Outcome of delayed surgery in developmental hip dysplasia in a tertiary care setting

Abstract

Background: The delay in the detection of developmental dysplasia of the hip (DDH) can lead to incomplete hip stabilization and poor outcomes. This might also infer that the delay in DDH surgery can also be associated with unfavorable consequences. The purpose of this study was to compare the outcome of delayed versus early surgery on DDH patients with respect to clinical and radiological factors. Methods: This is a retrospective cohort study in which the charts of patients who underwent DDH surgery and whose age was less than 5 years at the date of referral to the orthopedic clinic, between 2008 and 2011 were reviewed. Results: This study included 62 patients, 34 of which presented with unilateral joint involvement and 28 affected bilaterally. Half of the patients underwent early surgeries (<6 months) and the other half had delayed surgeries (≥6 months). Post-operatively the range of motion was significantly limited in the late surgery group (P=0.001). Limping gait was also significantly associated with late surgery (P=0.005). Radiological abnormalities of all the X-Ray findings didn't reveal any statistically significant difference between early and delayed surgery except for the reduction in acetabular angle in the right hip post-op (P=0.04). Conclusion: Delayed DDH surgery can lead to a worse clinical outcome, physical disability and possible radiological effects on the patients. Poor outcome was significantly associated with the timing of the surgery. It is therefore recommended to perform DDH surgeries as early as possible to decrease the morbidity and prevent adverse clinical and radiological outcomes.