Bilateral developmental dysplasia of the hip: asymmetric outcome in the older child.

Fifteen patients who were 2 years of age or older and had bilateral developmental dysplasia of the hip were reviewed. Thirty hips had required open reduction combined with osteotomy on the pelvic or femoral side or both as necessary. The results were assessed according to McKay and Severin classifications, and complications including asymmetric outcome were recorded. An asymmetric outcome existed if the clinical or radiologic result for the contralateral hip was more than one unit difference or a leg length discrepancy of more than 1 cm was observed. Before surgery, there was no significant difference clinically and radiologically between the right and left hips for all patients. Surgical procedures required for both hips also were symmetric in 14 (93%) patients. However, asymmetric outcome occurred in four (27%) patients, three of whom were older than 5 years. An asymmetric outcome as defined is a potential risk after surgical treatment of bilateral developmental dysplasia of the hip in children who are older than 5 years.