The evolution of non-surgical therapy for hip dysplasia



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Abstract

BACKGROUND: One of the important conditions for the prevention of dysplastic coxarthrosis is the timely and effective treatment of hip dysplasia of infants and young children. Despite the large number of studies on this topic, a high percentage of severe complications remains. In 40-86,3% of cases it leads to the formation of dysplastic coxarthrosis, and in 11-38% to disability of patients, which determines the social significance of the problem.

AIM: To analyze the data of the available world literature on conservative methods of treatment of hip dysplasia of infants and young children.

MATERIALS AND METHODS: The world literature on the conservative treatment of hip dysplasia of infants and young children was searched in the open information databases PubMed, Science Direct, Google Scholar, eLibrary from 1710 to 2024.

RESULTS: For many years, conservative treatment of hip dysplasia has been one of the most pressing issues in pediatric orthopedics. Today, the optimal method for the treatment of hip dysplasia of infants and young children is recognized as functional, which consists in gentle centering of the femoral head in the acetabulum and immobilization of the lower extremities while maintaining joint mobility. Over the past ten years, a large number of studies have been conducted on this topic. Many authors offer various options for additions to the functional treatment method, and they are also developing and putting into practice new models of functional and dynamic splints that allow maintain activity in the hip joints, which improves the quality and effectiveness of treatment.

CONCLUSIONS: The evolution of conservative methods of treating hip dysplasia reflects all the principles of pediatric orthopedics that are relevant today: early detection of pathology, the use of a functional method immediately after diagnosis, in the absence of positive dynamics against the background of conservative treatment, timely transition to surgical, long-term patient monitoring and, if necessary, rehabilitation in order to prevent degenerative-dystrophic changes. All the treatments of hip dysplasia can prevent the development of complications and the formation of dysplastic coxarthrosis in this category of patients.

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About the authors

Alyona Grigorieva

Author for correspondence.
Email: alena-grig00@mail.ru
ORCID iD: 0009-0001-8031-0193

