A New Radiographic Classification System for Developmental Hip Dysplasia is Reliable and Predictive of Successful Closed Reduction and Late Pelvic Osteotomy

Ramo, Brandon; Rocha, Adriana De La; Sucato, Daniel J.; Jo, Chan Hee

doi:10.1097/bpo.0000000000000733

Cited by 38 publications

(68 citation statements)

References 7 publications

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“…Moreover, the ossific nucleus was not present in 34% hips. Comparing IHDI classification to Tönnis classification, Both Miao and Brandon et al [13,14] concluded that IHDI classification is more flexibly and better reflect the severity of the condition, especially for those cases without ossific nucleus of the femoral head.…”

Section: Discussionmentioning

confidence: 99%

Timing for closed reduction procedure for developmental dysplasia of the hip and its failure analysis

Zhang

et al. 2020

BMC Musculoskelet Disord

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Background It remains controversial whether the older age to perform closed reduction (CR) procedure for developmental dysplasia of the hip (DDH), the higher incidence of complications. The aim of this study is to evaluate the midterm outcome of CR for DDH among different age groups, and to analyze and identify risk factors for the failure of this procedure. Methods Clinical data of 107 DDH patients, who received CR, were retrospectively reviewed. Data were divided into three groups according to initial treatment age (Group I: younger than 12 months; Group II: 12 months to less or equal to18 months; Group III: older than 18 months). The presence of avascular necrosis (AVN), residual acetabular dysplasia (RAD), re-dislocation, and further surgeries (FS) were observed. The risk factors were identified for those outcomes aforementioned using univariable logistic regression models. For identified risk factor age, pre-op acetabular index (AI) and post-op AI, their prediction of CR failure were evaluated by receiver operating characteristics curve (ROC). Results A total of 107 patients (156 hips) undergoing CR procedure were evaluated with a median age at initial reduction of 13.0 ± 5.4 months (range, 4 to 28 mo). Mean follow-up time in this study was 6.7 ± 0.8 years (range, 3–8 years). The incidence of AVN, RAD and re-dislocation was 15.4% (24/156), 17.3% (27/156) and 14.7% (23/156) respectively. For AVN, RAD and re-dislocation, the significant risk factors are pre-op IHDI IV (p = 0.033), age ≥ 18 months (p = 0.012), and pre-op IHDI IV (p = 0.004) and walking (p = 0.011), respectively. The areas under the ROC curve of each type of failures were 0.841 (post-op AI), 0.688 (pre-op AI) and 0.650 (age). Conclusions Severe DDH patients older than 18 months with CR procedure may result in a high risk of RAD complication. Re-dislocation is significantly associated with pre-op IHDI IV and walking. Patients, who are older than 12.5 months or have a pre-op AI of 38.7° or a post-op AI of 26.4°, are also more likely to fail of CR procedure.

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Section: Discussionmentioning

confidence: 99%

Timing for closed reduction procedure for developmental dysplasia of the hip and its failure analysis

Zhang

et al. 2020

BMC Musculoskelet Disord

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“…When the capital femoral ossification center was absent, the observers assumed the location of the ossific nucleus. [ 13 ]…”

Section: Methodsmentioning

confidence: 99%

Retrospective observational study comparing the international hip dysplasia institute classification with the Tonnis classification of developmental dysplasia of the hip

Miao

Cai

et al. 2017

Medicine

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“…The higher dislocation grading correlating with increased risk of open reduction [28] . In present study, our results also showed that the more severe dislocation of the DDH before treatment is signi cantly associated to the inferior outcomes after CR.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of closed reduction for developmental dysplasia of the hip: midterm outcomes and risk factors associated with treatment failure and avascular necrosis

Zhang

et al. 2020

Preprint

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Abstract Background: The purpose of this study was to evaluate the efficacy after closed reduction (CR) in the treatment of developmental dysplasia of the hip (DDH) and investigate risk factors associated with CR failure and avascular necrosis (AVN) occurrence in the follow-ups.Primary and secondary outcome measures: The study retrospectively included 110 patients and 138 hips with DDH diagnosis between February 2012 and November 2015 in our single tertiary medical institution and underwent closed reduction. The failure rate of CR and the underlying risk factors were evaluated. meanwhile, the incidence of AVN and the related risk factors among the successful CR cases were assessed.Results: The overall failure rate of DDH treated by CR in present study was 31.16% (43/138). Risk factors for the CR failure was older age at the time of CR (≥18.35 month), large medical interval before CR (≥35.35 millimeters), and severer dislocation of the affected hip (IDHI grade III and IV). The incidence of AVN was 8.33% (6/72) in the patients with successful CR at last follow-up. No significant risk factors had been established in present study that associated with the AVN occurrence.Conclusions: For the treatment of DDH with CR, patients with younger age might achieve better outcomes, early diagnosis and early treatment might be the key point in the DDH treatment.

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A New Radiographic Classification System for Developmental Hip Dysplasia is Reliable and Predictive of Successful Closed Reduction and Late Pelvic Osteotomy

Abstract: Level III.

Cited by 38 publications

References 7 publications

Timing for closed reduction procedure for developmental dysplasia of the hip and its failure analysis

Timing for closed reduction procedure for developmental dysplasia of the hip and its failure analysis

Retrospective observational study comparing the international hip dysplasia institute classification with the Tonnis classification of developmental dysplasia of the hip

Efficacy of closed reduction for developmental dysplasia of the hip: midterm outcomes and risk factors associated with treatment failure and avascular necrosis

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