Key result
In patients aged 6-24 months with DDH treated by closed reduction, age was not a risk factor for redislocation, AVN, or poor radiographic outcome, though older patients had a higher surgical risk.
Why the study?
The study investigated the effect of age on redislocation rates, avascular necrosis of the femoral head, and final radiographic outcomes in patients with developmental dysplasia of the hip treated with closed reduction.
Does age at the time of closed reduction affect the rates of redislocation, AVN, and final radiographic outcomes in patients aged 6-24 months with DDH?
Observational (n=276)
Does age at the time of closed reduction affect the rates of redislocation, AVN, and final radiographic outcomes in patients aged 6-24 months with DDH?
In children aged 6-24 months with DDH treated by closed reduction, age does not significantly impact redislocation or AVN rates, though older age increases the risk for secondary surgery.
Supports earlier closed reduction before 12 months in DDH to lower secondary surgery risk; leaves open effects on redislocation and AVN.
This study aimed to investigate the effect of age on the rates of redislocation, avascular necrosis (AVN) of the femoral head, and final radiographic outcomes in patients with developmental dysplasia of the hip (DDH) treated with closed reduction. A total of 308 hips (276 patients) with DDH treated with closed reduction were included and divided into three groups according to age (<12, 12-18, 18-24 months). Tönnis grade, rate of redislocation and AVN, Severin radiographic grade, and risk of surgery were evaluated on radiographs. Tönnis grade significantly increased with age (P < 0.001). Redislocation occurred in 17 (5.5%) and AVN occurred in 36 (11.7%) hips. The rate of redislocation and AVN was similar among the three age groups in all Tönnis grades. However, redislocation rate significantly increased with Tönnis grade (P = 0.027). Overall, 246 hips (79.9%) had satisfactory final outcomes, and 62 hips (20.1%) had unsatisfactory outcome; no difference was observed among three age groups. A total of 103 hips (33.4%) were found to be at risk for secondary surgery. The surgical risk (25%) in patients younger than 12 months was lower than that of older patients (12-18 months: 34.4%; 18-24 months: 37.9%). Logistic regression analysis also confirmed that age was not a risk factor for redislocation, AVN, or poor radiographic outcome. In conclusion, age has no significant impact on redislocation and AVN in patients aged 6-24 months with DDH treated by closed reduction. Although older patients have a higher risk developing residual acetabular dysplasia, secondary pelvic surgery provides favorable outcomes in most patients.
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Li et al. (2019) conducted an observational in Developmental dysplasia of the hip (DDH) (n=276). Age (<12, 12-18, 18-24 months) vs. Different age groups was evaluated on Rates of redislocation, avascular necrosis (AVN), and final radiographic outcomes. In patients aged 6-24 months with DDH treated by closed reduction, age was not a risk factor for redislocation, AVN, or poor radiographic outcome, though older patients had a higher surgical risk.
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