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Developmental Dysplasia of the Hip: Controversies in Management

  • Pediatric Orthopedics (I Swarup, Section Editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

Many aspects of developmental hip dysplasia (DDH) care and evaluation are still active areas of debate. Recent studies have provided more insight into these topics such as strategies for reducing osteonecrosis, assessing hip reduction after closed and open reduction, and the management of residual acetabular dysplasia.

Recent Findings

The presence of the ossific nucleus at the time of reduction does not alter the risk of osteonecrosis. The risk of osteonecrosis may be higher when hips are immobilized in excessive abduction. Limited sequence MRI may be the best choice for assessing hip reduction after closed and open reduction; however, new technologies are emerging such as 3D fluoroscopy and perfusion MRI. The treatment of residual acetabular dysplasia with bracing has been shown to be effective and the decision to perform a pelvic osteotomy is based on patient-specific factors.

Summary

The spectrum of DDH treatment has evolved over the past several decades. Recent studies have provided insights into strategies for osteonecrosis prevention, hip evaluation during after reduction, and the management of residual acetabular dysplasia. However, there is ample room for additional and more rigorous studies guiding advanced imaging for assessing hip reduction such as 3D fluoroscopy and perfusion MRI, as well as the management of residual acetabular dysplasia.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Bialik V, Bialik GM, Blazer S, Sujov P, Wiener F, Berant M. Developmental dysplasia of the hip: a new approach to incidence. Pediatrics. 1999;103:93–9, 99.

  2. Noordin S, Umer M, Hafeez K, Nawaz H. Developmental dysplasia of the hip. Orthop Rev. 2010;2:19.

    Article  Google Scholar 

  3. Pollet V, Percy V, Prior HJ. Relative risk and incidence for developmental dysplasia of the hip. J Pediatr. 2017;181:202–7.

    Article  PubMed  Google Scholar 

  4. de Hundt M, Vlemmix F, Bais JMJ, Hutton EK, de Groot CJ, Mol BWJ, Kok M. Risk factors for developmental dysplasia of the hip: a meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2012;165:8–17.

    Article  PubMed  Google Scholar 

  5. Harsanyi S, Zamborsky R, Krajciova L, Kokavec M, Danisovic L. Developmental dysplasia of the hip: a review of etiopathogenesis, risk factors, and genetic aspects. Medicina. 2020;56:153.

    Article  PubMed Central  Google Scholar 

  6. Shaw BA, Segal LS, Otsuka NY, Schwend RM, Ganley TJ, Herman MJ, et al. Evaluation and referral for developmental dysplasia of the hip in infants. Pediatrics. 2016;138.

  7. Holen KJ, Tegnander A, Bredland T, Johansen OJ, Saether OD, Eik-Nes SH, et al. Universal or selective screening of the neonatal hip using ultrasound? J Bone Joint Surg. 2002;84:886–90.

    Article  CAS  Google Scholar 

  8. Barrera CA, Cohen SA, Sankar WN, Ho-Fung VM, Sze RW, Nguyen JC. Imaging of developmental dysplasia of the hip: ultrasound, radiography and magnetic resonance imaging. Pediatr Radiol. 2019;49:1652–68.

    Article  PubMed  Google Scholar 

  9. Clarke NMP, Reading IC, Corbin C, Taylor CC, Bochmann T. Twenty years experience of selective secondary ultrasound screening for congenital dislocation of the hip. Arch Dis Child. 2012;97:423–9.

    Article  PubMed  Google Scholar 

  10. Schwend RM, Shaw BA, Segal LS. Evaluation and treatment of developmental hip dysplasia in the newborn and infant. Pediatr Clin N Am. 2014;61:1095–107.

    Article  Google Scholar 

  11. Larson JE, Patel AR, Weatherford B, Janicki JA. Timing of Pavlik harness initiation: can we wait? J Pediatr Orthop. 2019;39:335–8.

    Article  PubMed  Google Scholar 

  12. Zomar BO, Mulpuri K, Schaeffer EK. Examining the short-term natural history of developmental dysplasia of the hip in infancy: a systematic review. Indian J Orthop. 2021;55:1372–87.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Swarup I, Penny CL, Dodwell ER. Developmental dysplasia of the hip: an update on diagnosis and management from birth to 6 months. Curr Opin Pediatr. 2018;30:84–92.

