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Topic:

Developmental Dysplasia of the Hip

Issue:

Hip

Category:

Developmental

Title:

Long-term Results of Developmental Hip Dysplasia Under Therapy With Pavlik Harness

Author:

Gahleitner, Manuel MD; Pisecky, Lorenz MD; Gotterbarm, Tobias MD; Högler, Wolfgang MD; Luger, Matthias MD; Klotz, Matthias C. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

March 2024

Reference:

44(3): p 135-140, DOI: 10.1097/BPO.0000000000002575

Level Of Evidence:

IV

# of Patients:

60 patients (80 affected hips)

Study Type:

Retrospective cohort study

Location:

Not specified

Summary:

This study evaluates the long-term outcomes of treating developmental dysplasia of the hip (DDH) using the Pavlik harness in newborns with severe forms of DDH (Graf type IIc or worse). Follow-up included clinical and radiologic evaluations after an average of 20 years

Methods:

Ultrasound screening of 7372 newborns, identifying 203 dysplastic hips in 152 patients. Pavlik harness treatment was discontinued when Graf type Ia/b was reached. Long-term follow-up (mean 20.46 years) with clinical (Oxford Hips, Schulthess Hip, Harris Hip Scores) and radiological evaluations (center-edge angle, Reimers migration percentage, Sharp angle).

Exclusions:

None specified

Results:

39.5% (60 patients) of the cohort was re-examined. Radiologic outcomes: 2 patients (3.77%) had slight residual dysplasia. No avascular necrosis was found. Sharp angle average was 38 degrees, with minimal residual dysplasia. Clinically, no patients had significant hip pain affecting daily activities or sports.

Conclusions:

Treatment of DDH with the Pavlik harness in Graf type IIc, D, III has shown excellent long-term results. The rate of residual dysplasia was very low (2.81%), and clinical and radiologic outcomes were highly satisfactory.

Relevance:

Limitations:

Perspective:

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