Ultrasonography in screening for developmental dysplasia of the hip in newborns: systematic review

Introduction: Early diagnosis and early treatment have become the gold standard for management of developmental dysplasia of the hip. Surgery is required in case of failed initial treatment. Innominate pelvic osteotomy of Salter (SIO), Pemberton’s pericapsular osteotomy (PPO) and Dega’s acetabuloplasty (DA) are among the most used procedures. We performed a systematic review and meta-analysis of the past 57 years in order to assess the mid- and long-term outcome of these techniques. Methods: Studies met inclusion criteria if they: (1) reported at least 5 cases treated by 1 of the abovementioned surgical techniques; (2) included children aged between 1 and 8 years; (3) surgical indication was late detected DDH or a failed initial treatment; (4) presented a minimal follow-up of 24 months; (5) reported the radiological score of Severin and/or the clinical score of McKay. Clinical and radiological outcomes were dichotomised into favourable and unfavourable outcome and weighted summary rates were determined using meta-analysis models. Results: From a total of 7391 articles, 48 level of evidence grade IV articles were included in our review. A total of 2143 cases with a mean follow up of 112.4 months were included. Pooled Severin score indicated a statistically better outcome for PPO and DA compared to SIO ( p = 0.0003 and p = 0.002, respectively). By dichotomising the results in favourable and unfavourable outcome, PPO showed the best results ( p = 0.0002 vs. SIO, p = 0.01 vs. DA). Pooled McKay score showed a statistically better outcome for PPO and DA compared to SIO ( p < 0.0001 and p = 0.03, respectively) as well as better outcomes for PPO compared to DA ( p = 0.01). By dichotomising the results in favourable and unfavourable, PPO showed the best results. Conclusions: Even if our review demonstrates slightly better radiological and clinical results with the PPO, the currently available and limited data do not allow for clear recommendation towards one of these techniques.

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Association between mode of delivery and developmental dysplasia of the hip in breech infants: a systematic review of cohort studies

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild.2011.300164.73 ◽

2011 ◽

Vol 96 (Supplement 1) ◽

pp. Fa39-Fa39 ◽

Cited By ~ 1

Author(s):

K. Bitar ◽

N. Panagiotopoulou

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Mode Of Delivery ◽

Developmental Dysplasia ◽

Dysplasia Of The Hip

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Comparison Between Hip Arthroscopic Surgery and Periacetabular Osteotomy for the Treatment of Patients With Borderline Developmental Dysplasia of the Hip: A Systematic Review

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211007401 ◽

2021 ◽

Vol 9 (5) ◽

pp. 232596712110074

Author(s):

Yoichi Murata ◽

Naomasa Fukase ◽

Maitland Martin ◽

Rui Soares ◽

Lauren Pierpoint ◽

...

Keyword(s):

Systematic Review ◽

Periacetabular Osteotomy ◽

Arthroscopic Surgery ◽

Patient Characteristics ◽

Developmental Dysplasia ◽

Edge Angle ◽

Center Edge ◽

Lateral Center Edge Angle ◽

Dysplasia Of The Hip ◽

Center Edge Angle

Background: The treatment for borderline developmental dysplasia of the hip (BDDH) has historically been arthroscopic surgery or periacetabular osteotomy (PAO). As orthopaedic surgery is constantly evolving, a lack of comparison of outcomes for these 2 treatment methods could potentially be stalling the progression of treatment for patients with BDDH. Purpose: To evaluate the existing literature on patient characteristics, procedures, clinical outcomes, and failure rates for patients with BDDH and to determine whether PAO or hip arthroscopic surgery is a better treatment method for patients with BDDH. Study Design: Systematic review; Level of evidence, 4. Methods: Studies included were found using the following search words: “hip” and “borderline dysplasia,” “osteotomy” or “arthroscopy,” and “outcome” or “procedure.” Articles were included if they detailed participants of all sexes and ages, reported on isolated hips, and had patients diagnosed with BDDH. Results: A search was conducted across 3 databases, resulting in 469 articles for consideration, from which 12 total studies (10 on arthroscopic surgery and 2 on PAO) were chosen for a review. There were 6 studies that included patients with a lateral center-edge angle of 18° to 25°, while the remainder included patients with a lateral center-edge angle of 20° to 25°. All the studies reviewing arthroscopic surgery reported concomitant/accessory procedures, while the articles on the topic of PAO did not. It was determined that, whether treated using arthroscopic surgery or PAO, outcomes improved across all patient-reported outcome measures. Revision surgery was also common in both procedures. Conclusion: There is a lack of consensus in the literature on the best treatment option for patients with BDDH. Preoperative patient characteristics and concomitant injuries should be considered when evaluating which surgical procedure will result in the most favorable outcomes.

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