Results of Medial Open Reduction of the Hip in Infants With Developmental Dislocation of the Hip

Konigsberg, David E.; Karol, Lori A.; Colby, Scott; O'Brien, Shana

doi:10.1097/01241398-200301000-00001

Cited by 62 publications

(55 citation statements)

References 13 publications

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“…One study [56] found no difference in osteonecrosis occurrence when comparing medial open reduction performed during the first versus second year of life, but did find an association between total osteonecrosis incidence and age using chi square analysis. Another study [49] found the average age at medial open reduction to be significantly older for patients who had osteonecrosis develop than for patients who did not have osteonecrosis develop. Additionally, one study [62] found osteonecrosis occurrence increased with age in a comparison of subjects operatively treated 12 months old or younger, 13 to 24 months old, and older than 24 months old.…”

Section: Study Characteristicsmentioning

confidence: 97%

“…Although some classify it as a form of Grade I osteonecrosis [9,49,81], others do not consider it osteonecrosis [13,20,30,41,56,63,72,85,96]. Because of such variability, osteonecrosis was defined as radiographic changes of Grade II or greater in the meta-analysis.…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…Sufficient subject-level data were available to exclude the following ineligible cases: four dislocations of the hip secondary to neuromuscular or teratologic causes [15,67], 188 hips treated by open reduction with concomitant pelvic osteotomy [8,10,19,20,29,31,33,38,46,59,69,74,95,96], and 280 hips treated by other ineligible interventions [23,64,85,94]. Additionally, one study [13] included 12 hips treated by medial open reduction that at least partly overlapped with a more recently published article [49]. Subject-level data for the 12 hips were not available on request, and therefore we excluded the entire study subset to avoid inclusion of duplicate data.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Sixteen studies [1,4,5,11,14,27,49,53,56,61,62,65,69,88,94,95] statistically analyzed the relationship between age at reduction and the occurrence of osteonecrosis. The analyses of five studies [56,62,69,94,95] were based partly on data that did not reflect our definition of index reduction.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The same is true for DDH treatment by open reduction. Although a correlation between increased age at reduction and osteonecrosis has been reported [49,55,56,62,65], others have found no such association [4,5,11,27,95].…”

Section: Introductionmentioning

confidence: 96%

See 4 more Smart Citations

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

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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.

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Section: Study Characteristicsmentioning

confidence: 97%

Section: Search Strategy and Criteriamentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

See 3 more Smart Citations

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

show abstract

Risk factor analysis of femoral avascular necrosis after operation for Tönnis grade IV developmental dysplasia of the hip

Wu,

Li,

Lin

et al. 2023

International Orthopaedics (SICOT)

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Residual gait deviations in children treated by medial open reduction for developmental dysplasia of the hip at long-term follow-up: a comparison with healthy controls

Demirel,

Evrendilek,

Akalan

et al. 2024

International Orthopaedics (SICOT)

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Purpose This study aimed to analyze and compare gait patterns and deviations at long-term follow-up in children who received medial open reduction (MOR) before 18 months for unilateral or bilateral hip developmental dysplasia (DDH). Methods A retrospective chart review was conducted on children who underwent MOR. The study population was divided into two groups: the unilateral group, including unilateral (five children with unilateral) and bilateral (five children with bilateral DDH). Ten healthy children were recruited for the control group. Spatiotemporal, kinematic, stiff-knee gait (SKG), and kinetic gait characteristics were analyzed. Results Stance time was significantly shorter in both the unilateral (median [IQR]; 590 ms, [560.0–612.5] and bilateral (575 ms, [550–637.5]) groups than in the control group (650, [602.5–677.5]) (p < 0.001), whereas swing time did not differ substantially (p = 0.065) There was no considerable difference in the mean knee flexion at swing between the unilateral (31.6°, [30–36]) and control (30.11°, [27.8–33.6] groups (p > 0.05), but the bilateral group (28.5°, [24.9–32.1]) showed the lower values than the other groups (p < 0.001 for bilateral vs unilateral group; p = 0.008 bilateral vs unilateral group). All the SKG parameters significantly differed among the groups in multi-group comparisons (p < 0.001 for each parameter). Three children had borderline SKG, and two had not-stiff limbs in the unilateral group. In the bilateral group, four children had stiff limbs, and one had borderline SKG. Most kinetic gait parameters were not statistically different between groups (p > 0.05). Conclusion This study has revealed notable deviations in gait patterns of children with DDH treated by MOR at long-term follow-up compared to healthy children’s gait. MOR could negatively affect pelvic motion during gait due to impaired functions of the iliopsoas and adductor muscles, and SKG can be encountered secondary to iliopsoas weakness.

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Results of Medial Open Reduction of the Hip in Infants With Developmental Dislocation of the Hip

Cited by 62 publications

References 13 publications

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

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

Risk factor analysis of femoral avascular necrosis after operation for Tönnis grade IV developmental dysplasia of the hip

Residual gait deviations in children treated by medial open reduction for developmental dysplasia of the hip at long-term follow-up: a comparison with healthy controls

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