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Bakti K, Lankinen V, Helminen M, Välipakka J, Laivuori H, Hyvärinen A. Clinical and sonographic improvement of developmental dysplasia of the hip: analysis of 948 patients. J Orthop Surg Res 2022; 17:538. [PMID: 36510263 PMCID: PMC9743506 DOI: 10.1186/s13018-022-03432-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Developmental dysplasia of the hip is a common condition, which varies in severity. Abduction treatment is widely used to correct the development of the hips, but mild forms of DDH can also recover spontaneously. The purpose of this study was to evaluate factors affecting the rate of improvement of developmental dysplasia of the hip, and evaluate any risk factors slowing the process. MATERIAL AND METHODS The study population consisted of patients diagnosed with DDH in Tampere University hospital in the years 1998-2018. Data were retrospectively collected, and associations between clinical variables and rate of improvement were analyzed. Alpha angles were assessed monthly, and associations between risk factors and improvement of alpha angles were studied. A total of 948 patients were included in the analysis. RESULTS More severe first status of the hips was associated with faster improvement in dynamic ultrasound compared to milder DDH in univariate design in first 3 months of age; in the multivariable design, Ortolani positivity was conversely associated with lower alpha angles in 1-month follow-up. Immediate abduction treatment was associated with faster recovery rate compared to delayed abduction or watchful waiting. Female sex and positive family history were associated with slower rate of improvement and lower alpha angles. In multivariable design, female sex, positive family history and treatment strategy remained statistically significant as initiation time of the treatment explained the first found association of clinical hip status and the recovery rate after 2 months of age. CONCLUSION Female sex and positive family history might be independent risk factors for slower recovery in DDH before 6 months of age. These children might need special attention in their follow-up plans and abduction treatment.
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Affiliation(s)
- Karim Bakti
- grid.502801.e0000 0001 2314 6254Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Vilma Lankinen
- grid.502801.e0000 0001 2314 6254Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland ,grid.410552.70000 0004 0628 215XDepartment of Pediatric Surgery, Turku University Hospital, Savitehtaankatu 5, 20520 Turku, Finland
| | - Mika Helminen
- grid.502801.e0000 0001 2314 6254Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland ,grid.412330.70000 0004 0628 2985Tays Research Services, Tampere University Hospital, Tampere, Finland
| | | | - Hannele Laivuori
- grid.502801.e0000 0001 2314 6254Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland ,grid.502801.e0000 0001 2314 6254Center for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland ,grid.412330.70000 0004 0628 2985Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland ,grid.7737.40000 0004 0410 2071Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Medical and Clinical Genetics, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Anna Hyvärinen
- grid.502801.e0000 0001 2314 6254Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland ,grid.412330.70000 0004 0628 2985Tays Research Services, Tampere University Hospital, Tampere, Finland ,Department of Surgery, Mehiläinen Länsi-Pohja Oy, Kemi, Finland ,grid.412326.00000 0004 4685 4917Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, Oulu, Finland ,grid.10858.340000 0001 0941 4873Clinical Medicine Research Unit, Medical Research Center, University of Oulu, Oulu, Finland
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