Open reduction and Pemberton periacetabular osteotomy (PPO) are most preferred techniques for the treatment of developmental hip dysplasia (DDH) in children at walking age. The goal of a new study published in the Journal of Pediatric Orthopedics was to compare the outcomes, length of hospitalization and total cost between patients who had single-stage open reduction and PPO or two consecutive operations due to bilateral DDH. Here, 130 patients with bilateral DDH underwent open reduction and PPO for both hips. Seventy-five patients had one-stage open reduction and PPO for both of the hips while 55 patients had two separate consecutive operations. Total time of exposure to anesthetics, blood loss and duration of operation were noted. Hospitalization period and total treatment costs were also noted for each patient. The findings showed no statistically significant difference between the groups regarding the preoperative and postoperative acetabular indices (AIs). On comparing the total cost, length of hospitalization, exposure to anesthetics and perioperative blood loss – a statistically significant difference between the groups was found. Moreover, the single-stage surgery had favorable outcomes; major benefits in cases with bilateral DDH were – reduced costs, anesthesia duration, intraoperative blood loss and hospitalization period. In inference, it was stated that prolonged immobilization can lead to loss of bone strength and result in fragility fractures. Thus, single-stage open reduction and PPO for bilateral DDH can be preferred in experienced clinics.

Source: Journal of Pediatric Orthopedics. 2020 Jan 8. doi: 10.1097/BPB.0000000000000714