HIP International最新文献

{"title":"Complication rates are not higher after outpatient compared to inpatient fast-track total hip arthroplasty: a propensity-matched prospective comparative study.","authors":"Aymard de Ladoucette, Julien Godet, Resurg, Jean-Yves Jenny, Sonia Ramos-Pascual, Ankitha Kumble, Jacobus H Muller, Mo Saffarini, Grégory Biette, Philippe Boisrenoult, Damien Brochard, Thomas Brosset, Pascal Cariven, Julien Chouteau, Marc-Pierre Henry, Christophe Hulet","doi":"10.1177/11207000241267977","DOIUrl":"10.1177/11207000241267977","url":null,"abstract":"<p><strong>Purpose: </strong>Concerns remain with regards to safety of fast-track (FT) and especially outpatient procedures. The purpose of this study was to compare complication rates and clinical outcomes of propensity-matched patients who received FT total hip arthroplasty (THA) in outpatient versus inpatient settings. The hypothesis was that 90-day postoperative complication rates of outpatient FT THA would not be higher than after inpatient FT THA.</p><p><strong>Methods: </strong>This is a prospective study of consecutive patients who received FT THA at various rates of outpatient and inpatient surgery by 10 senior surgeons (10 centres). The decision between outpatient and inpatient surgery was made on a case-by-case basis depending on the surgeon and patient. All patients were followed until 90 days after surgery. Complications, readmissions and reoperations were collected, and their severity was assessed according to Clavien-Dindo. Patients completed Oxford Hip Score (OHS) at the latest follow-up.</p><p><strong>Results: </strong>Compared to inpatient FT THA, patients scheduled for outpatient FT THA had no significant differences in 90-day postoperative complication rates (10.7% vs. 12.9%, <i>p</i> = 0.129). There were no significant differences between the 2 groups in 90-day readmission rates and reoperation rates, in severity of postoperative complications, and in time of occurrence of postoperative complications.</p><p><strong>Conclusions: </strong>There were no differences in rates of intraoperative complications, 90-day postoperative complications, readmissions, or reoperations between outpatient and inpatient FT THA. These findings may help hesitant surgeons to move towards outpatient THA pathways as there is no greater risk of early postoperative complications that could be more difficult to manage after discharge.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"724-732"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation of native acetabular anteversion to the orientation of transverse acetabular ligament","authors":"Michal Kuchař, Ondřej Pelc, Alexander Morávek, Petr Henyš, Axel Heinemann, Benjamin Ondruschka, Tomáš Kučera","doi":"10.1177/11207000241267705","DOIUrl":"https://doi.org/10.1177/11207000241267705","url":null,"abstract":"Background:Precise positioning of the acetabular component during total hip replacement is the key to achieving optimal implant function and ensuring long-term patient comfort. However, different anatomical variations, degenerative changes, dysplasia, and other diseases make it difficult. In this study, we discuss a method based on the three-dimensional direction of the transverse ligament, predicting native acetabular anteversion with higher accuracy.Methods:Angular positions of the acetabulum and direction of the transverse ligament were automatically calculated from routine computed tomography data of 270 patients using a registration algorithm. The relationship between acetabular angles and ligament direction and their relationship with sex, age, and pelvic tilt were sought. These relationships were then modelled using multilinear regression.Results:Including the direction of the transverse ligament in the sagittal and transverse planes as a regressor in the multilinear model explained the variation in acetabular anteversion (R<jats:sup>2</jats:sup> = 0.76 for men, R<jats:sup>2</jats:sup> = 0.63 for women; standard deviation in prediction: men, 3.92° and women, 4.00°).Conclusions:The results indicate that the ligament was suitable as a guidance structure almost insensitive to the ligament in the sagittal and transverse planes must be considered. Estimation based on the direction in only 1 plane was not sufficiently accurate. The operative acetabular inclination was not correlated with the direction of the ligament. The correlations were higher in men than in women.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":"108 1","pages":"11207000241267705"},"PeriodicalIF":1.