Effects of arthroscopic-assisted surgery on irreducible developmental dislocation of hip by mid-term follow-up

Abstract

The purpose of this study was to investigate the indications, surgical technique, and the clinical effects of arthroscopic-assisted treatment of irreducible developmental dislocation of the hip by mid-term follow-up. Arthroscopic-assisted surgeries were performed on 40 children (52 hips) between January 2005 and December 2009. Anterior and antero-superior greater trochanter portals were used in these treatments. Spica cast and abduction splint were applied for 3 months postoperatively. The follow-up was conducted on every 3 months postoperatively. During 12-month follow-up, a secondary treatment such as acetabuloplasty and/or femoral osteotomy (shortening, varus, and derotation) was applied if the acetabular angle was greater than 25°. The pelvic acetabular angle, Mckay and Severin score were evaluated every 6 months in all children. With 36 to 96 months (average 71 months) follow-up, 35 children (44 hips) were successfully followed up with complete case data while 5 children unsuccessfully. According to Tönnis classification, there were 5 grade 1 hips, 14 grade 2 hips, 14 grade 3 hips, 11 grade 4 hips, in which 3 children (4 hips) were failed in arthroscopic reduction and femoral head avascular necrosis occurred in 2 children (4 hips). According to Mckay standard, the good rate is 100%. According to Severin standard, the good rate is 84.1%. Arthroscopic assisted treatment is an effective way of reduction of the irreducible hip. Compared with the open reduction, arthroscopic treatment combined with acetabuloplasty and/or femoral osteotomy has advantages of less trauma and better function preservation.

Arthroscopic Reduction And Dega Acetobuloplasty Treatment In Walking Age Children With Irreducible Developmental Dysplasia Of The Hip

“…In patients under 18 months of age Bulut et al and in children under 2 years of age and not requiring supraacetabuler osteotomy, Lee et al arthroscopically eliminated the structures preventing intraarticular reduction using a technique that may be described as arthroscopicassisted reduction after open iliopsosas tenotomy, and reported good results (11)(12)(13). Again, Xu et al published a 40-patient series of arthroscopicassisted reduction and reported that better functional results could be obtained with arthroscopic treatment although the patients were not homogenous in terms of age and the majority of them later required supraacetabular osteotomy (14).…”