Evaluating the Short-Term Impact of Closed Versus Open Reduction Techniques on Acetabular Remodeling in Developmental Hip Dysplasia.

INTRODUCTION

Developmental dysplasia of the hip (DDH) encompasses abnormalities in the acetabulum or the femoral head, ranging from mild dysplasia to complete dislocation. The primary goal of DDH treatment is to achieve and maintain a concentric reduction of the hip joint, allowing for normal acetabular and femoral head remodeling.

METHOD

This retrospective study reviewed records of patients treated for idiopathic DDH between 2016 and 2021 at a single institution. Patients included had undergone either closed or open reduction and completed at least two years of follow-up. Demographic data and radiographic assessments at multiple intervals postreduction were collected and analyzed using IBM SPSS Statistics for Windows, Version 29 (Released 2023; IBM Corp., Armonk, New York, United States).

RESULTS

A total of 41 patients (64 hips) were included, with a mean age at reduction of 6.92 months and a follow-up duration of 51.5 months. Closed reduction was performed on 38 hips, while 26 hips underwent open reduction. The mean age at reduction was significantly lower in the closed reduction group (4.58 months) compared to the open reduction group (10.34 months). The mean preoperative acetabular index (AI) decreased from 37.39 to 19.54 in the closed reduction group and from 36.74 to 19.4 in the open reduction group.

CONCLUSION

The study found no significant difference between closed and open reduction techniques in acetabular remodeling. While residual dysplasia and avascular necrosis (AVN) were more common in the closed group, the differences were not statistically significant. Further research with larger sample sizes and longer follow-up periods is recommended to confirm these findings.