scholarly journals Efficacy of closed reduction for developmental dysplasia of the hip: midterm outcomes and risk factors associated with treatment failure and avascular necrosis

2020 ◽  
Author(s):  
Ge Zhang ◽  
Ming Li ◽  
Xiangyang Qu ◽  
Yujiang Cao ◽  
Xing Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Avascular Necrosis ◽  
Failure Rate ◽  
Closed Reduction ◽  
Significant Risk ◽  
Developmental Dysplasia ◽  
Secondary Outcome ◽  
Factors Associated ◽  
Related Risk ◽  
Dysplasia Of The Hip

Abstract Background: The purpose of this study was to evaluate the efficacy after closed reduction (CR) in the treatment of developmental dysplasia of the hip (DDH) and investigate risk factors associated with CR failure and avascular necrosis (AVN) occurrence in the follow-ups.Primary and secondary outcome measures: The study retrospectively included 110 patients and 138 hips with DDH diagnosis between February 2012 and November 2015 in our single tertiary medical institution and underwent closed reduction. The failure rate of CR and the underlying risk factors were evaluated. meanwhile, the incidence of AVN and the related risk factors among the successful CR cases were assessed.Results: The overall failure rate of DDH treated by CR in present study was 31.16% (43/138). Risk factors for the CR failure was older age at the time of CR (≥18.35 month), large medical interval before CR (≥35.35 millimeters), and severer dislocation of the affected hip (IDHI grade III and IV). The incidence of AVN was 8.33% (6/72) in the patients with successful CR at last follow-up. No significant risk factors had been established in present study that associated with the AVN occurrence.Conclusions: For the treatment of DDH with CR, patients with younger age might achieve better outcomes, early diagnosis and early treatment might be the key point in the DDH treatment.

scholarly journals Efficacy of closed reduction for developmental dysplasia of the hip: midterm outcomes and risk factors associated with treatment failure and avascular necrosis

2020 ◽  
Author(s):  
Ge Zhang ◽  
Ming Li ◽  
Xiangyang Qu ◽  
Yujiang Cao ◽  
Xing Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Avascular Necrosis ◽  
Failure Rate ◽  
Closed Reduction ◽  
Significant Risk ◽  
Developmental Dysplasia ◽  
Factors Associated ◽  
Related Risk ◽  
Younger Age ◽  
Dysplasia Of The Hip

Abstract Background: The purpose of this study was to evaluate the efficacy after closed reduction (CR) in the treatment of developmental dysplasia of the hip (DDH) and to investigate risk factors associated with CR failure and avascular necrosis (AVN) occurrence in follow-ups. Mehtods: The study retrospectively included 110 patients and 138 hips with DDH diagnosis that underwent closed reduction between February 2012 and November 2015 in our single tertiary medical institution. The failure rate of CR and the underlying risk factors were evaluated. Meanwhile, the incidence of AVN and the related risk factors among the successful CR cases were assessed.Results: The overall failure rate of DDH treated by CR in present study was 31.16% (43/138). Risk factors for the CR failure was older age at the time of CR (≥18.35 month), large medical interval before CR (≥35.35 millimeters), and severer dislocation of the affected hip (IDHI grade III and IV). The incidence of AVN was 8.33% (6/72) in the patients with successful CR at last follow-up. No significant risk factors had been established in present study that associated with the AVN occurrence.Conclusions: For the treatment of DDH with CR, patients with younger age might achieve better outcomes, early diagnosis and early treatment might be the key point in the DDH treatment.

scholarly journals Efficacy of closed reduction for developmental dysplasia of the hip: midterm outcomes and risk factors associated with treatment failure and avascular necrosis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Ge Zhang ◽  
Ming Li ◽  
Xiangyang Qu ◽  
Yujiang Cao ◽  
Xing Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Avascular Necrosis ◽  
Failure Rate ◽  
Closed Reduction ◽  
Significant Risk ◽  
Developmental Dysplasia ◽  
Factors Associated ◽  
Related Risk ◽  
Younger Age ◽  
Dysplasia Of The Hip

Abstract Background The purpose of this study was to evaluate the efficacy of closed reduction (CR) in the treatment of developmental dysplasia of the hip (DDH) and to investigate risk factors associated with CR failure and avascular necrosis (AVN) occurrence in follow-ups. Methods The study retrospectively included 110 patients and 138 hips with DDH diagnosis that underwent closed reduction between February 2012 and November 2015 in our single tertiary medical institution. The failure rate of CR and the underlying risk factors were evaluated. Meanwhile, the incidence of AVN and the related risk factors among the successful CR cases were assessed. Results The overall failure rate of DDH treated by CR in the present study was 31.16% (43/138). Risk factors for the CR failure were older age at the time of CR (≥ 18.35 month), large medical interval before CR (≥ 35.35 mm), and severer dislocation of the affected hip (IDHI grades III and IV). The incidence of AVN was 8.33% (6/72) in patients with successful CR at the last follow-up. No significant risk factors had been established in the present study that associated with the AVN occurrence. Conclusions For the treatment of DDH with CR, patients with younger age might achieve better outcomes; early diagnosis and early treatment might be the key point in the DDH treatment.