    Article  PubMed  Google Scholar 

  14. Pavlik A. Method of functional therapy with strap braces as a principle of conservative therapy of congenital dislocation of the hip in infants. Zeitschrift fur Orthopadie und ihre Grenzgebiete 1957;89:341–352.

  15. Yang S, Zusman N, Lieberman E, Goldstein RY. Developmental dysplasia of the hip. Pediatrics. 2019;143.

  16. Schmitz MR, Murtha AS, Clohisy JC. Developmental dysplasia of the hip in adolescents and young adults. J Am Acad Orthop Surg. 2020;28:91–101.

    Article  PubMed  Google Scholar 

  17. de Courtivron B, Brulefert K, Portet A, Odent T. Residual acetabular dysplasia in congenital hip dysplasia. Orthop Traumatol Surg Res. 2021;103172:103172.

    Google Scholar 

  18. Mau H, Dörr WM, Henkel L, Lutsche J. Open reduction of congenital dislocation of the hip by Ludloff’s method. J Bone Joint Surg Am volume. United States; 1971;53:1281–1288.

  19. O’Hara JN, Bernard AA, Dwyer NSJP. Early results of medial approach open reduction in congenital dislocation of the hip: use before walking age. J Pediatr Orthop. 1988;8:288–94.

    Article  PubMed  Google Scholar 

  20. Castillo R, Sherman FC. Medial adductor open reduction for congenital dislocation of the hip. J Pediatr Orthop. United States; 1990;10:335–340.

  21. Sosna A, Rejholec M. Ludloff’s open reduction of the hip: long-term results. J Pediatr Orthop. United States; 1992;12:603–606.

  22. Mergen E, Adyaman S, Omeroglu H, Erdemli B, Isiklar U. Medial approach open reduction for congenital dislocation of the hip using the Ferguson procedure. A review of 31 hips. Arch Orthop Trauma Surg. Germany; 1991;110:169–172.

  23. Konigsberg DE, Karol LA, Colby S, O’Brien S. Results of medial open reduction of the hip in infants with developmental dislocation of the hip. J Pediatr Orthop. United States; 2003;23:1–9.

  24. Kiely N, Younis U, Day JB, Meadows TM. The ferguson medial approach for open reduction of developmental dysplasia of the hip. A clinical and radiological review of 49 hips. J Bone Joint Surg British volume. England; 2004;86:430–433.

  25. Mankey MG, Arntz GT, Staheli LT. Open reduction through a medial approach for congenital dislocation of the hip. A critical review of the Ludloff approach in sixty-six hips. J Bone Joint Surg Am volume. United States; 1993;75:1334–1345.

  26. Kalamchi A, MacEwen GD. Avascular necrosis following treatment of congenital dislocation of the hip. J Bone Joint Surg Am volume. United States; 1980;62:876–888.

  27. Ferguson AB. Primary open reduction of congenital dislocation of the hip using a median adductor approach. J Bone Joint Surg Am. 1973;55:671–89.

    Article  PubMed  Google Scholar 

  28. Schur MD, Lee C, Arkader A, Catalano A, Choi PD. Risk factors for avascular necrosis after closed reduction for developmental dysplasia of the hip. Journal of Children’s Orthopaedics [Internet]. Springer Verlag; 2016 [cited 2022 Jan 5];10:185–92. Available from: https://online.boneandjoint.org.uk/doi/abs/10.1007/s11832-016-0743-7

  29. Hussain RN, Rad D, Watkins WJ, Carpenter C. The incidence of avascular necrosis following a cohort of treated developmental dysplasia of the hip in a single tertiary centre. Journal of Children’s Orthopaedics [Internet]. J Child Orthop; 2021 [cited 2021 Dec 27];15:232–40. Available from: https://pubmed.ncbi.nlm.nih.gov/34211599/. Study highlighting the incidence of AVN, particularly after closed and open reduction.

  30. Roposch A, Wedge JH, Riedl G. Reliability of bucholz and ogden classification for osteonecrosis secondary to developmental dysplasia of the hip. Clinical Orthopaedics and Related Research. Springer New York LLC; 2012;470:3499–3505.

  31. Kitoh H, Kawasumi M, Ishiguro N. Predictive factors for unsuccessful treatment of developmental dysplasia of the hip by the Pavlik harness J Pediatr Orthop; 2009;29:552–557.