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142178004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low revision rate throughout the adoption of the direct superior approach in primary total hip arthroplasty: an analysis based on 1551 total hip arthroplasties from the Dutch Arthroplasty Register.","authors":"Pelle Bos, Bart-Jan van Dooren, Rinne M Peters, Harmen B Ettema, Stefan B T Bolder, Frank P van den Berg, Nic J G M Veeger, B Willem Schreurs, Wierd P Zijlstra","doi":"10.1177/11207000241240065","DOIUrl":"10.1177/11207000241240065","url":null,"abstract":"<p><strong>Background: </strong>Recently, surgeons introduced a minimally invasive modification on the classic posterolateral approach (PLA) in total hip arthroplasty (THA): the direct superior approach (DSA). We investigated the association between surgeon's experience and the risk of early revision of the DSA in primary THA, using data from the Dutch Arthroplasty Register (LROI).</p><p><strong>Methods: </strong>We retrieved all primary THAs performed using the DSA in 4 hospitals between 2016 and 2022 (<i>n</i> = 1551). Procedures were sorted in 5 groups using the date of operation and number of previous procedures per surgeon: 1-25; 26-50; 51-75; 76-100; >100. Subsequently, data from different surgeons were pooled together and the risk of revision was calculated via a multilevel time-to-event analysis.</p><p><strong>Results: </strong>The overall revision rate was 1.5% after a mean follow-up of 2 years. Patients from the 1-25 group had comparable risks of revision compared to patients in the >100 group (hazard ratio [HR] 1.0 [CI, 0.3-3.2]). The risk for patients in groups 26-50, 51-75 and 75-100 was also not statistically different from the >100 group (resp. HR 1.5 [CI, 0.5-5.0], 1.8 [CI, 0.5-6.4] and 0.5 [CI, 0.1-4.0]). Main reasons of revision were dislocation (0.5%) and infection (0.4%).</p><p><strong>Conclusions: </strong>We did not identify an association between the surgeon's experience and the early risk of revision for the DSA in primary THA in the Netherlands. The DSA seems safe in the early adoption phases with a low risk of revision due to dislocation and revision for all other causes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"614-621"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between physical function and parameters of hip structural analysis in patients with hip fracture.","authors":"Takuya Umehara, Akinori Kaneguchi, Keita Watanabe, Nobuhisa Katayama, Hidefumi Teramoto, Daisuke Kuwahara, Ryo Kaneyashiki, Toshiyuki Mizuno, Nobuhiro Kito, Masayuki Kakehashi","doi":"10.1177/11207000241265868","DOIUrl":"10.1177/11207000241265868","url":null,"abstract":"<p><strong>Objectives: </strong>The current study sought to investigate whether physical function and activity were associated with hip structural analysis (HSA) parameters on the non-fracture side of patients with hip fractures.</p><p><strong>Methods: </strong>Participants were patients with unilateral hip fracture treated by surgery. HSA of the proximal femur was conducted based on dual-energy x-ray absorptiometry data. HSA parameters in the narrow neck region included cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), section modulus (SM), and buckling ratio (BR). Hierarchical multiple regression analysis was conducted to identify predictors of HSA.</p><p><strong>Results: </strong>Except for the adjustment variables, age, gender and BMI, other variables were extracted. Hierarchical multiple regression analysis (standardised partial regression coefficients) identified movement control during one-leg standing on the non-fractured side (0.15) as factors associated with CSA. Hierarchical multiple regression analysis (standardised partial regression coefficients) identified hand grip (0.12, 0.23) as factors associated with CSMI and SM, respectively. Hierarchical multiple regression analysis (standardised partial regression coefficients) identified presence of steroid (0.23) and cerebrovascular disease (0.19) as factors associated with BR. The coefficients of determination adjusted for degrees of freedom (<i>R</i>²) were 0.545, 0.331, 0.401, and 0.148 for CSA, CSMI, SM, and BR, respectively.</p><p><strong>Conclusions: </strong>Our results indicate that movement control during 1-leg standing and muscle strength may be important for maintaining and improving bone strength.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"677-683"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Department closed reduction of dislocated THR: the REDDTHR Prospective Multi-centre Study.","authors":"Saima Waseem, Albert Ngu, Jason Patel","doi":"10.1177/11207000241251696","DOIUrl":"10.1177/11207000241251696","url":null,"abstract":"<p><strong>Introduction: </strong>Dislocation is a potentially devastating complication severely affecting outcomes post total hip arthroplasty (THR). We aimed to assess the efficacy and safety of closed reduction of a dislocated THR within the Emergency Department (ED).