scholarly journals Efficacy of closed reduction for developmental dysplasia of the hip: midterm outcomes and risk factors associated with treatment failure and avascular necrosis

2020 ◽  
Author(s):  
Ge Zhang ◽  
Ming Li ◽  
Xiangyang Qu ◽  
Yujiang Cao ◽  
Xing Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Avascular Necrosis ◽  
Failure Rate ◽  
Closed Reduction ◽  
Significant Risk ◽  
Developmental Dysplasia ◽  
Factors Associated ◽  
Related Risk ◽  
Younger Age ◽  
Dysplasia Of The Hip

Abstract Background: The purpose of this study was to evaluate the efficacy after closed reduction (CR) in the treatment of developmental dysplasia of the hip (DDH) and to investigate risk factors associated with CR failure and avascular necrosis (AVN) occurrence in follow-ups. Mehtods: The study retrospectively included 110 patients and 138 hips with DDH diagnosis that underwent closed reduction between February 2012 and November 2015 in our single tertiary medical institution. The failure rate of CR and the underlying risk factors were evaluated. Meanwhile, the incidence of AVN and the related risk factors among the successful CR cases were assessed.Results: The overall failure rate of DDH treated by CR in present study was 31.16% (43/138). Risk factors for the CR failure was older age at the time of CR (≥18.35 month), large medical interval before CR (≥35.35 millimeters), and severer dislocation of the affected hip (IDHI grade III and IV). The incidence of AVN was 8.33% (6/72) in the patients with successful CR at last follow-up. No significant risk factors had been established in present study that associated with the AVN occurrence.Conclusions: For the treatment of DDH with CR, patients with younger age might achieve better outcomes, early diagnosis and early treatment might be the key point in the DDH treatment.

scholarly journals Timing for Closed Reduction Procedure for Developmental Dysplasia of the Hip and its Failure Analysis

2020 ◽  
Author(s):  
Zhiqiang Zhang ◽  
Hao Li ◽  
Hai Li ◽  
Ziming Zhang
Keyword(s):  
Risk Factors ◽  
Closed Reduction ◽  
Age Groups ◽  
Significant Risk ◽  
Developmental Dysplasia ◽  
Operating Characteristics ◽  
Logistic Regression Models ◽  
Midterm Outcome ◽  
Group I ◽  
Dysplasia Of The Hip

Abstract Background It remains controversial whether the older age to perform closed reduction (CR) procedure for developmental dysplasia of the hip (DDH), the higher incidence of complications. The aim of this study is to evaluate the midterm outcome of CR for DDH among difference age groups, and to analyze and identify risk factors for the failure of this procedure. Methods Clinical data of 107 DDH patients, who received CR, were retrospectively reviewed. Data were divided into three groups according to initial treatment age (Group I: younger than 12 months; Group II: 12 months to less or equal to18 months; Group III: older than 18 months). The presence of avascular necrosis (AVN), residual acetabular dysplasia (RAD), re-dislocation, and further surgeries (FS) were observed. The risk factors were identified for those outcomes aforementioned using univariable logistic regression models. For identified risk factor age, pre-op acetabular index (AI) and post-op AI, their prediction of CR failure were evaluated by receiver operating characteristics curve (ROC).Results A total of 107 patients (156 hips) undergoing CR procedure were evaluated with a median age at initial reduction of 13.0±5.4 months (range, 4 to 28 mo). Mean follow-up time in this study was 6.7±0.8 years (range, 3-8 years). The incidence of AVN, RAD and re-dislocation was 15.4% (24/156), 17.3% (27/156) and 14.7% (23/156) respectively. For AVN, RAD and re-dislocation, the significant risk factors are pre-op IHDI IV (p=0.033), age≥18 months (p=0.012), and pre-op IHDI IV (p=0.004) and walking (p=0.011), respectively. The areas under the ROC curve of each type of failures were 0.841 (post-op AI), 0.688 (pre-op AI) and 0.650 (age).Conclusions Severe DDH patients older than 18 months with CR procedure may result in a high risk of RAD complication. Re-dislocation is significantly associated with pre-op IHDI IV and walking. Patients, who are older than 12.5 months or have a pre-op AI of 38.7° or a post-op AI of 26.4°, are also more likely to fail of CR procedure.

scholarly journals Risk factors for avascular necrosis after closed reduction for developmental dysplasia of the hip

2016 ◽  
Vol 10 (3) ◽  
pp. 185-192 ◽  
Author(s):  
Mathew D. Schur ◽  
Christopher Lee ◽  
Alexandre Arkader ◽  
Anthony Catalano ◽  
Paul D. Choi
Keyword(s):  
Risk Factors ◽  
Avascular Necrosis ◽  
Closed Reduction ◽  
Developmental Dysplasia ◽  
Dysplasia Of The Hip

