Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Systematic Reviews
Published in: Systematic Reviews 1/2024

Open Access 01-12-2024 | Hip Dysplasia | Protocol

Comparison of clinical and radiological outcomes for the anterior and medial approaches to open reduction in the treatment of bilateral developmental dysplasia of the hip: a systematic review protocol

Authors: Edward Alan Jenner, Govind Singh Chauhan, Abdus Burahee, Junaid Choudri, Adrian Gardner, Christopher Edward Bache

Published in: Systematic Reviews | Issue 1/2024

Login to get access

Abstract

Background

Developmental dysplasia of the hip (DDH) affects 1–3% of newborns and 20% of cases are bilateral. The optimal surgical management strategy for patients with bilateral DDH who fail bracing, closed reduction or present too late for these methods to be used is unclear. There are proponents of both medial approach open reduction (MAOR) and anterior approach open reduction (AOR); however, there is little evidence to inform this debate.

Methods

We will perform a systematic review designed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. We will search the medical and scientific databases including the grey and difficult to locate literature. The Medical Subject Headings “developmental dysplasia of the hip”, “congenital dysplasia of the hip”, “congenital hip dislocation”, “developmental hip dislocation”, and their abbreviations, “DDH” and “CDH” will be used, along with the qualifier “bilateral”. Reviewers will independently screen records for inclusion and then independently extract data on study design, population characteristics, details of operative intervention and outcomes from the selected records. Data will be synthesised and a meta-analysis performed if possible. If not possible we will analyse data according to Systematic Review without Meta-Analysis guidance. All studies will be assessed for risk of bias. For each outcome measure a summary of findings will be presented in a table with the overall quality of the recommendation assessed using the Grading of Recommendations Assessment Development and Evaluation approach.

Discussion

The decision to perform MAOR or AOR in patients with bilateral DDH who have failed conservative management is not well informed by the current literature. High-quality, comparative studies are exceptionally challenging to perform for this patient population and likely to be extremely uncommon. A systematic review provides the best opportunity to deliver the highest possible quality of evidence for bilateral DDH surgical management.

