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Topic:

Developmental Dysplasia of the Hip

Issue:

Hip

Category:

Developmental

Title:

Femoral Head Remodeling After Surgical Reduction of Developmental Hip Dislocations

Author:

Ellsworth, Bridget K. MD; Lee, Julianna Y. BA; Sankar, Wudbhav N. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

March 2024

Reference:

44(3): p e211-e217, DOI: 10.1097/BPO.0000000000002597

Level Of Evidence:

IV

# of Patients:

74 patients (69 females), 96 hips

Study Type:

Retrospective cohort study

Location:

Single institution

Summary:

This study investigates femoral head remodeling after closed or open reduction for developmental dysplasia of the hip (DDH) by assessing femoral head sphericity through MRI imaging at multiple time points.

Methods:

Retrospective cohort study with immediate postoperative and 3-week follow-up MRIs. A subset of patients had 3-year follow-up MRIs. Femoral head sphericity was quantified by comparing the radii of the femoral head on axial and coronal MRI slices, with variance representing sphericity.

Exclusions:

Patients with insufficient imaging or bony procedures at the time of reduction were excluded.

Results:

The median age at reduction was 8.7 months. Over half (58.3%) of the hips underwent closed reduction, and the rest had open reduction. Sphericity improved over time: immediate post-op variance = 1.1, 3-week variance = 0.51, and 3-year variance = 0.31, indicating better femoral head sphericity with time.

Conclusions:

Femoral head sphericity improves postoperatively and continues to improve during the first few years after surgical reduction of developmental hip dislocations. Further studies are needed to understand the mechanisms behind femoral head remodeling and the optimal timing of reduction.

Relevance:

Limitations:

Perspective:

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