Developmental Dysplasia of the Hip (DDH): Etiology, Diagnosis, and Management

Abstract

Developmental dysplasia of the hip (DDH) is a complex disorder that refers to different hip problems, ranging from neonatal instability to acetabular or femoral dysplasia, hip subluxation, and hip dislocation. It may result in structural modifications, which may lead to early coxarthrosis. Despite identifying the risk factors, the exact aetiology and pathophysiology are still unclear. Neonatal screening, along with physical examination and ultrasound, is critical for the early diagnosis of DDH to prevent the occurrence of early coxarthrosis. This review summarizes the currently practised strategies for the detection and treatment of DDH, focusing particularly on current practices for managing residual acetabular dysplasia (AD). AD may persist even after a successful hip reduction. Pelvic osteotomy is required in cases of persistent AD. It could also be undertaken simultaneously with an open hip reduction. Evaluation of the residual dysplasia (RD) of the hip and its management is still a highly active area of discussion. Recent research has opened the door to discussion on this issue and suggested treatment options for AD. But there is still room for more research to assist in managing AD.

Treatment of bilateral developmental dysplasia of the hip joint with an improved technique: A case report

“…In the case of severe dislocation, the false acetabulum is located above the real acetabulum, which results in difficulties in identification of the acetabulum. The upward movement of the rotation center of the hip joint, dysplasia of the anterior and posterior walls of the acetabulum, proliferation of osteophytes, and the appearance of a false acetabulum make it more difficult for the surgeon to restore the position of the femoral head and acetabulum[ 6 ].…”

Displasia do quadril: uma revisão atualizada das diretrizes ortopédicas e pediátricas

“…A Displasia do Desenvolvimento do Quadril (DDQ) é uma condição ortopédica comum em recém-nascidos e crianças, sendo mais prevalente em pacientes do sexo feminino. Essa patologia é caracterizada por anormalidades na formação e na articulação do quadril, abrangendo uma variedade de condições que vão desde a subluxação suave até a luxação franca da articulação Contribuciones a Las Ciencias Sociales, São José dos Pinhais, v.17, n.2, p. [1][2][3][4][5][6][7][8][9][10][11][12][13]2024 coxofemoral. Embora, a DDQ, em sua maior parte, seja reversível nas primeiras semanas de vida, a sua manutenção pode levar a problemas de mobilidade, dor e instabilidade no quadril ao longo da vida (ALHADDAD et al, 2023).…”

The Outcome of Total Hip Arthroplasty Without Subtrochanteric Shortening Osteotomy in Severe Developmental Dysplasia of the Hip

“…However, delayed diagnosis, lack of appropriate treatment, or treatment failure can lead to complications, such as premature osteoarthritis, secondary femoral injuries, and movement disorders, potentially necessitating total hip joint replacement (4). Total hip arthroplasty (THA) is a surgical technique for correcting DDH (5)(6)(7). Various THA-based techniques have been developed for managing end-stage osteoarthritis in Crowe DDH type III or IV patients.…”

“…Several studies have assessed the long-term outcomes of THA for DDH using shortening subtrochanteric osteotomy (STO) (10)(11)(12)(13)(14)(15). However, this approach remains challenging, as incompatibility between the diameters of the proximal and distal canals post-shortening STO can lead to difficulties in achieving lasting and secure fixation, increasing the risk of delayed bone healing, malunion, or nonunion (5,12,(16)(17)(18)(19). Additional complications include nerve palsy (17)(18)(19)(20)(21), femoral fractures during surgery (12,16,22), and dislocation (12,18,19,21).…”