THE IMPACT OF SURGICAL INTERVENTIONS ON HIP DYSPLASIA OUTCOMES: A RETROSPECTIVE ANALYSIS OF RANGE OF MOTION AND PAIN MANAGEMENT

Abbas Ali; Mudir Khan; Sikandar Hayat; Imran Khan; Israr Khan; Dawood Ullah

doi:10.46903/gjms/23.2.2003

THE IMPACT OF SURGICAL INTERVENTIONS ON HIP DYSPLASIA OUTCOMES: A RETROSPECTIVE ANALYSIS OF RANGE OF MOTION AND PAIN MANAGEMENT

Abbas Ali, Mudir Khan, Sikandar Hayat, Imran Khan, Israr Khan, Dawood Ullah

Abstract

Background: Hip dysplasia has been observed to be common and if left untreated can worsen over time. The goal of this research was to analyse how range of motion, abduction, and limb length differences improved after surgery at different age level.

Materials & Methods: In retrospective cross-sectional study, data was gathered from patient files in a Lady reading Hospital Peshawar over three years (2020-23). Dataset involving 35 patients diagnosed with Developmental Dysplasia of the Hip (DDH) who underwent surgical treatment was analyzed. Information pertaining to motion range, abduction, internal and external rotation, weight and height, and discrepancy between limbs was gathered and subjected to analysis using ANOVA and post-hoc evaluations. A confidence threshold of p <0.05 was set as statistically significant.

Results: There were differences in the left hip range of motion between the ages of 1-3 years and 4-6 years (-1.94, 0.0087) as well as between 4-6 years and 7-10 years (2.96, 0.0062). Weight changes were observed for the difference between 1-3 years and 4-6 years (-3.33, 0.044). Change in right hip abduction was observed from 7-10 to 1-3 (9.27, 0.014). A difference was observed in the limb length discrepancy of 7-10 and 1-3 year old children -0.24, 0.004.

Conclusion: The study analyses the differences in surgical outcomes for DDH patients of different ages, emphasizing the necessity of age tailored strategies. Achieving the desired results greatly depends on precise identification and individualized treatment plans.

Keywords

Hip Dysplasia Developmental; Limb Length Discrepancy; Pediatric Orthopedics; Range of Motion; Treatment Outcome.

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References

Harsanyi S, Zamborsky R, Krajciova L, Kokavec M, Danisovic L. Developmental dysplasia of the hip: a review of etiopathogenesis, risk factors, and genetic aspects. Medicina. 2020;56(4):153. https://doi.org/10.3390/medicina56040153

Wilkin GP, Ibrahim MM, Smit KM, Beaulé PE. A contemporary definition of hip dysplasia and structural instability: toward a comprehensive classification for acetabular dysplasia. J Arthroplasty. 2017;32(9 Suppl):S20-7. https://doi.org/10.1016/j.arth.2017.02.067

Chand S, Aroojis A, Pandey RA, Johari AN. The incidence, diagnosis, and treatment practices of developmental dysplasia of hip (DDH) in India: a scoping systematic review. Indian J Orthop. 2021:1-12. https://doi.org/10.1007/s43465-021-00526-y

Mills SE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth. 2019;123(2):e273-83. https://doi.org/10.1016/j.bja.2019.03.023

Strobel O, Neoptolemos J, Jaeger D, Buechler MW. Optimizing the outcomes of pancreatic cancer surgery. Nat Rev Clin Oncol. 2019;16(1):11-26. https://doi.org/10.1038/s41571-018-0112-1

Vonlanthen R, Lodge P, Barkun JS, Farges O, Rogiers X, Soreide K, et al. Toward a consensus on centralization in surgery. Ann Surg. 2018;268(5):712-24. https://doi.org/10.1097/SLA.0000000000002965

Tong Y, Fernandez L, Bendo JA, Spivak JM. Enhanced recovery after surgery trends in adult spine surgery: a systematic review. Int J Spine Surg. 2020;14(4):623-40. https://doi.org/10.14444/7083

Ermann K, Olivier B. The association of hip range of movement, and its side-to-side asymmetries, and non-specific lower back pain in adults aged 40 years and older. N Am Spine Soc J. 2025;21:100581. https://doi.org/10.1016/j.xnsj.2025.100581

Iwata M, Yamamoto A, Matsuo S, Hatano G, Miyazaki M, Fukaya T, et al. Dynamic stretching has sustained effects on range of motion and passive stiffness of the hamstring muscles. J Sports Sci Med. 2019;18(1):13.

Baba K, Chiba D, Mori Y, Kuwahara Y, Kogure A, Sugaya T, et al. Impacts of external rotators and the ischiofemoral ligament on preventing excessive internal hip rotation: a cadaveric study. J Orthop Surg Res. 2022;17(1):4. https://doi.org/10.1186/s13018-021-02873-w

Rodd C, Metzger DL, Sharma A; Canadian Pediatric Endocrine Group Working Committee for National Growth. Extending World Health Organization weight-for-age reference curves to older children. BMC Pediatr. 2014;14:32. https://doi.org/10.1186/1471-2431-14-32

Libretti A, Savasta F, Nicosia A, Corsini C, De Pedrini A, Leo L, et al. Exploring the father's role in determining neonatal birth weight: a narrative review. Medicina (Kaunas). 2024;60(10):1661. https://doi.org/10.3390/medicina60101661

O'Connor C, Chrystal R, McIntyre M, Delahunt E, Thorborg K. Hip adduction and abduction strength values in elite-level male and female youth soccer players: a comparison between sexes, and across age-groups. Phys Ther Sport. 2024;70:7-14. https://doi.org/10.1016/j.ptsp.2024.08.006

Johnson ME, Mille ML, Martinez KM, Crombie G, Rogers MW. Age-related changes in hip abductor and adductor joint torques. Arch Phys Med Rehabil. 2004;85(4):593-7. https://doi.org/10.1016/j.apmr.2003.07.022

Ribič A, Hadzic V, Spudić D. Hip adduction and abduction strength in different test positions and their relationship to previous groin injuries in women footballers. Res Sports Med. 2024. https://doi.org/10.1080/15438627.2024.2368898

Böhm H, Dussa CU. Impact of mild leg length discrepancy on pelvic alignment and gait compensation in children. Gait Posture. 2025;118:122-9. https://doi.org/10.1016/j.gaitpost.2025.02.003

Starobrat G, Danielewicz A, Szponder T, Wójciak M, Sowa I, Różańska-Boczula M, et al. Limb axis disorder during leg length discrepancy treatment with temporary epiphysiodesis using eight-plate implants. J Clin Med. 2025;14(1):258. https://doi.org/10.3390/jcm14010258

Böhm H, Reinhold SM, Dussa CU. Anatomical leg length discrepancy in children: can it be accurately determined using 3-D motion capturing? Gait Posture. 2024;109:311-7. https://doi.org/10.1016/j.gaitpost.2024.02.013

Stricker S, Hunt T. Evaluation of leg length discrepancy in children. Int Pediatr. 2004;19:134-46. Available from: http://www.int-pediatrics.org/PDF/Volume_19/19_3/134_146_ip1904.pdf

Scorcelletti M, Reeves N, Rittweger J, Ireland A. Femoral anteversion: significance and measurement. J Anat. 2020;237. https://doi.org/10.1111/joa.13249

DOI: https://doi.org/10.46903/gjms/23.2.2003