Intermediate-term outcomes of arthroscopic-assisted surgical treatment for developmental dislocation of the hip in children

TIAN Qi; LI Xu-sheng; ZHOU Sheng-hu; GAO Ming-xuan

doi:10.3969/j.issn.2095-252X.2015.07.011

Abstract：Objective To summarize the intermediate-term clinical outcomes of arthroscopic-assisted surgical treatment for developmental dislocation of the hip ( DDH ) in children.Methods A retrospective analysis was performed based on the clinical data of 18 patients ( 24 hips ) who underwent arthroscopic-assisted surgical treatment from May 2007 to May 2009. There were 4 males and 14 females, whose average age was 13.6 months ( range: 9- 16 months ). There were 9 left hips and 15 right hips, and bilateral DDH was found in 6 patients and unilateral DDH in 12 patients. Closed reduction failed in all the patients under general anesthesia before the operation was decided. Results All the incisions healed by the ifrst intention. All the patients were followed up for a mean period of 6.5 years ( range: 5-7 years ). The mean duration of surgery was 42.5 min ( range: 35-56 min ). Plaster immobilization was used for a mean duration of 31.2 weeks ( range: 24-36 weeks ) postoperatively. During the follow-up, all the patients had a normal gait and full range of motion ( ROM ) of the hip. According to the preoperative radiographic examination, the Shenton’s line was discontinuous, which became normal in all the patients postoperatively. The mean preoperative acetabular index was improved from 40.1° ( range: 33.0°-52.0° ) to 25.8° from ( range: 21.0°-34.0° ) postoperatively (P=0.000 ). The concentric circles of the femoral head and the acetabulum were matched in all the patients postoperativly. During the follow-up, secondary acetabular dysplasia was found in 1 patient, who was treated by Salter innominate osteotomy later.Conclusions The arthroscopic-assisted surgical treatment of failed closed reduction in the children with DDH is safe and effective, with satisfactory intermediate-term clinical outcomes.