Comparison of the clinical and radiological outcomes of open reduction via medial and anterior approach in devleopmental dysplasia of the hip.

Abstract

This study aims to investigate the effects of surgical approach on the clinical and radiological outcomes, the incidence of avascular necrosis (AVN), and the need for revision surgery in children undergoing open reduction via medial or anterior approach for developmental dysplasia of the hip (DDH). Forty-three hips of 36 patients (9 males, 27 females; mean age 13.8 month; range 6 to 18 months) treated for DDH, followed-up regularly for at least four years between January 1997 and December 2010, and who were aged five or above in the final control were included in this retrospective study. Patients were divided into two groups according to surgical approaches. Group 1 consisted of 21 hips of 19 patients who underwent open reduction through medial approach. Group 2 consisted of 22 hips of 17 patients who underwent open reduction through anterior approach. Groups were compared in terms of clinical and radiological outcomes as well as the incidence of AVN and the need for revision surgery. There was no statistically significant difference between the groups with respect to clinical and radiological outcomes (p=0.407 and p=0.661, respectively). Similarly, there was no statistically significant difference between the groups in terms of AVN incidence and need for revision surgery (p=0.993 and p=0.170, respectively). On the other hand, acetabular index improved significantly in both groups at follow-up. This study showed that open reduction via medial or anterior approach in DDH has similar clinical and radiological results, significant improvement was achieved in the acetabular index with both approaches, and no significant difference was present in the incidence of AVN and the need for revision surgery between the groups.