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Objective: We evaluated the efficacy of reconstructive surgery for hip diseases before skeletal maturity, including acetabular dysplasia after developmental dysplasia of the hip (DDH), Legg-Calve-Perthesdisease (LCPD) and slipped capital femoral epiphysis (SCFE).
Materials and methods: Seventy-one of 294 cases with DDH were treated with triple innominate osteotomy due to residual acetabular dysplasia. Twenty-five patients with difficult LCPD, which had been overlooked for longer than 6 months or showed significant collapsed epiphyses after the initial treatment, underwent surgical treatments. In 14 cases with unstable SCFE, causative factors of avascular necrosis and an appropriate strategy were investigated.
Results: For cases with acetabular dysplasia and difficult LCPD, reconstructive hip surgery such as a triple osteotomy showed excellent results. Seven of 14 cases with unstable SCFE had avascular necrosis. Delayed reduction of an unstable slip without joint aspiration appeared to increase the risk of development of osteonecrosis.
Conclusion: Reconstructive surgery during the infant and adolescent stages can provide excellent remodeling and congruity, leading to reasonable function of the hips for the long term. Appropriate methods of treatment and optimal timing for the correct indication are the most important considerations.
