Management of developmental dysplasia of the hip in young adults

Abstract

The term developmental dysplasia of the hip (DDH) describes a spectrum of disorders that results in abnormal development of the hip joint. If not treated successfully in childhood, these patients may go on to develop hip symptoms and/or secondary osteoarthritis in adulthood. In this review we describe the altered anatomy encountered in adults with DDH along with the management options, and the challenges associated with hip arthroscopy, osteotomies and arthroplasty for the treatment of DDH in young adults.

CORR Insights®: Survivorship of the Bernese Periacetabular Osteotomy: What Factors Are Associated With Long-term Failure?

“…All the factors identified in the present study have been associated with increased disability from osteoarthritis (irrespective of a diagnosis of DDH or a PAO procedure) [5]. Patients with untreated DDH can expect to have poor hip function, and it is possible that intervention through PAO may lead to better patient outcomes and greater quality of life [2,8].…”

“…Future studies also need to help inform us about how best to manage those patients with poor prognostic factors. As Kosuge et al note [5], not surprisingly, it is these young patients with severe dysplasia who are most likely to suffer profound disability. It therefore would seem especially important to focus future efforts on the management and outcomes of this challenging subgroup of DDH patients.…”

Long-term results of acetabular reconstruction using three bulk bone graft techniques in cemented total hip arthroplasty for developmental dysplasia

“…The aim of THA in DDH is to restore the centre of hip rotation and proximal femoral anatomy to allow optimal abductor function [19], and the acetabular component should be placed at the true hip centre by acetabular reconstruction. Many authors report excellent results of bulk bone graft for DDH in cemented THA [6,8,9,[20][21][22][23], and survivorship for revision of aseptic and radiological loosening is reported to be 85-100 % and 82-100 %, respectively, during a minimum follow-up of ten years.…”

Hip Dysplasia in the Young Adult

“…Although they had an improvement in functional scores at one year, the scores had decreased at the two-year mark. Additionally, acetabular chondral and labral lesions, mainly located in the anterosuperior region, are common arthroscopic findings in up to 77.8% of hips with dysplasia 106,107 . Consequently, the role of hip arthroscopy as an adjunct to a pelvic osteotomy 108,109 continues to evolve until it will allow concomitant treatment of chondral and/or labral lesions, potentially improving the postoperative clinical function.…”