”

Section: Discussionmentioning

confidence: 99%

Femoral Head Deformity after Open Reduction by Ludloff's Medial Approach

Okano

Enomoto

Osaki

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Open reduction for congenital dislocation of the hip: comparison of the long-term results of the wide exposure method and Ludloff’s method

Cited by 36 publications

References 12 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

Radiological results of treatment using an extensive anterolateral approach for developmental dysplasia of the hip: minimum 5-year follow-up

Femoral Head Deformity after Open Reduction by Ludloff's Medial Approach

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