Open reduction of CDH before one year of age: 69 hips followed for 13 (10–19) years

Doudoulakis, Jason K.; Cavadias, Apostolos X.

doi:10.3109/17453679308994568

Cited by 14 publications

(7 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Early hip subluxation after open reduction and/or redislocation while wearing the plaster cast has been reported in a range of 0% to 11% with a mean of 2.4% for anterior and medial open reductions [7,10,11,16,18,20,21,23,31,37,40,46,50,52,69,70,[77][78][79]88]. Our patients had a redislocation rate of 2.8%.…”

Section: Discussionmentioning

confidence: 54%

See 1 more Smart Citation

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

Farsetti

Caterini

Potenza

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background During the last 35 years, the medial approach has been reported more frequently than the anterior approach for open reduction of developmental dislocation of the hip (DDH), however, few studies have followed children treated by medial open reduction to adulthood. Questions/purposes The purposes of our study were: (1) to assess the development of 71 completely dislocated hips after medial open reduction, the incidence of additional surgery and avascular necrosis during the followup period, and the long-term radiographic and functional results; and (2) to compare our results with those obtained by others who performed open reduction either by the medial or anterior approach. Patients and Methods We retrospectively evaluated, after the end of growth, 71 hips in 52 patients who underwent open reduction by the medial approach. The mean age of the patients was 16 months (range, 3-36 months). After surgery, the hips were immobilized in 100°flexion, 60°a bduction, and neutral rotation for an average of 6 months. All patients had staged clinical and radiographic followups until skeletal maturity. The length of followup averaged 22 years (range, 13-32 years). Results In all the surgically treated hips, the acetabular index normalized by the end of growth, the incidence of avascular necrosis was 18%, and additional surgery was required in 15% of our cases. At the last followup, 93% of the hips were classified as Severin Classes I or II and 7% as Class III; 76% of the hips had an excellent result, 17% had a good result, and 7% had a fair result according to the McKay scale as modified by Barrett and colleagues. Conclusions Open reduction of DDH through a medial approach provided good long-term radiographic and functional results in patients 3 to 36 months old and it was the only surgery performed in 85% of our cases. Future comparative studies are needed to confirm our results, especially in older children. Level of evidence Level IV, therapeutic study.

show abstract

Section: Discussionmentioning

confidence: 54%

“…During the last 36 years, the anterior approach has been reported less frequently [1,10,17,18,20,23,25,30,31,47,58,70,71,73,79,80] than the medial approach [4, 6, 7, 11, 16, 21, 22, 33, 36, 37, 39, 40, 46, 48-50, 52-54, 60, 69, 77, 78, 85, 88], especially in younger children.…”

Section: Introductionmentioning

confidence: 99%

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

Farsetti

Caterini

Potenza

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Thirty studies did not report osteonecrosis occurrence for all patients eligible for open or closed reduction specific to age at index reduction (12 months or younger versus older than 12 months). Ten studies [11,15,19,20,24,38,40,64,67,74] reported the age-specific occurrence of Grade I or greater osteonecrosis but not Grade II or greater osteonecrosis. One additional study [46] reported osteonecrosis occurrence by age at index open reduction but not by operative approach (medial versus anterior) and was excluded from the meta-analysis.…”

Section: Critical Reviewmentioning

confidence: 99%

“…Ten studies [4,20,23,24,45,58,63,66,74,84] did not report the criteria used to assess osteonecrosis.…”

Section: Study Characteristicsmentioning

confidence: 99%

Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis

Novais

Hill

Carry

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Osteonecrosis of the femoral head is a major complication that negatively impacts the clinical and radiographic long-term outcome after treatment of developmental hip dysplasia (DDH). There are conflicting results in the literature whether age at the time of closed or open reduction and a specific surgical approach are associated with osteonecrosis. Better understanding of the impact of age at reduction and surgical approach is important to reduce the risk of osteonecrosis in patients with DDH. Questions/purposes We aimed to evaluate the association between occurrence of osteonecrosis and (1) age at closed reduction; (2) age at open reduction; and (3) medial versus anterior operative approaches.Methods A systematic review identified studies reporting osteonecrosis occurrence after treatment of DDH and at least 2 years of followup. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Methodologic quality was assessed using the methodologic index for nonrandomized studies. Generalized logistic models were used to estimate pooled odds ratios (ORs) in the meta-analysis. Sixty-six studies were included in the systematic review and 24 in the meta-analysis. Data on 481 hips treated by closed reduction and 584 hips treated by open reduction were available to evaluate the association between osteonecrosis and age. The association between osteonecrosis and operative approach was assessed using data on 364 hips treated by medial open reduction and 220 hips treated by anterior open reduction. Results Age at reduction ([ 12 months versus B 12 months) was not associated with osteonecrosis after closed reduction (OR, 1.1; 95% confidence interval [CI], 0.4-3.2; p = 0.9) or open reduction (OR, 1.1; 95% CI, 0.7-1.9; p = 0.66). The overall, adjusted incidence of osteonecrosis (C Grade II) was 8.0% (95% CI, 2.8%-20.6%) among patients treated with closed reduction at or before 12 months of age and 8.4% (95% CI, 3.0%-21.

show abstract

“…11,13 We found that the use of a TAP was an effective measure in maintaining reduction, with a lower rate of redislocation than when it was not used and a lower rate of redislocation when compared with other series. 5,8,[26][27][28][29][30][31][32] The quality and maintenance of reduction of a dislocated hip are key for the subsequent development of the acetabulum. [33][34][35][36] Adequate acetabular development is of the highest importance in predicting the long-term prognosis of a dysplastic hip.…”

Section: Discussionmentioning

confidence: 99%

The Safety and Efficacy of a Transarticular Pin for Maintaining Reduction in Patients With Developmental Dislocation of the Hip Undergoing an Open Reduction

Castañeda

Tejerina

Nualart

et al. 2015

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

show abstract

Open reduction of CDH before one year of age: 69 hips followed for 13 (10–19) years

Cited by 14 publications

References 11 publications

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis

The Safety and Efficacy of a Transarticular Pin for Maintaining Reduction in Patients With Developmental Dislocation of the Hip Undergoing an Open Reduction

Contact Info

Product

Resources

About