When is surgery indicated in the treatment of developmental dysplasia of the hip (DDH)?

Updated: Feb 26, 2018
  • Author: Junichi Tamai, MD; Chief Editor: William L Jaffe, MD  more...
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Answer

Indications for surgical treatment of developmental dysplasia of the hip (DDH) are met if the results of such treatment would be better than the results of the natural progression of the disease. [48] The natural history of DDH depends, in part, on the severity of the disease, bilaterality, and whether or not a false acetabulum is formed. [9, 49, 50]

Unilateral dislocations result in significant leg-length inequality, with a gait disturbance and possibly associated hip and knee pain. In addition, hip pain commonly manifests as knee or anterior thigh pain as a consequence of the innervation of the hip joint (obturator and femoral nerve distribution). Typically, true hip pain is identified as groin pain.

The development of a false acetabulum is associated with a poor outcome in approximately 75% of patients. Bilateral hip dislocation in a patient without false acetabula has a better overall prognosis. In fact, a case was reported of a 74-year-old man with no history of hip or thigh pain whose dislocated hips were only discovered shortly before his death. [51]


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