ArticleCureus2025
Early Outcomes of Arthroscopic Versus Open Reduction for Developmental Dysplasia of the Hip in Children: A Randomized Controlled Trial.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
aimThis study aims to assess and compare the early outcomes of arthroscopic-assisted reduction with open reduction techniques in the surgical treatment of developmental dysplasia of the hip (DDH) in children. The trial was conducted in two tertiary care hospitals specializing in pediatric orthopedic surgery in Erbil, Iraq. MATERIALS AND
methodsThis parallel-group, randomized controlled trial (RCT) included a total of 43 children aged 12-24 months with DDH (Tönnis grade II or higher) who were randomly allocated into two groups: arthroscopic-assisted reduction (n = 19) and open surgical reduction (n = 24). Exclusion criteria included neuromuscular disorders, teratologic hip dislocations, and previous hip surgery. The patients were treated by either arthroscopic-assisted or open reduction according to the randomization. The postoperative treatment was the same for all groups, comprising hip spica casting. The study's main outcome measures were clinically and radiographically documented redislocation rates at 6, 12, and 24 months postoperatively, operative time, estimated blood loss, radiographic measurements of the acetabular index, and complications such as avascular necrosis (AVN).
resultsRedislocation rates were significantly lower in the arthroscopic-assisted reduction group (0%) compared to that of the open surgical reduction group (44%) (p = 0.047). The arthroscopic-assisted reduction resulted in shorter operative times (mean 94.3 minutes) and lower estimated blood loss (mean 141.9 mL) compared to open reduction techniques (p < 0.001). No significant differences were observed in the acetabular index across groups at six months, one year, or two years postoperatively (p > 0.05). AVN rates were highest in the open surgical reduction group (44%) compared to the arthroscopic group (21%), but this difference was not statistically significant (p = 0.074).
conclusionArthroscopic-assisted reduction demonstrated superior short-term outcomes in terms of redislocation rates, operation time, and blood loss compared with open surgical techniques. Although the rates of AVN did not reach statistical significance, the possibility of preserving vascularity in arthroscopic procedures is promising for reducing long-term complications. Longer follow-up and further multicenter trials are required to confirm these findings.
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