</p><p><strong>Methods: </strong>A prospective multi-centre study was conducted over a 1-year period from November 2020 to December 2021 within 10 hospitals based in the East of England. Collected data included patient demographics, agent used for sedation, hospital length of stay, implant type and discharge destination. Patients were analysed according to whether successful reduction was performed in the ED or not. The primary outcome was length of stay, with secondary outcomes including discharge destination and pain post-procedure.</p><p><strong>Results: </strong>We studied 99 patients with an average age of 77.02 years, with 39 (39%) patients being male. 11 patients had revision hip replacements and 88 patients had primary THRs. 57 (57.6%) underwent closed reduction in the Emergency department, of which 44 (77.2%) were successful. Successful closed reduction was significantly associated with lower patient age (<i>p</i> = 0.02), lower American society of Anesthesiologists (ASA) score (<i>p</i> < 0.01) and use of propofol (<i>p</i> < 0.01). Patients who underwent successful ED closed reduction had a lower hospital stay than those that did not (1 vs. 3 days, <i>p</i> < 0.01), however there was no significant difference in discharge destination.</p><p><strong>Conclusions: </strong>When adopted, success following closed reduction is increased in younger patients with less comorbidities following use of propofol sedation. Following sedation, patients have a significantly shorter hospital stay. Increasing uptake of closed reduction of THR dislocation within the ED in suitable patients with evidence-based best practice protocols will maximise patient outcomes whilst allowing efficient resource utilisation.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"633-640"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral femoral wall thickness in trochanteric hip fractures: a systematic review.","authors":"Amr Selim, Nikhil Ponugoti, Ahmed Daoub, Sarah Johnson-Lynn, Shin Jae Rhee","doi":"10.1177/11207000241267708","DOIUrl":"10.1177/11207000241267708","url":null,"abstract":"<p><strong>Background: </strong>Thin lateral femoral wall has been investigated as a sign of instability in trochanteric hip fractures, necessitating lateral wall reconstruction or the use of a cephalomedullary nail (CMN). Various cut-off values have been proposed to guide implant choice. This review aims to determine the clinical significance of the lateral femoral wall thickness (LWT) in trochanteric hip fractures and identify an optimal cut-off value for increased risk of lateral wall (LW) fracture when using Dynamic Hip Screw (DHS).</p><p><strong>Methods: </strong>A comprehensive search was conducted in databases including Medline, Embase, and the Cochrane library up to July 2023. A predefined strategy was employed, with 5 eligible studies critically appraised using the methodological index for non-randomized studies (MINORS) criteria. Outcomes assessed encompassed the standardised mean difference (SMD) of LWT between the LW fracture and non LW fracture groups, aggregate LWT mean in LW fracture group, and the relation between AO/OTA fracture type with LW fracture utilising the chi-square test.</p><p><strong>Results: </strong>Among 481 patients from 5 studies, 112 experienced LW fractures, while 369 did not postoperatively. Analysis indicated a significantly lower LWT in the LW fracture group (SMD -1.13, I² = 41.3%, <i>p =</i> 0.146). The mean LWT in the LW fracture group was 18.2 mm, with a 95% confidence interval of 17.29-19.10 mm.</p><p><strong>Conclusions: </strong>A preoperative thin lateral femoral wall is a critical predictor of fixation failure and suboptimal functional outcomes when using a DHS. Thorough evaluation of pre- and intraoperative x-rays is essential. CMN is recommended over DHS in cases with LWT measurements <19 mm.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"668-676"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to surfing following hip arthroplasty.","authors":"Garrett K Berger, Canhnghi N Ta, Michael Hachadorian, Cooper B Ehlers, Ryan O'Leary, Pradyumna Gurusamy, Scott T Ball","doi":"10.1177/11207000241254802","DOIUrl":"10.1177/11207000241254802","url":null,"abstract":"<p><strong>Background: </strong>To date, no previous studies have explored return to surfing after hip arthroplasty. The objective of this study is to analyse return to a risky activity following hip arthroplasty.