Igor A. Norkin

Email: norkinia@sarniito.ru
ORCID iD: 0000-0002-6770-3398

References

  1. Bakarman K, Alsiddiky AM, Zamzam M, et al. Developmental Dysplasia of the Hip (DDH): Etiology, Diagnosis, and Management. Cureus 2023;15(8):e43207. doi: 10.7759/cureus.43207
  2. Tikhilov RM, Lila AM, Kochish AYu, et al. Coxarthrosis. Clinic, diagnosis and treatment: clinical guidelines (abridged version). N.N. Priorov Journal of Traumatology and Orthopedics. 2022;29(1):87-112. (In Russ.) doi: https://doi.org/10.17816/vto107102
  3. Akhtamov AA, Zhuraev AM. Development of the hip joint after functional treatment of congenital hip dislocation in infants. Turner Readings: Annual scientific and practical conference dedicated to current issues of childhood traumatology and orthopedics, St. Petersburg, October 07-08, 2021. St. Petersburg, 2021. P. 25-29. (In Russ.)
  4. Baindurashvili AG, Solovyova KS, Zaletina AV, et al. Congenital anomalies (malformations) of the musculoskeletal system in children. New technologies in traumatology and orthopedics of childhood: Collection of scientific articles dedicated to the 125th anniversary of the Research Children's Orthopedic Institute named after G.I. Turner. St. Petersburg, 2017. P. 24-40. (In Russ.)
  5. Baskov VE, Vissarionov SV, Filippova MS, et al. Current issues in the diagnostics of hip dysplasia in newborns in the regions of the Russian Federation. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 2023;11(4):439-448. (In Russ.) doi: https://doi.org/10.17816/PTORS603050
  6. Nandhagopal T, Tiwari V, De Cicco FL. Developmental Dysplasia of the Hip 2024. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
  7. Mulpuri K, Schaeffer EK, Kelley SP, et al. What Is the Impact of Center Variability in a Multicenter International Prospective Observational Study on Developmental Dysplasia of the Hip? Clin Orthop Relat Res. 2016;474(5):1138-1145. (In Russ.) doi: 10.1007/s11999-016-4746-y
  8. Zhang G, Li M, Qu X, et al. Efficacy of closed reduction for developmental dysplasia of the hip: midterm outcomes and risk factors associated with treatment failure and avascular necrosis. J Orthop Surg Res. 2020;15(1):579. doi: 10.1186/s13018-020-02098-3
  9. Tastanbekova ZhU, Lozovoy VM, Karabekova RA, Trofimchuk VA. Diagnosis and treatment of developmental hip dysplasia in children. Medical Journal Astana 2020;3(105):169-172. (In Russ.).
  10. Yakhyaev YaM, Yakhyaeva TYa, Abdurazakov MA. Treatment of dysplasia and congenital dislocation of the hip in children in a clinic. Technological innovations in traumatology, orthopedics and neurosurgery: integration of science and practice: Collection of materials, Saratov, April 26-28, 2017. Saratov, 2017. P. 363-365. (In Russ.).
  11. Mirzoeva SM, Kurbanov SKh, Kurbanova RT, Mirzobekov KS. Early diagnosis and treatment of congenital hip joint pathology in children. Bulletin of the Academy of Medical Sciences of Tajikistan 2017;4(24):42-46. (In Russ.).
  12. Pakhomova NYu, Strokova EL, Kozhevnikov VV, et al. Congenital dislocation of the hip – theories, etiological and predisposing factors (risk factors). Siberian Scientific Medical Journal 2022;42(4):62-73. (In Russ.). doi: 10.18699/SSMJ20220405
  13. Levytskyy AF, Golovatiuk DV, Karabeniuk OV, Vityaz VN. Diagnostics and treatment of hip dysplasia and congenital hip dislocation in children. Pediatric surgery 2019;1(62):90-98. (In Ukr.). doi: 10.15574/PS.2019.62.90
  14. Turdaliyeva BS, Aimbetova GE, Krestyashin VM, et al. Prognostic signs for the development of hip diplasia in children. Life and Health Science 2020;(1):58-63. (In Russ.). doi: 10.24411/1995-5871-2020-10066
  15. Kamosko MM, Poznovich MS. Conservative treatment of hip dysplasia. Orthopedics, traumatology and reconstructive surgery of children 2014;2(4):51-60. (In Russ.).
  16. Pozdnikin IYu, Baskov VE, Voloshin SYu, et al. Errors of diagnosis and the initiation of conservative treatment in children with congenital hip dislocation. Orthopedics, traumatology and reconstructive surgery of children 2017;5(2):42-51. (In Russ.). doi: 10.17816/PTORS5242-51
  17. Chipyshev AV, Koshkina KS. Ultrasonographic support of rehabilitation activities for infants with hip dysplasia. Medical-biological and pedagogical foundations of adaptation, sports activity and healthy lifestyle: Collection of scientific articles of the VI All-Russian correspondence scientific and practical conference with international participation, Voronezh, April 27, 2017. Voronezh, 2017. P. 454-458. (In Russ.).