  32. Flynn JM. Wudbhav N. Sankar and SWW. Operative techniques in pediatric orthopaedic surgery. Philadelphia: Wolters Kluwer; 2016.

    Google Scholar 

  33. Wang YJ, Yang F, Wu QJ, Pan SN, Li LY. Association between open or closed reduction and avascular necrosis in developmental dysplasia of the hip: A PRISMA-compliant meta-analysis of observational studies. Medicine. Wolters Kluwer Health; 2016;95.

  34. Tiruveedhula M, Reading IC, Clarke NMP. Failed pavlik harness treatment for DDH as a risk factor for avascular necrosis. Journal of Pediatric Orthopaedics [Internet]. Lippincott Williams and Wilkins; 2015 [cited 2022 Mar 6];35:140–3. Available from: https://journals.lww.com/pedorthopaedics/Fulltext/2015/03000/Failed_Pavlik_Harness_Treatment_for_DDH_as_a_Risk.7.aspx

  35. Zhou Y, Li R, Li C, Zhou P, Li Y, Ke YH, et al. Tübingen hip flexion splints for developmental dysplasia of the hip in infants aged 0-6 months. BMC Pediatrics [Internet]. BioMed Central Ltd.; 2020 [cited 2022 Mar 6];20:1–8. Available from: https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02171-0.

  36. Zhi X, Xiao X, Wan Y, Wei P, Canavese F, Xu H. Tübingen hip flexion splint for the treatment of developmental dysplasia of the hip in children younger than six months age: a meta-analysis. J Child Orthop. 2021;15:402–8.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Cheon J-E, Kim JY, Choi YH, Kim WS, Cho T-J, Yoo WJ. MRI risk factors for development of avascular necrosis after closed reduction of developmental dysplasia of the hip: Predictive value of contrast-enhanced MRI. PLoS ONE. 2021;16:e0248701. Study investigating MRI risk factors for osteonecrosis post-reduction.

  38. Kitoh H, Kawasumi M, Ishiguro N. Predictive factors for unsuccessful treatment of developmental dysplasia of the hip by the Pavlik harness. Journal of pediatric orthopedics [Internet]. J Pediatr Orthop; 2009 [cited 2022 Mar 6];29:552–7. Available from: https://pubmed.ncbi.nlm.nih.gov/19700982/

  39. Dhar S, Taylor JF, Jones WA, Owen R. Early open reduction for congenital dislocation of the hip. The Journal of bone and joint surgery British volume. J Bone Joint Surg (Br). 1990;72:175–80.

    Article  CAS  Google Scholar 

  40. Weiner DS, Hoyt WA Jr, HW O’dell. Congenital dislocation of the hip. The relationship of premanipulation traction and age to avascular necrosis of the femoral head. J Bone Joint Surg Am Volume. 1977;59:306–311.

  41. Chen C, Doyle S, Green D, Blanco J, Scher D, Sink E, et al. Presence of the ossific nucleus and risk of osteonecrosis in the treatment of developmental dysplasia of the hip: a meta-analysis of cohort and case-control studies. J Bone Joint Surg Am; 2017;99:760–7. Meta-analysis suggesting the presence of the ossific nucleus does not alter osteonecrosis risk.

  42. Novais EN, Hill MK, Carry PM, Heyn PC. Is age or surgical approach associated with osteonecrosis in patients with developmental dysplasia of the hip? A meta-analysis. Clin Orthop Relat Res. 2016;474:1166–77.

    Article  PubMed  Google Scholar 

  43. Flynn JM, Wudbhav N, Sankar MD, Sam WW. Operative techniques in pediatric orthopaedic surgery. Philadelphia: Wolters Kluwer; 2016.

  44. Ramsey PL, Lasser S, MacEwen GD. Congenital dislocation of the hip. Use of the Pavlik harness in the child during the first six months of life. J Bone Joint Surg Am volume. United States; 1976;58:1000–1004.

