Clinical efficacy of early postoperative rehabilitation training in children with developmental dysplasia of the hip

Abstract

This retrospective cohort included children with developmental dysplasia of the hip (DDH) undergoing surgery at a single institution from January 2019 to December 2024. An early postoperative rehabilitation protocol was introduced in January 2022; patients treated earlier comprised the control group (n = 51), and those treated thereafter formed the observation group (n = 58). Eligible participants were 6 months to 7 years old with radiographically confirmed DDH (Tönnis II–IV or International Hip Dysplasia Institute criteria) and received closed or open reduction with or without osteotomy, followed by standard immobilization. Outcomes were assessed over 6 months and included pain by the visual analogue scale (VAS), hip function by the Harris hip score, lower-limb motor performance by the simplified Fugl–Meyer assessment, and health-related quality of life by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 (EORTC QLQ-C30). Baseline characteristics were comparable between groups. VAS declined over time in both groups; no between-group difference was detected at 6 hours and 1 day, whereas the observation group showed significantly lower VAS from day 3 to day 14. The observation group demonstrated significantly higher Harris hip score, Fugl–Meyer assessment, and QLQ-C30 scores at 1, 3, and 6 months. Early rehabilitation was associated with faster analgesic recovery and superior functional and quality-of-life outcomes. Findings support integration of structured, stability-aware early rehabilitation after DDH surgery, recognizing the limitations of a nonrandomized design and 6-month follow-up.