  18. Safronova DP. Khalezova GV, Yudina EV. Modern technologies in the diagnosis of hip joints in newborns and young children. New science: Theoretical and practical view 2017;1(3):13-16. (In Russ.).
  19. Graf R. Hip Sonography. Springer Berlin, Heidelberg, 1999. 114p. doi: 10.1007/3-540-30958-6
  20. Verduc JB. Pathologie chirurgicale [Surgical pathology]. Paris, 1710. 311 p. (In French).
  21. Humbert M. Luxation congenitale du femur. Etiologie et traitement [Congenital dislocation of the femur. Etiology and treatment]. Bull. d' Acad. De med. 1838;(6):39. (In French).
  22. Pravaz CG. Luxation congenitale du femur [Congenital dislocation of the femur]. Bull. Acad. Med. (Paris) 1837;(579):2. (In French).
  23. Dupuytren G. Mémoire sur un déplacement originel ou congénital de la tête des fémurs [Memory on an original or congenital displacement of the head of the femurs]. Répertoire général d’anatomie et de physiologie pathologiques 1826;(2):82-93. (In French).
  24. Poggi A. Contributo alla cura cruenta della lussazione congenital dell' anca [Contributo to the cure of the birth of the congenital lussazione dell'anca]. Arch. Ortop. (Milano) 1888;(4):105. (In Ital.).
  25. Margary F. Cura operative della lussazione dell'anca [Operative treatment of hip dislocation]. Arch. Ortop. (Milano) 1884;(2):38. (In Ital.).
  26. Paci A. Nuovo contributo alla patologia della lussazione iliaca del femore [New contribution to the pathology of iliac dislocation of the femur]. Arch. E d'Atti Soc. Jt. Chir. 1887;(3):444. (In Ital.).
  27. Lorenz A. Uber die mechanische Behandlung der angeborenen Huftverrenkung [On the mechanical treatment of congenital hip dislocation]. Zbl. Chir. 1895;(22.):153. (In Germ.)
  28. Bade P. Die angeborene Huftverrenkung [The congenital hip dislocation]. Ferdinand Enke Verlag, Stuttgart 1907. (In Germ.)
  29. Joachimstanl G. Die Retention des eingerenkten Oberschenkelkopfes durch Neubildung des knochernen Pfannendaches [The retention of the dislocated femoral head through the reformation of the bony acetabular roof]. Verh. Dtsch. Orthop. Ges. 1909;(8):152. (In Germ.)
  30. Lange F. Lehrbuch der Orthopadie [Textbook of orthopedics]. Gustav Fischer Verlag, Jena 1928. 718 p. (In Germ.)
  31. Calot F. Orthopedie indispensable [Essential Orthopedics]. A. Maloine. Paris 1911. 1032 p. (In French).
  32. Zelenin MG. Methods of conservative treatment of orthopedic diseases of childhood. Kharkov, 1935. 163 p. (In Russ.).
  33. Hilgenreiner H. Zur Fruhdiagnose und Fruhbehandlung der angeborenen Huftgelenkverrenkung [For early diagnosis and early treatment of congenital hip dislocation]. Med Klin. 1925;(21):1385-1388. (In Germ.).
  34. Roser W. Über angeborene Hüftverrenkung [About congenital hip dislocation]. Arch Chir. 1879;(24):309-313. (In Germ.).
  35. Schede M. Die angeborene Luxation des Hüftgelenkes [Congenital dislocation of the hip]. Hamburg, Lucas Gräfe & Sillem, 1900. 26 p. (In Germ.).
  36. Forrester-Brown M. Apparecchio per il trattamento della lussazione cong. Nei neonati [Device for the treatment of cong. dislocation. In newborns]. Chir. Organi Mov. 1933;(18):119. (In Ital.).
  37. Bauer F. Die neue Behandlung der angeborenen Huftverrenkung mit dem Spreizband [The new treatment of congenital hip dislocation with the spreader band]. Med. Klin. 1935;(31):110. (In Germ.).
  38. Dzhamalbekova ED. Early diagnosis and treatment of hip dysplasia in children in infancy. Bulletin of Science and Practice 2019;5(9):59-67. (In Russ.). doi: 10.33619/2414-2948/46/05
  39. Dzhamalbekova ED, Dzhumabekov S. Results of early diagnostics and treatment of hip dysplasia in children in infancy. Bulletin of Science and Practice 2019;5(9):68-72. (In Russ.). doi: 10.33619/2414-2948/46/06
  40. Frejka B. Prävention der angeborenen Hiiftgelenksluxation durch das Abduktionspolster [Prevention of congenital hip joint dislocation using the abduction pad]. Wiener Med Wschr. 1941;(25):523-524. (In Germ.).
  41. Pavlic A. Novy smer v leceni vrozenych vykloubeni kycli u deti do prvniho roku aktivnim pohybem s pomoci trmenu [A harness for treatment of congenital hip dislocation in infants]. Acta Chir. Orthop. Traum. Cech. 1953. N 20(5-6). P. 93-100. PMID: 13113797. (In Chech).
  42. Ömeroğlu H, Köse N, Akceylan A. Success of Pavlik Harness Treatment Decreases in Patients ≥ 4 Months and in Ultrasonographically Dislocated Hips in Developmental Dysplasia of the Hip. Clin Orthop Relat Res. 2016;474(5):1146-52. doi: 10.1007/s11999-015-4388-5
  43. Bin K, Laville JM, Salmeron F. Developmental dysplasia of the hip in neonates: evolution of acetabular dysplasia after hip stabilization by brief Pavlik harness treatment. Orthop Traumatol Surg Res. 2014;100(4):357-361. doi: 10.1016/j.otsr.2014.03.017