  45. Liu YH, Xu HW, Li YQ, Hong K, Li JC, Pereira B, et al. Effect of abduction on avascular necrosis of the femoral epiphysis in patients with late-detected developmental dysplasia of the hip treated by closed reduction: a MRI study of 59 hips. Journal of Children’s Orthopaedics [Internet]. J Child Orthop; 2019 [cited 2022 Jan 8];13:438–44. Available from: https://pubmed.ncbi.nlm.nih.gov/31695810/

  46. Presch C, Eberhardt O, Wirth T, Fernandez FF. Comparison of arthroscopic and open reduction of conservatively irreducible dislocated hips of children. Journal of Children’s Orthopaedics [Internet]. J Child Orthop; 2019 [cited 2022 Jan 26];13:377–84. Available from: https://pubmed.ncbi.nlm.nih.gov/31489043/

  47. Bradley CS, Perry DC, Wedge JH, Murnaghan ML, Kelley SP. Avascular necrosis following closed reduction for treatment of developmental dysplasia of the hip: a systematic review. Journal of Children’s Orthopaedics [Internet]. J Child Orthop; 2016 [cited 2022 Jan 8];10:627–32. Available from: https://pubmed.ncbi.nlm.nih.gov/27812914/

  48. Jia G, Wang E, Lian P, Liu T, Zhao S, Zhao Q. Anterior approach with mini-bikini incision in open reduction in infants with developmental dysplasia of the hip. J Orthop Surg Res. BioMed Central Ltd.; 2020;15.

  49. Studer K, Williams N, Studer P, Baker M, Glynn A, Foster BK, et al. Obstacles to reduction in infantile developmental dysplasia of the hip. J Child Orthop; 2017 [cited 2022 Jan 26];11:358–66. Available from: https://pubmed.ncbi.nlm.nih.gov/29081850/

  50. Murphy RF, Kim YJ. Surgical management of pediatric developmental dysplasia of the hip. Journal of the American Academy of Orthopaedic Surgeons [Internet]. Lippincott Williams and Wilkins; 2016 [cited 2022 Jan 8];24:615–24. Available from: https://journals.lww.com/jaaos/Fulltext/2016/09000/Surgical_Management_of_Pediatric_Developmental.5.aspx

  51. Sankar WN, Gornitzky AL, Clarke NMP, Herrera-Soto JA, Kelley SP, Matheney T, et al. Closed reduction for developmental dysplasia of the hip: early-term results from a prospective, multicenter cohort. J Pediat Orthop. Lippincott Williams and Wilkins; 2019;39:111–8. Prospective cohort examining results of closed reduction.

  52. Liu YH, Xu HW, Li YQ, Hong K, Li JC, Pereira B, Xun FX, Canavese F Effect of abduction on avascular necrosis of the femoral epiphysis in patients with late-detected developmental dysplasia of the hip treated by closed reduction: a MRI study of 59 hips. J Child Orthop; 2019;13:438–444.

  53. Schur MD, Lee C, Arkader A, Catalano A, Choi PD. Risk factors for avascular necrosis after closed reduction for developmental dysplasia of the hip. Journal of Children’s Orthopaedics. Springer Verlag; 2016;10:185–192.

  54. Gardner ROE, Bradley CS, Howard A, Narayanan UG, Wedge JH, Kelley SP. The incidence of avascular necrosis and the radiographic outcome following medial open reduction in children with developmental dysplasia of the hip: a systematic review. Bone and Joint Journal. British Editorial Society of Bone and Joint Surgery; 2014;96 B:279–86.

  55. Barkatali BM, Imalingat H, Childs J, Baumann A, Paton R. MRI versus computed tomography as an imaging modality for postreduction assessment of irreducible hips in developmental dysplasia of the hip: an interobserver and intraobserver reliability study. Journal of Pediatric Orthopedics Part B. United States; 2016;25:489–492.

  56. Ludloff K. The open reduction of the congenital hip dislocation by an anterior incision. Am J Orthop Surg. 1913.

  57. Weintsein SL. Anteromedial approach to reduction for congenital hip dysplasia. Strat Orthop Surg. 1987;6:2.

    Google Scholar 

  58. Weinstein SL. The medial approach in congenital dislocation of the hip. Isr J Med Sci. 1980;16:272–5.

    CAS  PubMed  Google Scholar 

  59. Ferguson AB. Primary open reduction of congenital dislocation of the hip using a median adductor approach. J Bone Joint Surg Am. 1973;55:671–89.

    Article  PubMed  Google Scholar 

  60. Murphy RF, Kim YJ. Surgical management of pediatric developmental dysplasia of the hip. Journal of the American Academy of Orthopaedic Surgeons. Lippincott Williams and Wilkins; 2016;24:615–624.