Systematic review registration

The protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO ID CRD42022362325).
Appendix
Available only for authorised users
Literature
1.
Zhang S, Doudoulakis KJ, Khurwal A, Sarraf KM. Developmental dysplasia of the hip. Br J Hosp Med Lond Engl 2005. 2020;81(7):1–8.
2.
3.
Marks DS, Clegg J, Al-Chalabi AN. Routine ultrasound screening for neonatal hip instability. Can it abolish late-presenting congenital dislocation of the hip? J Bone Joint Surg Br. 1994;76(4):534–8.PubMedCrossRef
4.
Macnicol MF. Results of a 25-year screening programme for neonatal hip instability. J Bone Joint Surg Br. 1990;72(6):1057–60.PubMedCrossRef
5.
Bialik V, Bialik GM, Blazer S, Sujov P, Wiener F, Berant M. Developmental dysplasia of the hip: a new approach to incidence. Pediatrics. 1999;103(1):93–9.PubMedCrossRef
6.
Cooperman DR, Wallensten R, Stulberg SD. Acetabular dysplasia in the adult. Clin Orthop. 1983;175:79–85.CrossRef
7.
Furnes O, Lie SA, Espehaug B, Vollset SE, Engesaeter LB, Havelin LI. Hip disease and the prognosis of total hip replacements. A review of 53,698 primary total hip replacements reported to the Norwegian Arthroplasty Register 1987–99. J Bone Joint Surg Br. 2001;83(4):579–86.PubMedCrossRef
8.
Kitoh H, Kawasumi M, Ishiguro N. Predictive factors for unsuccessful treatment of developmental dysplasia of the hip by the Pavlik harness. J Pediatr Orthop. 2009;29(6):552–7.PubMedCrossRef
9.
Viere RG, Birch JG, Herring JA, Roach JW, Johnston CE. Use of the Pavlik harness in congenital dislocation of the hip. An analysis of failures of treatment. J Bone Joint Surg Am. 1990;72(2):238–44.PubMedCrossRef
10.
Greene WB, Drennan JC. A comparative study of bilateral versus unilateral congenital dislocation of the hip. Clin Orthop. 1982;162:78–86.CrossRef
11.
Zionts LE, MacEwen GD. Treatment of congenital dislocation of the hip in children between the ages of one and three years. J Bone Joint Surg Am. 1986;68(6):829–46.PubMedCrossRef
12.
Wang TM, Wu KW, Shih SF, Huang SC, Kuo KN. Outcomes of open reduction for developmental dysplasia of the hip: does bilateral dysplasia have a poorer outcome? J Bone Jt Surg Am. 2013;95(12):1081–6.CrossRef
13.
Segal LS, Boal DK, Borthwick L, Clark MW, Localio AR, Schwentker EP. Avascular necrosis after treatment of DDH: the protective influence of the ossific nucleus. J Pediatr Orthop. 1999;19(2):177–84.PubMedCrossRef
14.
Lerman JA, Emans JB, Millis MB, Share J, Zurakowski D, Kasser JR. Early failure of Pavlik harness treatment for developmental hip dysplasia: clinical and ultrasound predictors. J Pediatr Orthop. 2001;21(3):348–53.PubMedCrossRef
15.
Akilapa O. The medial approach open reduction for developmental dysplasia of the hip: do the long-term outcomes validate this approach? A systematic review of the literature. J Child Orthop. 2014;8(5):387–97.PubMedPubMedCentralCrossRef
16.
Okano K, Yamada K, Takahashi K, Enomoto H, Osaki M, Shindo H. Long-term outcome of Ludloff’s medial approach for open reduction of developmental dislocation of the hip in relation to the age at operation. Int Orthop. 2009;33(5):1391–6.PubMedPubMedCentralCrossRef
17.
Mankey MG, Arntz GT, Staheli LT. Open reduction through a medial approach for congenital dislocation of the hip. A critical review of the Ludloff approach in sixty-six hips. J Bone Joint Surg Am. 1993;75(9):1334–45.PubMedCrossRef
18.
Koizumi W, Moriya H, Tsuchiya K, Takeuchi T, Kamegaya M, Akita T. Ludloff’s medial approach for open reduction of congenital dislocation of the hip. A 20-year follow-up. J Bone Joint Surg Br. 1996;78(6):924–9.PubMedCrossRef
19.
Gardner ROE, Bradley CS, Howard A, Narayanan UG, Wedge JH, Kelley SP. The incidence of avascular necrosis and the radiographic outcome following medial open reduction in children with developmental dysplasia of the hip: a systematic review. Bone Jt J. 2014;96-B(2):279–86.CrossRef
20.
Hoellwarth JS, Kim YJ, Millis MB, Kasser JR, Zurakowski D, Matheney TH. Medial versus anterior open reduction for developmental hip dislocation in age-matched patients. J Pediatr Orthop. 2015;35(1):50–6.PubMedCrossRef
21.
Jia G, Wang E, Lian P, Liu T, Zhao S, Zhao Q. Anterior approach with mini-bikini incision in open reduction in infants with developmental dysplasia of the hip. J Orthop Surg. 2020;15(1):180.CrossRef
22.
Rudin D, Manestar M, Ullrich O, Erhardt J, Grob K. The anatomical course of the lateral femoral cutaneous nerve with special attention to the anterior approach to the hip joint. JBJS. 2016;98(7):561–7.CrossRef
23.
24.
Subasi M, Arslan H, Cebesoy O, Buyukbebeci O, Kapukaya A. Outcome in unilateral or bilateral DDH treated with one-stage combined procedure. Clin Orthop. 2008;466(4):830–6.PubMedPubMedCentralCrossRef
