A Comparative Study of Clinical and Radiological Outcomes of Open Reduction Using the Anterior and Medial Approaches for the Management of Developmental Dysplasia of the Hip.

BACKGROUND: The literature is scanty on reports directly comparing the outcomes of anterior open reduction (AOR) and medial open reduction (MOR) in the management of developmental dysplasia of the hip (DDH). PURPOSE OF THE STUDY: To compare clinical and radiographic outcomes of surgical treatment using either AOR or MOR in children with DDH aged < 24 months and to evaluate the procedure-inherent risks of avascular necrosis of the femoral head (AVN) and need for further corrective surgery (FCS).
METHODS: 61 children who underwent surgical treatment for DDH were categorized into two groups: AOR (31 hips of 28 patients) and MOR (39 hips of 33 patients). The mean age was 17 ± 5.85 (range 7-24) months in group AOR and 13 ± 5.31 (range 6-24) months in group MOR. The mean follow-up was 118 ± 41.2 (range 24-192) months and 132 ± 36.7 (range 24-209) months in group AOR and MOR. At the final follow-up, mid- to long-term clinical and radiographic outcomes were assessed. FCS was recorded.
RESULTS: Regarding McKay's clinical criteria, both groups exhibited similar results (p = 0.761). No significant differences were observed between the groups in both the center-edge-angle (p = 0.112) and the Severin score (p = 0.275). The AVN rate was 32% in the AOR group and 20% in the MOR group (p = 0.264). The FCS rate was 22% in the AOR group and 12% in the MOR group (p = 0.464).
CONCLUSIONS: This study showed similar clinical and radiological outcomes with AOR and MOR with no significant relation to AVN and FCS. LEVEL OF EVIDENCE: Level III. © Indian Orthopaedics Association 2020.