Medial Open Reduction via Anteromedial Approach in Developmental Hip Dysplasia: Long-term Clinical and Radiological Outcomes

Abstract

Aim:The anteromedial approach in medial open reduction techniques is rarely used to treat developmental dysplasia of the hip (DDH). The objective of this study was to present the clinical and radiological outcomes of DDH patients treated with the anteromedial approach.Methods:Fifty-nine hips of 52 patients aged between 6 and 18 months who underwent medial open reduction between 2009 and 2017 through an anteromedial approach and who had at least 5 years of follow-up were retrospectively evaluated. Results were reviewed in terms of avascular necrosis (AVN) rates and the need for further surgery.Results:At the last follow-up, the rate of clinically significant AVN was 11.9%. Additional corrective surgery was performed on 20.3% of the patients. According to the modified McKay classification, 91.5% of the patients had excellent results. Radiologically, 93.2% of the patients were classified as Severin type 1. The mean age at operation time and initial Tönnis type of patients were significantly higher in patients who required advanced corrective surgery than in those who did not (p=0.042 and p=0.018, respectively).Conclusion:The anteromedial approach is safe and practical for improving radiological outcomes and reducing the need for further surgery. Long-term studies focusing on the period after bone formation are required.

Keywords

• anteromedial approach
• avascular necrosis
• developmental dysplasia of the hip
• medial open reduction
• further surgery