  61. Okano K, Enomoto H, Osaki M, Takahashi K, Shindo H. Femoral head deformity after open reduction by ludloff’s medial approach. Clin Orthop Relat Res. Springer New York; 2008;466:2507–2512.

  62. Zamzam MM, Khoshhal KI, Abak AA, Bakarman KA, AlSiddiky AMM, AlZain KO, et al. One-stage bilateral open reduction through a medial approach in developmental dysplasia of the hip. Journal of Bone and Joint Surgery - Series B. The British Editorial Society of Bone and Joint Surgery; 2009;91:113–118.

  63. Kotlarsky P, Haber R, Bialik V, Eidelman M. Developmental dysplasia of the hip: what has changed in the last 20 years? http://www.wjgnet.com/. Baishideng Publishing Group Inc.; 2015;6:886–901.

  64. Castañeda PG, Moses MJ. Closed compared with open reduction in developmentally dislocated hips: a critical analysis review. JBJS Reviews [Internet]. Journal of Bone and Joint Surgery Inc.; 2019 [cited 2022 Jan 8];7. Available from: https://journals.lww.com/jbjsreviews/Fulltext/2019/10000/Closed_Compared_with_Open_Reduction_in.1.aspx

  65. Murphy RF, Kim YJ. Surgical management of pediatric developmental dysplasia of the hip. J Am Acad Orthop Surg. Lippincott Williams and Wilkins; 2016;24:615–624.

  66. Jia G, Wang E, Lian P, Liu T, Zhao S, Zhao Q. Anterior approach with mini-bikini incision in open reduction in infants with developmental dysplasia of the hip. J Orthop Surg Res. BioMed Central Ltd.; 2020;15.

  67. Jia G, Wang E, Lian P, Liu T, Zhao S, Zhao Q. Anterior approach with mini-bikini incision in open reduction in infants with developmental dysplasia of the hip. J Orthop Surg Res. BioMed Central Ltd.; 2020;15.

  68. Kotlarsky P, Haber R, Bialik V, Eidelman M. Developmental dysplasia of the hip: What has changed in the last 20 years? http://www.wjgnet.com/. Baishideng Publishing Group Inc.; 2015;6:886–901.

  69. Kalamchi A, MacEwen GD. Avascular necrosis following treatment of congenital dislocation of the hip. J Bone Joint Surg Am volume. United States; 1980;62:876–888.

  70. Severin E. Contribution to knowledge of congenital dislocation of hip joint: late results of closed reduction and arthrographic studies of recent cases. Acta Chir Scand. 1941:1–142.

  71. Lönnerholm T. Arthrography of the hip in children. Technique, normal anatomy and findings in unstable hip joints. Acta Radiologica: Diagnosis. Sweden; 1980;21:279–292.

  72. Drummond DS, O’Donnell J, Breed A, Albert MJ, Robertson WW. Arthrography in the evaluation of congenital dislocation of the hip. Clin Orthop Relat Res. United States; 1989;148–156.

  73. Race C, Herring JA. Congenital dislocation of the hip: an evaluation of closed reduction. J Pediatr Orthop. 1983;3:166–72.

    Article  CAS  PubMed  Google Scholar 

  74. Gans I, Sankar WN. The medial dye pool revisited: correlation between arthrography and MRI in closed reductions for DDH. Journal of Pediatric Orthopaedics [Internet]. Lippincott Williams and Wilkins; 2014 [cited 2022 Jan 19];34:787–90. Available from: https://journals.lww.com/pedorthopaedics/Fulltext/2014/12000/The_Medial_Dye_Pool_Revisited__Correlation_Between.9.aspx

  75. Chin MS, Betz BW, Halanski MA. Comparison of hip reduction using magnetic resonance imaging or computed tomography in hip dysplasia. Journal of pediatric orthopedics [Internet]. J Pediatr Orthop; 2011 [cited 2022 Jan 19];31:525–9. Available from: https://pubmed.ncbi.nlm.nih.gov/21654460/

  76. Sachleben B, Perry DC, Wedge J, Kelley SP. Intraoperative assessment of closed reduction for developmental dislocation of the hip using 3-dimensional fluoroscopy. J Pediatr Orthop. United States; 2015;35:246–252.

  77. Gould SW, Grissom LE, Niedzielski A, Kecskemethy HH, Bowen JR, Harcke HT. Protocol for MRI of the hips after spica cast placement. J Pediatr Orthop. United States; 2012;32:504–509.

