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Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH)

Volume 9 | Issue 2 | May-August 2023 | Page: 21-26 | Atul Bhaskar DOI- https://doi.org/10.13107/ijpo.2023.v09.i02.167 Submitted: 24/02/2023; Reviewed: 18/03/2023; Accepted: 25/05/2023; Published: 10/08/2023 Authors: Atul Bhaskar MS Ortho, FRCS Ortho [1] [1] Department of Orthopaedics, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India. Address of Correspondence Dr. Atul Bhaskar, Paediatric Orthopaedic Surgeon, Department of […]

Functionality Against Odds: Lower Extremity Functional Scale and Children Health Assessment Questionnaire in Children with Bilateral Septic Sequelae of Hip

Volume 9 | Issue 1 | January-April 2023 | Page: 21-25 | Abdus Sami, Anil Agarwal, Lokesh Sharma., Yogesh Patel, Varun Garg DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.151 Authors: Abdus Sami [1] MS Orth., Anil Agarwal [1] MS Orth., Lokesh Sharma [1] MS Orth., Yogesh Patel [1] MS Orth., Varun Garg [1] MS Orth. [1] Department of Paediatric Orthopaedics, […]

Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH)

Functionality Against Odds: Lower Extremity Functional Scale and Children Health Assessment Questionnaire in Children with Bilateral Septic Sequelae of Hip

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Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH)

Volume 9 | Issue 2 | May-August 2023 | Page: 21-26 | Atul Bhaskar

DOI- https://doi.org/10.13107/ijpo.2023.v09.i02.167

Submitted: 24/02/2023; Reviewed: 18/03/2023; Accepted: 25/05/2023; Published: 10/08/2023

Authors: Atul Bhaskar MS Ortho, FRCS Ortho [1]

[1] Department of Orthopaedics, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Atul Bhaskar,
Paediatric Orthopaedic Surgeon, Department of Orthopaedics, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India.
E-mail: arb_25@yahoo.com

Abstract

Background: Failure after primary DDH surgery can occur early or immediate, delayed (within six months) and late due to poor remodelling. We report the short-term results after revision surgery in eighteen children including four early and 14 delayed failures.
Patient and Methods: Between 2002 and 2017, eighteen children (19 hips) underwent primary surgery at a mean age of 19 months (range: 9 months – 24 months). There were 12 girls and 6 boys in the study, with nine left and eight right sided dislocations. One child had bilateral dislocation. The mean age at revision surgery was 30 months (range: 22 months – 48 months).
Results: All cases were assessed with the modified Ponseti score to include squatting and cross-leg sitting. Eleven children (61%) were completely pain free, able to squat (Modified Ponseti score 1 and 2), three (17%) had mild limp and four (22%) had gross limitation of function. Avascular necrosis (AVN) was recorded according to Kalamchi and MacEwen criteria. Nine hips (50%) had mild AVN and six (33%) had coxa valga due to lateral physeal arrest.
The radiological outcome at final radiograph was based on Severin grade. Only 4 hips (22%) had a spherical head. Ten hips had moderate deformity (55%) and 5 hips (27%) had aspherical incongruency.
Conclusion: Early and delayed failures in DDH surgery are mainly due to inadequate initial exposure and poor hip stabilization techniques. About 50% of the revision cases had a satisfactory outcome on short term follow-up.
Keywords: Hip, Revision, Surgery, Function, Outcome

References

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How to Cite this Article: Bhaskar | A Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH) | International Journal of Paediatric Orthopaedics | May-August 2023; 9(2): 21-26. https://doi.org/10.13107/ijpo.2023.v09.i02.167

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Functionality Against Odds: Lower Extremity Functional Scale and Children Health Assessment Questionnaire in Children with Bilateral Septic Sequelae of Hip

Volume 9 | Issue 1 | January-April 2023 | Page: 21-25 | Abdus Sami, Anil Agarwal, Lokesh Sharma., Yogesh Patel, Varun Garg

DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.151

Authors: Abdus Sami [1] MS Orth., Anil Agarwal [1] MS Orth., Lokesh Sharma [1] MS Orth., Yogesh Patel [1] MS Orth., Varun Garg [1] MS Orth.

[1] Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India.

Address of Correspondence

Dr. Anil Agarwal,
Specialist, Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India.
E-mail: anilrachna@gmail.com

Abstract

Purpose: We assessed the functional and radiological outcomes of children with sequelae of bilateral septic hips. Additionally, we attempted to determine the impact of radiological unstable hips on clinical functionality of the child.
Material and methods: The retrospective case series included 9 children minimum 2 years post infection. The functional outcomes were assessed using Lower Extremity Function Score (LEFS) and Children Health Assessment Questionnaire (CHAQ). Follow up hip radiographs were classified according to the Choi’s classification. We labelled the patient as having instability if either hip had a Choi type >3A.
Results: The mean age at final follow-up was 7.6 years. Five patients had multiple joints affection. The mean LEFS score was 62.7 and CHAQ-DI 0.2. The mean LEFS values for radiological stable hips (n= 5 patients) was 66 ± 19.4 and 58.5 ± 15.3 for unstable hips (p=0.5487) while corresponding CHAQ-DI scores were 0.12 ± 0.13 and 0.27 ± 0.12 respectively (p=0.1098) indicating poor relatability between functional capabilities of the child and the radiological appearances of the hips. A strong negative correlation however existed between LEFS/ CHAQ-DI values (R= -0.897; p=0.001).
Conclusions: Septic hip sequelae in children leads to various degrees of functional limitations and patients with multiple joint involvement have worse outcomes. The hip radiological findings do not relate with the overall functional status of the child.
Keywords: Functional outcome, Disability, Hip, Sepsis, Child

References

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How to Cite this Article: Sami A, Agarwal A, Sharma L, Patel Y, Garg V | Functionality Against Odds: Lower Extremity Functional Scale and Children Health Assessment Questionnaire in Children with Bilateral Septic Sequelae of Hip | International Journal of Paediatric Orthopaedics| January-April 2023; 9(1): 21-25 | https://doi.org/10.13107/ijpo.2023.v09.i01.151

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH)

Functionality Against Odds: Lower Extremity Functional Scale and Children Health Assessment Questionnaire in Children with Bilateral Septic Sequelae of Hip

Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH)

Functionality Against Odds: Lower Extremity Functional Scale and Children Health Assessment Questionnaire in Children with Bilateral Septic Sequelae of Hip

Full Sized Blog Element (Big Preview Pic)

Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH)

Abstract

(Article Text HTML) (Full Text PDF)

Functionality Against Odds: Lower Extremity Functional Scale and Children Health Assessment Questionnaire in Children with Bilateral Septic Sequelae of Hip

Authors: Abdus Sami [1] MS Orth., Anil Agarwal [1] MS Orth., Lokesh Sharma [1] MS Orth., Yogesh Patel [1] MS Orth., Varun Garg [1] MS Orth.

Abstract

(Article Text HTML) (Full Text PDF)

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