Osteonecrosis secondary to the treatment of developmental dysplasia of the hip is a relatively benign condition in children and teenagers. While it was associated with limited hip function, it was not associated with physical disability. However, we speculate that this function will decline with increasing age. With regard to clinical outcome, Bucholz-Ogden grade-I hips are similar to grade-II hips and grade-III hips are similar to grade-IV hips.

Background Clinicians use various criteria to diagnose developmental dysplasia of the hip (DDH) in early infancy, but the importance of these various criteria for a definite diagnosis is controversial. The lack of uniform, widely agreed-on diagnostic criteria for DDH in patients in this age group may result in a delay in diagnosis of some patients. Questions/Purposes Our purpose was to establish a consensus among pediatric orthopaedic surgeons worldwide regarding the most relevant criteria for diagnosis of DDH in infants younger than 9 weeks. Material and Methods We identified 212 potential criteria relevant for diagnosing DDH in infants by surveying 467 professionals. We used the Delphi technique to reach a consensus regarding the most important criteria. We then sent the survey to 261 orthopaedic surgeons from 34 countries. Results The response rate was 75%. Thirty-seven items were identified by surgeons as most relevant to diagnose DDH in patients in this age group. Of these, 10 of 37 (27%) related to patient characteristics and history, 13 of 37 (35%) to clinical examination, 11 of 37 (30%) to ultrasound, and three of 37 (8%) to radiography. A Cronbach alpha of 0.9 for both iterations suggested consensus among the panelists. Conclusion We established a consensus regarding the most relevant criteria for the diagnosis of DDH in early infancy and established their relative importance on an international basis. The highest ranked clinical criteria included the Ortolani/Barlow test, asymmetry in abduction

Summary mTOR inhibitors have been associated with wound complications and lymphoceles. We systematically reviewed randomized controlled trials (RCTs) to compare these outcomes for solid organ transplant recipients. Relevant medical databases were searched to identify RCTs in solid organ transplantation comparing mTOR inhibitors with an alternative therapy reporting on wound complications and/or lymphoceles. Methodological quality of RCTs was assessed. Pooled analyses were performed to calculate odds ratios (OR) and 95% confidence intervals (CI). Thirty‐seven RCTs in kidney, heart, simultaneous pancreas‐kidney and liver transplantation were included. Pooled analyses showed a higher incidence of wound complications (OR 1.77, CI 1.31–2.37) and lymphoceles (OR 2.07, CI 1.62–2.65) for kidney transplant recipients on mTOR inhibitors together with calcineurin inhibitors (CNIs). There was also a higher incidence of wound complications (OR 3.00, CI 1.61–5.59) and lymphoceles (OR 2.13, CI 1.57–2.90) for kidney transplant recipients on mTOR inhibitors together with antimetabolites. Heart transplant patients receiving mTOR inhibitors together with CNIs also reported more wound complications (OR 1.82, CI 1.15–2.87). We found a higher incidence of wound complications and lymphoceles after kidney transplantation and a higher incidence of wound complications after heart transplantation for immunosuppressive regimens that included mTOR inhibitors from the time of transplantation.

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