Surgical outcomes of open hip reduction with synovectomy for developmental dysplasia of the hip patient with Juvenile idiopathic arthritis: A case report

Thamer S Alhussainan,Abdullah M Alghamdi,Rakan A Almogbel

doi:10.1016/j.ijscr.2020.06.041

Abstract

IntroductionDevelopmental dysplasia of the hip (DDH) is a common hip disorder and its association with other musculoskeletal, genetic, and neurological diseases were well described in the literature. Juvenile idiopathic arthritis (JIA) is a rare rheumatological condition, and its presence in a Developmental dysplasia of the hip (DDH) child makes this a very challenging case. Presentation of the caseThis case report is describing the presentation of 9 months old girl to orthopedic service referred from the pediatric rheumatology clinic after diagnosing her and starting the treatment for Juvenile idiopathic arthritis (JIA). Bilateral neglected Developmental dysplasia of the hip (DDH) - International Hip Dysplasia Institute (IHDI) type 4- was detected during her clinical and radiological assessment, necessitating surgical management after controlling her Juvenile idiopathic arthritis (JIA). The surgical procedure and its clinical and radiological outcomes more than four years after her surgical treatment are described in detail in this report as well. DiscussionThe management of Developmental dysplasia of the hip (DDH) associated with Juvenile idiopathic arthritis (JIA) has no established guidelines in literature. Here, we share our experience in managing such rare cases. We believe that medical control of Juvenile idiopathic arthritis (JIA) before proceeding for open reduction of Developmental dysplasia of the hip (DDH) is the key to successful results. ConclusionThe reported case is uniquely having both Developmental dysplasia of the hip (DDH) and Juvenile idiopathic arthritis (JIA) treated with open reduction, pelvic osteotomy, and femoral shortening resulting in outstanding clinical and radiological outcomes.

Highlights

Developmental dysplasia of the hip (DDH) is a common hip disorder and its association with other musculoskeletal, genetic, and neurological diseases were well described in the literature
Medical treatment had been considered the backbone for managing Juvenile idiopathic arthritis (JIA)
The purpose of this study is to report an unusual case of a patient well known to have familial juvenile idiopathic polyarticular arthritis and presented with bilateral developmental dysplasia of the hip

Summary

Introduction

Developmental dysplasia of the hip (DDH) is a common hip disorder and its association with other musculoskeletal, genetic, and neurological diseases were well described in the literature. PRESENTATION OF THE CASE: This case report is describing the presentation of 9 months old girl to orthopedic service referred from the pediatric rheumatology clinic after diagnosing her and starting the treatment for Juvenile idiopathic arthritis (JIA). DISCUSSION: The management of Developmental dysplasia of the hip (DDH) associated with Juvenile idiopathic arthritis (JIA) has no established guidelines in literature. We believe that medical control of Juvenile idiopathic arthritis (JIA) before proceeding for open reduction of Developmental dysplasia of the hip (DDH) is the key to successful results. CONCLUSION: The reported case is uniquely having both Developmental dysplasia of the hip (DDH) and Juvenile idiopathic arthritis (JIA) treated with open reduction, pelvic osteotomy, and femoral shortening resulting in outstanding clinical and radiological outcomes. That includes nonsteroidal anti-inflammatory, systemic corticosteroids, methotrexate, sulfasalazine, and biological treatment [3]

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