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Medium-term results following arthroscopic reduction in walking-age children with developmental hip dysplasia after failed closed reduction.

Abstract：

BACKGROUND:Arthroscopic reduction has become increasingly popular as an alternative to open reduction for the treatment of developmental dysplasia of the hip (DDH). However, patient outcomes beyond one and a half years after surgery remain unclear. The purpose of this study is to report the medium-term outcomes of walking-age patients who received arthroscopic reduction after an unsuccessful closed reduction. This research was conducted as part of a retrospectively registered study. METHODS:We performed arthroscopic reduction in eight children with DDH after failed closed reduction between January 2010 and January 2012 and followed all cases for a minimum of 5 years. Arthroscopic reduction was performed using a two-portal approach without traction. Capsular release and resection of the transverse acetabular ligament were also performed if needed. Patient demographics, clinical variables, anatomical assessment measures, and post-operative complications were extracted from medical records. RESULTS:We treated five male and three female patients with an average age at operation of 15.6 months (range, 12 to 22 months). All obstacles to reduction were corrected arthroscopically. Concentric reduction of the hip joint was observed in post-operative X-rays in all cases. The average safe zone was increased from 17.5° (8° to 30°) to 42.1° (36° to 50°) after the operation. The average acetabular (AC) index was reduced from 40.3° (33° to 65°) to 21.9° (19° to 26°) at the end of follow-up. No complications occurred and no patients developed necrosis of the femoral head, recurrent dislocation, or residual hip dysplasia. CONCLUSIONS:Arthroscopic reduction is a suitable surgical procedure for the treatment of DDH among walking-age children with failed closed reduction and severe dislocation. This method is quick and safe, and it can be performed without post-operative complications over the medium term.

journal_name

J Orthop Surg Res

journal_title

Journal of orthopaedic surgery and research

authors

Zhao L,Yan H,Yang C,Cai D,Wang Y

doi

10.1186/s13018-017-0635-7

subject

Has Abstract

pub_date

2017-09-21 00:00:00

pages

135

issue

issn

1749-799X

pii

10.1186/s13018-017-0635-7

journal_volume

pub_type

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Medium-term results following arthroscopic reduction in walking-age children with developmental hip dysplasia after failed closed reduction.