Arthroscopic debridement and reduction is an effective procedure for failed closed reduction in young children with developmental dislocation of the hip

作者全名："Zhang, Yuan; Weng, Liuqi; Zhang, Ge; Zhou, Hai; Liu, Xing; Cao, Yujiang"

作者地址："[Zhang, Yuan; Weng, Liuqi; Zhang, Ge; Zhou, Hai; Liu, Xing; Cao, Yujiang] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Minist Educ,Key Lab Child Dev & Disorders, Dept Orthopaed,Childrens Hosp,Chongqing Key Lab Pe, 136 Zhongshan Er Rd, Chongqing 400014, Peoples R China"

通信作者："Cao, YJ (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Minist Educ,Key Lab Child Dev & Disorders, Dept Orthopaed,Childrens Hosp,Chongqing Key Lab Pe, 136 Zhongshan Er Rd, Chongqing 400014, Peoples R China."

来源：INTERNATIONAL ORTHOPAEDICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001182384700002

JCR分区：Q2

影响因子：2

年份：2024

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Developmental dislocation of the hip; Hip arthroscopy; Children; Closed reduction; Arthroscopic portals

摘要："Purpose To assess the efficacy of arthroscopic debridement and reduction through two medial portals for the treatment of developmental dislocation of the hip (DDH) with failure of initial closed reduction and to explore key pathological structures obstructing reduction. Methods Forty-eight children with 58 irreducible dislocated hips treated by arthroscopic reduction between January 2017 and December 2020 were retrospectively evaluated. Arthroscopic reduction was performed via two medial portals located in the superior and inferior adductor longus. All intra-articular obstacles were eliminated via arthroscopy, followed by manual reduction and spica cast immobilization. The surgical duration, extent of improvement in the safe zone, and extent of secondary surgical treatment were noted. All the children were followed up for > 24 months. Hip function and radiographic outcomes were evaluated. Results All 58 hips showed safe zone improvement and concentric reduction after arthroscopic debridement. Hypertrophic ligamentum teres and thickened pulvinars were detected and resected in all hips. Constrictive capsules preventing reduction were observed in 15 hips, which needed to be further released. No inverted labrum was observed. Secondary surgery was performed in four hips with redislocation and seven hips with subluxation during follow-up. The remaining 47 hips (81.03%) maintained their reduction at the last follow-up. Excellent and good clinical outcomes were achieved in 95.74% of patients according to McKay's criteria. Two hips, three hips, and one hip were diagnosed with grade I, II, and III osteonecrosis of the femoral head, respectively. Conclusion This study demonstrated that arthroscopic debridement and reduction is a safe and feasible choice for treating irreducible DDH."

基金机构：Youth Project of the National Clinical Research Center for Child Health and Disorders

基金资助正文：No Statement Available