  78. Chin MS, Betz BW, Halanski MA. Comparison of hip reduction using magnetic resonance imaging or computed tomography in hip dysplasia. J Pediatr Orthop. 2011;31:525–9.

    Article  PubMed  Google Scholar 

  79. Rosenbaum DG, Servaes S, Bogner EA, Jaramillo D, Mintz DN. MR Imaging in postreduction assessment of developmental dysplasia of the hip: goals and obstacles. Radiographics : a review publication of the Radiological Society of North America, Inc. United States; 2016;36:840–854.

  80. Barkatali BM, Imalingat H, Childs J, Baumann A, Paton R. MRI versus computed tomography as an imaging modality for postreduction assessment of irreducible hips in developmental dysplasia of the hip: an interobserver and intraobserver reliability study. Journal of Pediatric Orthopedics Part B. United States; 2016;25:489–492.

  81. Sachleben B, Perry DC, Wedge J, Kelley SP. Intraoperative assessment of closed reduction for developmental dislocation of the hip using 3-dimensional fluoroscopy. Journal of Pediatric Orthopedics. United States; 2015;35:246–252.

  82. Gornitzky AL, Georgiadis AG, Seeley MA, Horn BD, Sankar WN. Does perfusion MRI after closed reduction of developmental dysplasia of the hip reduce the incidence of avascular necrosis? Clinical Orthopaedics and Related Research. Association of Bone and Joint Surgeons; 2016;474:1153. Investigation of perfusion MRI after closed reduction.

  83. Tiderius C, Jaramillo D, Connolly S, Griffey M, Rodriguez DP, Kasser JR, et al. Post-closed reduction perfusion magnetic resonance imaging as a predictor of avascular necrosis in developmental hip dysplasia: a preliminary report. J Pediatr Orthop. 29:14–20.

  84. Tonnis D, Brunken D. Eine Abgrenzung normaler und pathologischer Hiiftpfannendaehwinkel zur Diagnose der Hiiftdysplasie Auswertungen yon 2294 Pfannendachwinkeln kindlicher Htiftgelenke. Arehiv fur orthopadische und Unfall-Chirurgie. 1968;64:197–228.

    CAS  Google Scholar 

  85. Tonnis D. Normal values of the hip joint for the evaluation of X-rays in children and adults. Clin Orthop Relat Res. 1976;119:39–47.

    Google Scholar 

  86. Novais EN, Pan Z, Autruong PT, Meyers ML, Chang FM. Normal percentile reference curves and correlation of acetabular index and acetabular depth ratio in children. J Pediatr Orthop. Lippincott Williams and Wilkins; 2018;38:163–9. Modern classical normal values of acetabular index in children up to 14 years of age.

  87. Akel I, Songür M, Karahan S, Yilmaz G, Demirkiran HG, Tümer Y. Acetabular index values in healthy Turkish children between 6 months and 8 years of age: a cross-sectional radiological study. Acta Orthop Traumatol Turc. 2013;47:38–42.

    Article  PubMed  Google Scholar 

  88. Caffey J, Ames R, Silverman WA, Ryder CT, Hough G. Contradiction of the congenital dysplasia-predislocation hypothesis of congenital dislocation of the hip through a study of the normal variation in acetabular angles at successive periods in infancy. Pediatrics. 1956;17:632–41.

    Article  CAS  PubMed  Google Scholar 

  89. Scoles P, Boyd A, Jones P. Roentgenographic parameters of the normal infant hip. J Pediatr Orthop. 1987;7:656–63.

    Article  CAS  PubMed  Google Scholar 

  90. Thieme W, Thiersch J. Translation: Hilgenreiner on congenital hip dislocation. J Pediatr Orthop. 1986;6:202–14.

    Article  Google Scholar 

  91. Segev E, Hemo Y, Wientroub S, Ovadia D, Fishkin M, Steinberg DM, Hayek S. Intra- and interobserver reliability analysis of digital radiographic measurements for pediatric orthopedic parameters using a novel PACS integrated computer software program. J Child Orthop. 2010;4:331–41.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Li LY, Zhang LJ, Li QW, Zhao Q, Jia JY, Huang T. Development of the osseous and cartilaginous acetabular index in normal children and those with developmental dysplasia of the hip: a cross-sectional study using MRI. Journal of Bone and Joint Surgery British volume. 2012;94:1625–1631.

