title: Effects of arthroscopic-assisted surgery on irreducible developmental dislocation of hip by mid-term follow-up: An observational study.
abstract: The purpose of this study was to investigate the indications, surgical technique, and the clinical effects of arthroscopic-assisted treatment of irreducible developmental dislocation of the hip by mid-term follow-up. Arthroscopic-assisted surgeries were performed on 40 children (52 hips) between January 2005 and December 2009. Anterior and antero-superior greater trochanter portals were used in these treatments. Spica cast and abduction splint were applied for 3 months postoperatively. The follow-up was conducted on every 3 months postoperatively. During 12-month follow-up, a secondary treatment such as acetabuloplasty and/or femoral osteotomy (shortening, varus, and derotation) was applied if the acetabular angle was greater than 25°. The pelvic acetabular angle, Mckay and Severin score were evaluated every 6 months in all children. With 36 to 96 months (average 71 months) follow-up, 35 children (44 hips) were successfully followed up with complete case data while 5 children unsuccessfully. According to Tönnis classification, there were 5 grade 1 hips, 14 grade 2 hips, 14 grade 3 hips, 11 grade 4 hips, in which 3 children (4 hips) were failed in arthroscopic reduction and femoral head avascular necrosis occurred in 2 children (4 hips). According to Mckay standard, the good rate is 100%. According to Severin standard, the good rate is 84.1%. Arthroscopic assisted treatment is an effective way of reduction of the irreducible hip. Compared with the open reduction, arthroscopic treatment combined with acetabuloplasty and/or femoral osteotomy has advantages of less trauma and better function preservation.
authors.affiliation: Department of Orthopeadics, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China..
authors.forename: Hui-Fa
authors.initials: HF
authors.lastname: Xu
authors.forename: Ya-Bo
authors.initials: YB
authors.lastname: Yan
authors.forename: Chao
authors.initials: C
authors.lastname: Xu
authors.forename: Tian-Qing
authors.initials: TQ
authors.lastname: Li
authors.forename: Tian-Feng
authors.initials: TF
authors.lastname: Zhao
authors.forename: Ning
authors.initials: N
authors.lastname: Liu
authors.forename: Lu-Yu
authors.initials: LY
authors.lastname: Huang
authors.forename: Chun-Li
authors.initials: CL
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Lei
mesh_terms: D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods; D002675:Child, Preschool; D005260:Female; D006618:Hip Dislocation, Congenital / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011182:Postoperative Care