Single-stage open reduction through a medial approach and innominate osteotomy in developmental dysplasia of the hip

Baki, Celål; Şener, Muhittin; Aydin, Hafız; Yıldız, Mehmet; Saruhan, Sertac

doi:10.1302/0301-620x.87b3.14663

Cited by 25 publications

(23 citation statements)

References 23 publications

(28 reference statements)

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“…Early hip subluxation after open reduction and/or redislocation while wearing the plaster cast has been reported in a range of 0% to 11% with a mean of 2.4% for anterior and medial open reductions [7,10,11,16,18,20,21,23,31,37,40,46,50,52,69,70,[77][78][79]88]. Our patients had a redislocation rate of 2.8%.…”

Section: Discussionmentioning

confidence: 54%

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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Section: Discussionmentioning

confidence: 54%

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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“…Open reduction is most commonly performed with the MOR or AOR approach and both approaches have the above mentioned advantages and disadvantages. [2,[9][10][11] However some modifications of MOR like anteromedial and posteromedial have been defined. [10,15,16,33] Anterior open reduction, another open reduction approach, may be done with Smith-Petersen or Bikini incision.…”

Section: Discussionmentioning

confidence: 99%

“…[8,12,13] Successful (excellent-good) clinical outcomes were reported with a ratio of 83-98% and successful radiologic outcomes were reported with a ratio of 77-91% with medial approach. [9,[13][14][15][16][17] In a study comparing the results of AOR and MOR, Bulut et al [12] reported that the vast majority (72.3%) of cases in MOR group which were followed up for at least 24 In AOR group, all cases were reported to be Tönnis type 4, the ratio of clinically successful results was 92.3% and the ratio of radiologically successful results were 84.6%. The authors reported that preoperative AI angles were significantly higher in AOR group however there was a significant improvement in AI angles in both groups.…”

Section: Discussionmentioning

confidence: 99%

“…[7] Open reduction is most commonly performed using the medial open reduction (MOR) or anterior open reduction (AOR) approach. [1,6,8,9] The medial approach is a simple, safe and cosmetically pleasing method which does not require blood transfusion and provides direct access to the medial structures with minimal dissection. However, it has some disadvantages.…”

mentioning

confidence: 99%

“…[6,8,[12][13][14] Successful results have been reported in various studies using both approaches. [9,13,[15][16][17][18] Avascular necrosis (AVN) and the need for revision surgery are reported at various rates. [2,11,12] Limited number of studies are available comparing the results of open reduction with anterior or medial approach.…”

mentioning

confidence: 99%

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Comparison of the clinical and radiological outcomes of open reduction via medial and anterior approach in devleopmental dysplasia of the hip

Yorgancigil

Aslan

2016

Eklem Hastalik Cerrahisi

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ÖZ Amaç:Bu çalışmada gelişimsel kalça displazisi (GKD) nedeniyle medial veya anterior yaklaşımla açık redüksiyon uygulanan çocuklarda cerrahi yaklaşımın klinik ve radyolojik sonuçlar, avasküler nekroz (AVN) insidansı ve revizyon cerrahisi gerekliliği üzerindeki etkileri araştırıldı. Hastalar ve yöntemler: Ocak 1997 -Aralık 2010 tarihleri arasında GKD tedavisi yapılan, en az dört yıl düzenli takip edilen ve son kontrolde beş yaş ve üzerinde olan 36 hastanın (9 erkek, 27 kız; ort. yaş 13.8 ay; dağılım 6-18 ay) 43 kalçası bu retrospektif çalışmaya dahil edildi. Hastalar cerrahi yaklaşıma göre iki gruba ayrıldı. Grup 1, medial yaklaşımla açık redüksiyon uygulanan 19 hastanın 21 kalçasından oluştu. Grup 2, anterior yaklaşımla açık redüksiyon uygulanan 17 hastanın 22 kalçasından oluştu. Gruplar klinik ve radyolojik sonuçlar ile AVN insidansı ve revizyon cerrahisi gerekliliği bakımından karşılaştırıldı. Bulgular: Klinik ve radyolojik sonuçlar bakımından gruplar arasında istatistiksel olarak anlamlı farklılık yoktu (sırasıyla, p= 0.407 ve p= 0.661). Benzer şekilde, AVN insidansı ve revizyon cerrahisi gerekliliği bakımından da gruplar arasında istatistiksel olarak anlamlı farklılık yoktu (sırasıyla, p= 0.993 ve p= 0.170). Diğer yandan, takipte her iki grubun asetabüler indeksi anlamlı olarak düzelmişti. Sonuç: Bu çalışma, GKD'de medial veya anterior yaklaşım ile açık redüksiyonun klinik ve radyolojik sonuçlarının benzer olduğunu, her iki yaklaşımla da asetabüler indekste anlamlı düzelme elde edildiğini ve AVN insidansı ve revizyon cerrahisi gerekliliği bakımından gruplar arasında anlamlı farklılık olmadığını göstermiştir.Anahtar sözcükler: Anterior açık redüksiyon; avasküler nekroz, gelişimsel kalça displazisi; medial açık redüksiyon; revizyon cerrahisi. ABSTRACT Objectives:This study aims to investigate the effects of surgical approach on the clinical and radiological outcomes, the incidence of avascular necrosis (AVN), and the need for revision surgery in children undergoing open reduction via medial or anterior approach for developmental dysplasia of the hip (DDH). Patients and methods: Forty-three hips of 36 patients (9 males, 27 females; mean age 13.8 month; range 6 to 18 months) treated for DDH, followed-up regularly for at least four years between January 1997 and December 2010, and who were aged five or above in the final control were included in this retrospective study. Patients were divided into two groups according to surgical approaches. Group 1 consisted of 21 hips of 19 patients who underwent open reduction through medial approach. Group 2 consisted of 22 hips of 17 patients who underwent open reduction through anterior approach. Groups were compared in terms of clinical and radiological outcomes as well as the incidence of AVN and the need for revision surgery. Results: There was no statistically significant difference between the groups with respect to clinical and radiological outcomes (p=0.407 and p=0.661, respectively). Similarly, there was no statistically significant difference between the groups in...

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Developmental Dysplasia of the Hip in Young Children

Weinstein

Holt

2019

The Pediatric and Adolescent Hip

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Single-stage open reduction through a medial approach and innominate osteotomy in developmental dysplasia of the hip

Cited by 25 publications

References 23 publications

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

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

Comparison of the clinical and radiological outcomes of open reduction via medial and anterior approach in devleopmental dysplasia of the hip

Developmental Dysplasia of the Hip in Young Children

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