Single-Center Experience of Surgical Treatment of Subjects with Late-Presenting Developmental Dysplasia of the Hip

Aim: This study aimed to delineate the single-center experience surrounding the long-term consequences of surgical reconstruction in subjects with late-presenting DDH (developmental dysplasia of the hip). Methods: We analyzed 23 hips of 21 subjects aged >6 years who underwent surgical interventions, such as pelvic osteotomy, open reduction, femoral shortening, and derotation, for developmental hip dysplasia. Results: After a median follow-up of 23.34 (8–120) months, there were no noteworthy alterations in the Harris score and anteversion. Nevertheless, significant improvements were observed in SHARP, CE angle, and depth and width index over the follow-up duration. Using Sever’s radiological criteria, 87.1% of subjects achieved excellent and good results. Assessment of femoral head avascular necrosis, based on Bucholz and Ogden’s classification, produced the subsequent findings: 52% of hips were Type I; 13% were Type II; 22% were Type III; and 13% were categorized as Type IV. Conclusion: Despite achieving favorable postoperative radiological outcomes, there's a noticeable decline in clinical success in these subjects, especially as their age increases. Additionally, they face an elevated risk of avascular necrosis. The juxtaposition of a 75% radiological success rate with a 50% clinical success rate accentuates this contrast. Crucially, the success rate of surgical corrections in late-presenting DDH is tied to the age of the patient, with the success rate decreasing as age progresses.