Acetabular Index in Developmental Dysplasia of the Hip: Imaging Assessment and Clinical Decision-Making

Abstract

Background: Developmental dysplasia of the hip is a common pediatric orthopedic condition with an estimated incidence of 1.4–80 cases per 1000 births, reported incidence varies considerably according to diagnostic method, population, and the age at assessment. Acetabular dysplasia is characterized by a shallow, immature acetabulum and may present with or without hip instability or dislocation⁽¹⁾. Instability of the hip causes superior and lateral migration of the femoral head that increases localized contact pressure, which eventually leads to degenerative changes. The severity of subluxation of the femoral head has an inverse relation to the time it takes for symptoms to develop.

Objective: There is still no uniform standard for the surgical timing and indications of RAD, so if some predictors can be identified to accurately assess and forecast the developmental prognosis after treatment, it can help to guide the timing of correction or avoid unnecessary surgery.

Conclusion: The treatment goal in developmental dysplasia of hip is to obtain stable congruous reduction either by closed or open methods to promote normal hip development. Many authors have reported that concentric reduction is the main factor affecting the acetabular development, and all acetabulae with DDH may develop satisfactorily if concentric reduction is obtained. Failure to sufficiently remodel results in residual acetabular dysplasia which may need additional surgeries.