Single-Stage Triple Procedure Bilateral Hip Open Reduction, Acetabuloplasty, and Femoral Shortening for Late Diagnosed Patients With Developmental Dysplasia of the Hip.

Abstract

Developmental dysplasia of the hip is a challenging pediatric condition requiring timely and effective surgical management. This study evaluates the clinical and radiographic outcomes of a simultaneous bilateral single-stage triple procedure, which integrates open reduction, acetabuloplasty, and femoral shortening osteotomy. This approach offers a potential alternative to standard staged procedures by reducing treatment time and cumulative anesthesia exposure. This retrospective study included 54 patients who underwent a standardized simultaneous bilateral single-stage procedure at two tertiary centers. The average age at the time of surgery is 3 ± 1.5 years. Clinical and radiographic outcomes were assessed, with follow-up extending to an average of 3 years. In our study of 54 patients (108 hips), significant improvements were noted after surgery with a mean reduction in the acetabular index of 27° ± 7° for the right hip and 26° ± 6° for the left hip (P = 0.0001). The Severin classification indicated 83% excellent, 13% good, and 4% poor outcomes. Redislocation occurred in 6% of hips, with no significant differences in osteonecrosis, lateral subluxation, or redislocation based on sex or age (P > 0.05). All patients achieved good-to-full range of motion by the final follow-up.