  44. Semenov AL, Kharitonov KN. Tactics of management of children of the first months of life with hip dysplasia in subluxation and dislocation stages in the outpatient practice of the Novosibirsk Scientific Research Institute of Traumatology and Orthopedics. Pediatria n.a. G.N. Speransky 2019;98(2):248-252. (In Russ.). doi: 10.24110/0031-403X-2019-98-2-248-252
  45. Zatsepin TS. Orthopedics of childhood and adolescence. Medgiz: Moscow, 1949. 276 p. (In Russ.).
  46. Somerville EW, Scott JC. Еhe direct approach to congenital dislocation of the hip. British Editorial Society of Bone & Joint Surgery 1957;39-B(4):623. doi: 10.1302/0301-620x.39b4.623
  47. Craig WA. Guided abduction in the treatment of congenital dislocation of the hip. In Western Orthop. Association. San Francisco, 1954.
  48. Craig WA, Risser JC, Kramer WG. Review of four hundred cases of congenital dysplasia and dislocation of the hip. J Bone Joint Surg Am. 1955;(37):403-404.
  49. Mishima K, Kamiya Y, Sawamura K, et al. Gradual Reduction Using Overhead Traction for Late-Detected Developmental Dysplasia of the Hip: A Report of Three Cases Diagnosed Among Children Over Four Years Old. Cureus 2024;4(16(7)):e63833. doi: 10.7759/cureus.63833
  50. Kozhevnikov VV, Korytkin AA, Duginova MV. Congenital hip dysplasia in children and adolescents. Diagnosis, treatment and rehabilitation. Novosibirsk, 2024. 44 p. (In Russ.).
  51. Walter SG, Endler CH, Remig AC, et al. Risk factors for failed closed reduction in dislocated developmental dysplastic hips. Int Orthop. 2020;44(11):2343-2348. doi: 10.1007/s00264-020-04655-1
  52. Akhtamov A. Our experience in the functional treatment of congenital hip dislocation in children under one year of age. Turner Readings: Collection of Articles. St. Petersburg, October 08-09, 2020. St. Petersburg, 2020. pp. 24-27. (In Russ.).
  53. Voloshin SY, Belousova EA. Features rehabilitation of infants with congenital hip dislocation on the stages of conservative treatment. Orthopedics, traumatology and reconstructive surgery of children 2015;3(2): 66-70. (In Russ.). doi: 10.17816/PTORS3266-70
  54. Voloshin SYu, Vissarionov SV, Kartavenko KA, Chursinov VA. Splint for the treatment of hip dysplasia in young children. Patent RU 2762498 C9. Application: 2020126008, 07/30/2020. Published: 12/21/2021 Bulletin. No. 36. (In Russ.).
  55. Kutsenok YaB. The use of new technologies in the functional treatment of children with congenital hip dislocation under 3 years old. Pediatric Surgery 2015;3-4(48-49):37-46. (In Russ.).
  56. Kornienko LV, Konovalova NG, Zagorodnikova OA. Local therapy of hip dysplasia in infants up to 6 months. Mother and Child in Kuzbass 2015;2(61):69-73. (In Russ.).
  57. Dzhalolov MZ, Mirzoeva SM. Results of conservative treatment of congenital hip dislocation in young children. Youth and Innovations-2023: Collection of materials of the 9th scientific and practical conference of students and young scientists, St. Petersburg, November 09, 2023. St. Petersburg, 2023. P. 27-28. (In Russ.).
  58. Evseev VI. A method for treating hip dysplasia in newborns and children of the first year of life. Patent RU 2654574 C1. Application: 2017116927, 05/15/2017. Published: 05/21/2018 Bulletin. No. 15. (In Russ.).
  59. Dudko АV. THE ROLE OF PHYSICAL THERAPY IN REHABILITATION MEASURES FOR HIP DYSPLASIA IN CHILDREN BEFORE PUBERTY. Stolypinsky Bulletin 2022;4(3):1374-1380. (In Russ.). doi: 10.55186/27131424_2022_4_3_2
  60. Kilsdonk I, Witbreuk M, Van Der Woude HJ. Ultrasound of the neonatal hip as a screening tool for DDH: how to screen and differences in screening programs between European countries. J Ultrason. 2021;7(21(85)):e147-e153. doi: 10.15557/JoU.2021.0024
  61. Pirov RR, Kurbanov SKh, Kurbanova RT, Sodirov VZ. Tactics of orthopedic treatment of congenital hip dislocation in young children. Simurg 2022;(13):38-43. (In Russ.).
  62. Razzokov AA, Karieva MZ. Dynamic splinting for treatment of congenital hip dislocation in children under one year of age. Avicenna Bulletin 2024;26(1):42-56. (In Russ.). doi: 10.25005/2074-0581-2024-26-1-42-56
  63. Karieva MZ. Comparative analysis of the results of treatment of congenital hip dislocation with abductor splints in children under one year old. Simurg 2023;(20):36-44.
  64. Vissarionov SV, Zorin VI, Zaletina AV, Shchepina EN. Implementation of research developments in clinical practice at H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery. Vestnik Roszdravnadzora 2024;(1):6-13.

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