Abduction Orthosis in Treatment of Primary Acetabular Dysplasia: Results of Three Years Follow-up

Authors : Sinan YÜKSEL, Serhan ÜNLÜ, Onder ERSAN, Faruk CATMA, Yenel Gurkan BİLGETEKİN, Kürşat Reşat DEMİR

Pages : 182-188

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Publication Date : 2021-09-22

Article Type : Research Paper

Abstract :Background: Acetabular dysplasia (AD) may appear after six-months-old despite normal previous physical and ultrasonographic examination, and management remains unclear. The purpose of the current study was to evaluate the success of abduction orthosis in the treatment of primary AD patients. Methods: Patients presented with AD between 2010-2017 were retrospectively reviewed. The study included AD patients who had stable hip joints on previous physical examination and Graf type1 on ultrasonography when younger than six months. AD was diagnosed according to the age-related acetabular index (AI) values. Abduction orthoses were applied full-time for five months plus part-time for three months. AI was re-measured at the sixth month, at the end of the first and third year. AI change was compared between dysplastic and nondysplastic hips. Results: It was evaluated 60 hips of 39 patients with AD treated with abduction orthosis at the median age of 6 months. The mean AI was 31.4 (range: 29-35)°±2.1° in dysplastic hips. AI decreased to 26.5°±2.2°, 24.5°±2°, 21°±2.1° at sixth months, first and third years after treatment; respectively. The mean AI of non-dysplastic hips was 25.3°(range: 22-28)±2.1°; and decreased to 22.6°±2.4°, 21.1°±2°, 17.9°±1.8° at sixth months, first and third years follow-ups, respectively. At the end of the first six months, dysplastic hips had significantly better improvement in AI (4.9±2.1°) compared to non-dysplastic hips (2.7°±0.8°) (p<0.001). There was no significant difference in AI improvement after six months. Conclusion: Primary acetabular dysplasia should not be ignored despite normal previous physical and ultrasonographic examination. Abduction orthosis may be used in the treatment of children with primary AD older than six months.
Keywords : Hip Dysplasia, Abduction Brace, Acetabular Index