25.
Ezirmik N, Yildiz K. Advantages of single-stage surgical treatment with salter innominate osteotomy and pemberton pericapsular osteotomy for developmental dysplasia of both hips. J Int Med Res. 2012;40(2):748–55.PubMedCrossRef
26.
Agus H, Bozoglan M, Kalenderer Ö, Kazımoğlu C, Onvural B, Akan İ. How are outcomes affected by performing a one-stage combined procedure simultaneously in bilateral developmental hip dysplasia? Int Orthop. 2014;38(6):1219–24.PubMedPubMedCentralCrossRef
27.
Kotzias Neto A, Ferraz A, Bayer Foresti F, Barreiros HR. Bilateral developmental dysplasia of the hip treated with open reduction and Salter osteotomy: analysis on the radiographic results. Rev Bras Ortop Engl Ed. 2014;49(4):350–8.CrossRef
28.
Rethlefsen ML, Kirtley S, Waffenschmidt S, Ayala AP, Moher D, Page MJ, et al. PRISMA-S: an extension to the PRISMA statement for reporting literature searches in systematic reviews. Syst Rev. 2021;10(1):39.PubMedPubMedCentralCrossRef
29.
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.PubMedPubMedCentralCrossRef
30.
Kalamchi A, MacEwen GD. Avascular necrosis following treatment of congenital dislocation of the hip. J Bone Joint Surg Am. 1980;62(6):876–88.PubMedCrossRef
31.
32.
Severin E. Congenital dislocation of the hip; development of the joint after closed reduction. J Bone Joint Surg Am. 1950;32-A(3):507–18.PubMedCrossRef
33.
McKay DW. A comparison of the innominate and the pericapsular osteotomy in the treatment of congenital dislocation of the hip. Clin Orthop. 1974;98:124–32.CrossRef
34.
Aguilar CM, Neumayr LD, Eggleston BE, Earles AN, Robertson SM, Jergesen HE, et al. Clinical evaluation of avascular necrosis in patients with sickle cell disease: children’s hospital Oakland hip evaluation scale–a modification of the harris hip score. Arch Phys Med Rehabil. 2005;86(7):1369–75.PubMedCrossRef
35.
Daltroy LH, Liang MH, Fossel AH, Goldberg MJ. The POSNA pediatric musculoskeletal functional health questionnaire: report on reliability, validity, and sensitivity to change. Pediatric Outcomes Instrument Development Group. Pediatric Orthopaedic Society of North America. J Pediatr Orthop. 1998;18(5):561–71.PubMedCrossRef
36.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.PubMedPubMedCentralCrossRef
37.
Dodwell ER, Pathy R, Widmann RF, Green DW, Scher DM, Blanco JS, et al. Reliability of the modified Clavien-Dindo-Sink complication classification system in pediatric orthopaedic surgery. JBJS Open Access. 2018;3(4):e0020.PubMedPubMedCentralCrossRef
38.
39.
40.
41.
Campbell M, McKenzie JE, Sowden A, Katikireddi SV, Brennan SE, Ellis S, et al. Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. BMJ. 2020;368:l6890.PubMedPubMedCentralCrossRef
42.
43.
Murad MH, Sultan S, Haffar S, Bazerbachi F. Methodological quality and synthesis of case series and case reports. BMJ Evid Based Med. 2018;23(2):60–3.PubMedPubMedCentralCrossRef
44.
45.
Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898.PubMedCrossRef
46.
Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919.PubMedPubMedCentralCrossRef
47.
Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383–94.PubMedCrossRef
48.
Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–6.PubMedPubMedCentralCrossRef
49.
Metadata
Title
Comparison of clinical and radiological outcomes for the anterior and medial approaches to open reduction in the treatment of bilateral developmental dysplasia of the hip: a systematic review protocol
Authors
Edward Alan Jenner
Govind Singh Chauhan
Abdus Burahee
Junaid Choudri
Adrian Gardner
Christopher Edward Bache
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2024
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-023-02444-6

Other articles of this Issue 1/2024

Systematic Reviews 1/2024 Go to the issue

Systematic review update

Effects of n-3 polyunsaturated fatty acid supplementation on appetite: a systematic review and meta-analysis of controlled clinical trials

Research

Comparative analysis of Cochrane and non-Cochrane reviews over three decades

Research

Does arthroscopic or open washout in native knee septic arthritis result in superior post-operative function? A systematic review and meta-analysis of randomised controlled trials and observational studies

Protocol

Self-reporting of psychoneurophysical (PNP) symptoms in adults with four chronic diseases: a protocol for a scoping review

Systematic review update

A systematic review of school-based weight-related interventions in the Gulf Cooperation Council countries

Systematic review update

Clinical prediction models for the early diagnosis of obstructive sleep apnea in stroke patients: a systematic review