Evaluation of avascular necrosis risk factors after closed reduction for developmental dysplasia of the hip before walking age

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Celal Bozkurt ◽  
Baran Sarikaya ◽  
Serkan Sipahioğlu ◽  
Baki Volkan çetin ◽  
Pelin Zeynep Bekin Sarikaya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Avascular Necrosis ◽  
Closed Reduction ◽  
Developmental Dysplasia ◽  
Walking Age ◽  
Dysplasia Of The Hip

scholarly journals Timing for closed reduction procedure for developmental dysplasia of the hip and its failure analysis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhiqiang Zhang ◽  
Hao Li ◽  
Hai Li ◽  
Ziming Zhang
Keyword(s):  
Risk Factors ◽  
Closed Reduction ◽  
Age Groups ◽  
Significant Risk ◽  
Developmental Dysplasia ◽  
Operating Characteristics ◽  
Logistic Regression Models ◽  
Midterm Outcome ◽  
Group I ◽  
Dysplasia Of The Hip

Abstract Background It remains controversial whether the older age to perform closed reduction (CR) procedure for developmental dysplasia of the hip (DDH), the higher incidence of complications. The aim of this study is to evaluate the midterm outcome of CR for DDH among different age groups, and to analyze and identify risk factors for the failure of this procedure. Methods Clinical data of 107 DDH patients, who received CR, were retrospectively reviewed. Data were divided into three groups according to initial treatment age (Group I: younger than 12 months; Group II: 12 months to less or equal to18 months; Group III: older than 18 months). The presence of avascular necrosis (AVN), residual acetabular dysplasia (RAD), re-dislocation, and further surgeries (FS) were observed. The risk factors were identified for those outcomes aforementioned using univariable logistic regression models. For identified risk factor age, pre-op acetabular index (AI) and post-op AI, their prediction of CR failure were evaluated by receiver operating characteristics curve (ROC). Results A total of 107 patients (156 hips) undergoing CR procedure were evaluated with a median age at initial reduction of 13.0 ± 5.4 months (range, 4 to 28 mo). Mean follow-up time in this study was 6.7 ± 0.8 years (range, 3–8 years). The incidence of AVN, RAD and re-dislocation was 15.4% (24/156), 17.3% (27/156) and 14.7% (23/156) respectively. For AVN, RAD and re-dislocation, the significant risk factors are pre-op IHDI IV (p = 0.033), age ≥ 18 months (p = 0.012), and pre-op IHDI IV (p = 0.004) and walking (p = 0.011), respectively. The areas under the ROC curve of each type of failures were 0.841 (post-op AI), 0.688 (pre-op AI) and 0.650 (age). Conclusions Severe DDH patients older than 18 months with CR procedure may result in a high risk of RAD complication. Re-dislocation is significantly associated with pre-op IHDI IV and walking. Patients, who are older than 12.5 months or have a pre-op AI of 38.7° or a post-op AI of 26.4°, are also more likely to fail of CR procedure.

scholarly journals Associations between risk factors and developmental dysplasia of the hip and ultrasonographic hip type: a retrospective case control study

2019 ◽  
Vol 13 (2) ◽  
pp. 161-166 ◽  
Author(s):  
H. Ömeroğlu ◽  
A. Akceylan ◽  
N. Köse
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Hip Dysplasia ◽  
Positive Family History ◽  
Significant Risk ◽  
Breech Presentation ◽  
Developmental Dysplasia ◽  
Type I ◽  
Dysplasia Of The Hip

Purpose We aimed to revisit the correlation between the previously defined risk factors and the occurrence of developmental dysplasia of the hip (DDH) and to assess the influence of these factors on the ultrasonographic type of hip dysplasia according to the Graf’s classification in patients with DDH. Methods Data of healthy infants (mean age 33 days) who had bilateral mature (normal) hips (Graf type I) were compared with the data of infants (mean age 105 days) who were treated by abduction brace due to unilateral or bilateral DDH (Graf type IIa- and worse hips). Results Infants with at least one risk factor had a significantly higher rate of DDH than those with no risk factors (p < 0.001). Likewise, infants with more than one risk factor had a significantly higher rate of DDH than those with only one risk factor (p = 0.008). Family history, breech presentation and swaddling were found to be the three significant risk factors related to the development of DDH. Family history, swaddling and oligohydramnios were found to be the three significant risk factors correlated with a higher rate of unstable/decentred hip(s) (Graf types D/III/IV) in patients with DDH. Conclusion The risk of DDH significantly increases in infants who have more than one risk factor for DDH. Positive family history and postnatal traditional swaddling are the two main factors both in the aetiology of DDH and in development of a more severe hip dysplasia in patients with DDH. Besides, breech presentation increases the risk of development of DDH and oligohydramnios leads to development of a more severe hip dysplasia in patients with DDH. By introducing these four variables as ‘absolute risk factors for DDH’ to the selective newborn hip screening programmes, the sensitivity and specificity of these programmes may be optimized and the risk of delayed diagnosis may be lessened. Level of Evidence Level III prognostic study

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