  93. Murray T, Cooperman DR, Thompson GH, Ballock RT. Closed reduction for treatment of developmental dysplasia of the hip in children. American Journal of Orthopedics (Belle Mead, NJ). 2007;36(2).

  94. Schoenecker PL, Dollard PA, Sheridan JJ, Strecker WB. Closed reduction of developmental dislocation of the hip in children older than 18 months. J Pediatr Orthop 1995;15:763–767.

  95. Zionts L, MacEwen G. Treatment of congenital dislocation of the hip in children between the ages of one and three years. J Bone Joint Surg. 1986;68(6):829–46.

    Article  CAS  PubMed  Google Scholar 

  96. Gholve PA, Flynn JM, Garner MR, Millis MB, Kim Y-J. Predictors for secondary procedures in walking DDH. J Pediatr Orthop. 2012;32:282–9.

    Article  PubMed  Google Scholar 

  97. Swarup I, Ge Y, Scher D, Sink E, Widmann R, Dodwell E. Open and closed reduction for developmental dysplasia of the hip in New York State. JBJS Open Access. Ovid Technologies (Wolters Kluwer Health); 2020;5:e0028.

  98. Dornacher D, Lippacher S, Reichel H, Nelitz M. Mid-term results after ultrasound-monitored treatment of developmental dysplasia of the hips. J Pediatr Orthop B. 2013;22:30–5.

    Article  PubMed  Google Scholar 

  99. Albinana J, Dolan LA, Spratt KF, Morcuende J, Meyer MD, Weinstein SL. Acetabular dysplasia after treatment for developmental dysplasia of the hip implications for secondary procedures. J Bone Joint Surg [Br]. 2004;86–876.

  100. Nakamura J, Kamegaya M, Saisu T, Someya M, Koizumi W, Moriya H, et al. Treatment for developmental dysplasia of the hip using the Pavlik harness long-term results. J Bone Joint Surg (Br). 2007;89-B:230–5.

    Article  Google Scholar 

  101. Malvitz TA, Weinstein SL. Closed reduction for congenital dysplasia of the hip. Functional and radiographic results after an average of thirty years. J Bone Joint Surg. 1994;76:1777–92.

    Article  CAS  PubMed  Google Scholar 

  102. Morcuende JA, Meyer MD, Dolan LA. Long-term outcome after open reduction through an anteromedial approach for congenital dislocation of the hip*. J Bone Joint Surg [Internet]. 1997;79-A:810–7. Available from: http://journals.lww.com/jbjsjournal

  103. Thillemann TM, Pedersen AB, Johnsen SP, Søballe K. Implant survival after primary total hip arthroplasty due to childhood hip disorders Results from the Danish Hip Arthroplasty Registry. Acta Orthop. 2008;79:769–776.

  104. Engesæter LB, Furnes O, Havelin LI. Developmental dysplasia of the hip — good results of later total hip arthroplasty. J Arthroplast. 2008;23:235–40.

    Article  Google Scholar 

  105. Ashraf A, Larson NA, Maradit-Kremers H, Kremers WK, Lewallen DG. Hospital costs of total hip arthroplasty for developmental dysplasia of the hip. Clin Orthop Relat Res. 2014;472:2237–44.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Gans I, Flynn JM, Sankar WN. Abduction bracing for residual acetabular dysplasia in infantile DDH. J Pediatr Orthop. 2013;33:714–8.

    Article  PubMed  Google Scholar 

  107. Swarup I, Talwar D, Sankar WN. Part-time abduction bracing in infants with residual acetabular dysplasia: does compliance monitoring support a dose-dependent relationship? J Pediatr Orthop. 2021;41:e125–9. Investigation demonstrating the effectiveness of bracing for management of residual acetabular dysplasia.

  108. Dega W. Transiliac osteotomy in the treatment of congenital hip dysplasia. Chir Narzadow Ruchu Ortop Pol. 1974;39:601–13.

    CAS  PubMed  Google Scholar 

  109. Mubarak SJ, Valencia FG, Wenger DR. One-stage correction of the spastic dislocated hip. Use of pericapsular acetabuloplasty to improve coverage. J Bone Joint Surg Am volume. 1992;74:1347–1357.

