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Topic:

Developmental Dysplasia of the Hip

Issue:

Hip

Category:

Developmental

Title:

Prevalence and Risk Factors for Stiffness Following Open Reduction for Developmental Dysplasia of the Hip

Author:

Desai, Vineet M. BS; Hall, Carter E. BS; Cardin, Stefano MD; DeFrancesco, Christopher J. MD; Sarkar, Sulagna MS; Sankar, Wudbhav N. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

November/December 2024

Reference:

44(10): p e908-e914, DOI: 10.1097/BPO.0000000000002769

Level Of Evidence:

IV

# of Patients:

170

Study Type:

Retrospective study

Location:

Not specified (single-center study)

Summary:

This study aims to identify the prevalence and risk factors for arthrofibrosis (stiffness) following open reduction (OR) surgery for developmental dysplasia of the hip (DDH). The study found that older age, superior displacement, and concomitant pelvic osteotomy are significant risk factors for postoperative stiffness.

Methods:

Retrospective review of all open hip reductions for DDH performed by a single surgeon from 2009 to 2022. Radiographs were used to calculate superior displacement. Patients were categorized into mild or significant arthrofibrosis based on postoperative bracing, physical therapy, and other interventions.

Exclusions:

Not explicitly stated, but the study focuses on patients with DDH undergoing open reduction with or without osteotomy.

Results:

Of 170 hips, 109 (64.1%) had no arthrofibrosis, 38 (22.4%) had mild stiffness, and 23 (13.5%) had significant arthrofibrosis. Older age, superior displacement (dislocations >16% of pelvic width), and concomitant pelvic osteotomy were associated with increased risk of stiffness.

Conclusions:

Stiffness following open reduction for DDH is more likely in older children, those with higher dislocations, and those with concomitant pelvic osteotomy. The study emphasizes the need to counsel families about the risk of postoperative stiffness, which affected 36% of patients in this cohort.

Relevance:

Limitations:

Perspective:

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