Surgical Treatment of Pathological Developmental Dysplasia of the Hip: A 12-Year Study
Aim: We aimed to assess outcomes of a 12-year longitudinal observational study of developmental dysplasia of the hip (DDH) requiring surgical intervention. Method: We conducted a prospective study from 2004 to 2015 of all cases of DDH undergoing surgical intervention. In addition to clinical examination, Tönnis acetabular index (AI) method and International Hip Dysplasia Institute (IHDI) grading used. Avascular necrosis of the femoral head (AVN) was assessed by the Kalamchi method. Results & Discussion: There were 81 hips in 72 patients (12 male, 60 female). Mean age of the first operative procedure was 16.4 months (95% CI, 13.66 to 19.14). Mean follow up was 47.6 months (95% CI, 41.8 to 53.4). 31 children underwent closed reductions, 48 required open reduction; 17 femoral and 39 pelvic osteotomies were performed during the course of the study. Overall, post-surgery 96.3 % were noted to have an acceptable AI (< 2 SD of the mean). Five hips were considered to have poor results due to residual subluxation/ dislocation (6.2%). Evidence of avascular necrosis was present in 16 of the 81 hips (19.8%).Higher grades of hip pathology were generally associated with a later age of diagnosis and likely to require more extensive surgical interventions. Conclusion: Operative intervention for DDH results in acceptable clinical and radiographic outcomes in the vast majority of children. Keywords: DDH, Developmental Dysplasia of the hip, Surgery.