  110. McNerney NP, Mubarak SJ, Wenger DR. One-stage correction of the dysplastic hip in cerebral palsy with the San Diego acetabuloplasty: results and complications in 104 hips. J Pediatr Orthop. 2000;20:93–103.

    Article  CAS  PubMed  Google Scholar 

  111. Permberton PA. Pericapsular osteotomy of the ilium for treatment of congenital subluxation and dislocation of the hip. J Bone Joint Surg Am volume. 1965;47:65–86.

  112. Caffrey JP, Jeffords ME, Farnsworth CL, Bomar JD, Upasani V v. Comparison of 3 pediatric pelvic osteotomies for acetabular dysplasia using patient-specific 3D-printed models. J Pediatr Orthop. Lippincott Williams and Wilkins; 2019;39:E159–64. 3D comparison comparing Dega, Permberton, and San Diego osteotomies.

  113. Salter RB. Innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. J Bone Joint Surg. 1961;43B(3):518–39.

    Article  Google Scholar 

  114. Ganz R, Klaue K, Vinh TS, Mast JW. A new periacetabular osteotomy for the treatment of hip dysplasias. Technique and preliminary results. Clin Orthop Relat Res. 1988;26–36.

  115. Wainwright D. The shelf operation for hip dysplasia in adolescence. J Bone Joint Surg Br volume. 1976;58-B:159–163.

  116. Chiari K. Medial displacement osteotomy of the pelvis. Clin Orthop Relat Res. 1974;98:55–71.

    Article  Google Scholar 

  117. Lalonde FD, Frick SL, Wenger DR. Surgical correction of residual hip dysplasia in two pediatric age-groups. J Bone Joint Surg. 2002;84:1148–56.

    Article  PubMed  Google Scholar 

  118. Salter RB, Dubos J-P. The first fifteen year’s personal experience with innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. Clin Orthop Relat Res. 1974;98:72–103.

    Article  Google Scholar 

  119. Lindstrom JR, Ponseti Iv, Wenger DR. Acetabular development after reduction in congenital dislocation of the hip. J Bone Joint Surg Am volume. 1979;61:112–118.

  120. Badrinath R, Bomar JD, Wenger DR, Mubarak SJ, Upasani Vv. Comparing the pemberton osteotomy and modified San Diego acetabuloplasty in developmental dysplasia of the hip. Journal of Children’s Orthopaedics. British Editorial Society of Bone and Joint Surgery; 2019;13:172–179.

  121. Czubak J, Kowalik K, Kawalec A, Kwiatkowska M. Dega pelvic osteotomy: indications, results and complications. Journal of Children’s Orthopaedics. British Editorial Society of Bone and Joint Surgery; 2018;12:342–348.

  122. Clohisy JC, Barrett SE, Gordon JE, Delgado ED, Schoenecker PL. Periacetabular osteotomy in the treatment of severe acetabular dysplasia. Surgical technique. J Bone Joint Surg. 2006;88 Suppl 1 Pt 1:65–83.

  123. Clohisy JC, Ackerman J, Baca G, Baty J, Beaulé PE, Kim Y-J, Millis MB, Podeszwa DA, Schoenecker PL, Sierra RJ, Sink EL, Sucato DJ, Trousdale RT, Zaltz I. Patient-reported outcomes of periacetabular osteotomy from the prospective ANCHOR cohort study. J Bone Joint Surg. 2017;99:33–41.

    Article  PubMed  PubMed Central  Google Scholar 

  124. Wyles CC, Vargas JS, Heidenreich MJ, Mara KC, Peters CL, Clohisy JC, et al. Natural history of the dysplastic hip following modern periacetabular osteotomy. J Bone Joint Surg. 2019;101:932–8. Study showing the 5 and 10 year outcomes for PAO procedures performed in adolescents and young adults.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA

    Steven Garcia, Leah Demetri & Ishaan Swarup

  2. University of California, Davis School of Medicine, Sacramento, CA, USA

    Ana Starcevich

  3. Touro University California College of Osteopathic Medicine, Vallejo, CA, USA

    Andrew Gatto

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  1. Steven Garcia
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Correspondence to Ishaan Swarup.

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Garcia, S., Demetri, L., Starcevich, A. et al. Developmental Dysplasia of the Hip: Controversies in Management. Curr Rev Musculoskelet Med 15, 272–282 (2022). https://doi.org/10.1007/s12178-022-09761-8

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