Minimally-Invasive Dega Osteotomy in Ambulatory Pediatric Patients With Residual Developmental Dysplasia of the Hips-A Technique and Prospective Case Series.

Abstract

Purpose: This study describes the minimally invasive Dega osteotomy for treating residual acetabular dysplasia in ambulatory pediatric patients. The focus is on assessing the safety, feasibility, and early outcomes of this minimally invasive technique.

Methods: A prospective series was conducted in a single tertiary orthopaedic center. The procedure involved an initial examination of hip joint stability using intraoperative arthrography. The surgical procedure involved a small transverse incision distal and lateral to the anterior superior iliac spine, followed by a Dega osteotomy and bone allografting. Variables such as surgical time, blood loss, incision length, and acetabular index were measured.

Results: In healthy ambulatory patients, 16 osteotomies were performed on 12 patients with an average age of 32 months. The mean incision length was 2.3 cm, average blood loss was 17 mL, and mean surgical time was 21 minutes per side. Preoperative and postoperative acetabular indices averaged 40.3° and 18.6°, respectively. The mean follow-up period was 13 months. No complications were seen in this series.

Conclusion: The minimally invasive Dega osteotomy technique is a safe and effective method for treating residual acetabular dysplasia in ambulatory patients. It offers advantages of minimal invasiveness, reduced surgical time, and less blood loss, with outcomes comparable to standard methods. However, further studies with larger cohorts and longer follow-up are necessary to fully establish its efficacy and safety profile.