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on all primary total hip arthroplasties (THA) and hip resurfacing arthroplasties (HRA) performed by the senior author from 2014 to 2021. Patients identified as surfers were contacted to complete a survey including surfing history and patient-reported outcomes.</p><p><strong>Results: </strong>83 hips in 67 patients were contacted. There were 66 THAs and 17 HRAs. 81 hips were performed through a posterior approach and 2 through an anterior approach. At an average of 67 months, there were no dislocations and no patients reported hip pain while surfing. Time to resume surfing was a median of 16 (range 8-144) weeks. Among 13 patients who did not return to surfing, 8 cited new lifestyle restrictions, 4 attributed it to other arthritic joints, and only 1 patient attributed their limitation to the replaced hip. This group had taken significantly more time off from surfing prior to surgery.</p><p><strong>Conclusions: </strong>Return to surfing following THA and HRA is common and safe in our study population with no complications and specifically no dislocations. Patients with other sites of arthritis and patients who have more extensive time away from surfing prior to surgery are less likely to return to sport. While surfing is clearly not without risk, patients can generally expect a high rate of successful return to surfing after hip arthroplasty.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"596-601"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which factors are associated with a successful outcome following total hip arthroplasty in patients with early radiographic osteoarthritis?","authors":"Martin Sharrock, Tim N Board","doi":"10.1177/11207000241235892","DOIUrl":"10.1177/11207000241235892","url":null,"abstract":"<p><strong>Background: </strong>It is unclear which factors are associated with a successful total hip arthroplasty (THA) in patients with early radiographic osteoarthritis (OA).</p><p><strong>Methods: </strong>70 patients with early OA (Kellgren and Lawrence [KL] grades 0-2) who underwent THA were compared with 200 patients with advanced OA (KL grades 3-4). Outcomes were Oxford Hip Scores (OHS), EQ-5D and EQ-VAS scores; compared preoperatively with 1 year postoperatively. We investigated which clinical and radiographic (plain x-ray, CT, MRI) features predicted successful THA (postoperative OHS ⩾42).</p><p><strong>Results: </strong>The early OA group were significantly younger (61 vs. 66 years; [<i>p</i> <i>=</i> 0.0035). There were no significant differences in BMI, ASA grade or gender. After adjusting for confounders, the advanced OA group had a significantly greater percentage of possible change (PoPC) in OHS (75.8% vs. 50.4%; <i>p</i> <i><</i> 0.0001) and improvement in EQ-5D (0.151 vs. 0.002; <i>p</i> <i><</i> 0.0001). There were no significant differences in complication, revision or readmission rates. In the early OA group, 16/70 (22.9%) patients had a 'successful' THA. Patients who had a 'successful' THA were significantly more likely to have subchondral cysts on CT/MRI (91.7% vs. 57.7%; <i>p</i> <i>=</i> 0.0362). The presence of cysts on CT/MRI was associated with a significantly greater PoPC in OHS (61.6% vs. 38.2%; <i>p</i> <i>=</i> 0.0353). The combination of cysts and joint space width <1 mm was associated with a PoPC of 68%.</p><p><strong>Conclusions: </strong>THA in patients with early OA (KL grades 0-2) on plain radiographs should be indicated with caution. We advocate preoperative cross-sectional imaging in these patients. In the absence of cysts on CT/MRI, a THA seems unlikely to provide a satisfactory outcome.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"588-595"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140093848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early surgery within 48 hours of admission for hip fracture did not improve 1-year mortality in Japan: a single-institution cohort study.","authors":"Hiroki Iida, Yasuhiko Takegami, Yoshihito Sakai, Tsuyoshi Watanabe, Yusuke Osawa, Shiro Imagama","doi":"10.1177/11207000241248836","DOIUrl":"10.1177/11207000241248836","url":null,"abstract":"<p><strong>Introduction: </strong>Early surgery for hip fracture, within 48 hours of hospital admission, is effective in reducing mortality. However, the average preoperative waiting time for hip fractures in Japan is 4.5 days and the 1-year mortality rate after a hip fracture is 10% in Japan. This study aimed to investigate whether early surgery, within 48 hours, could reduce the 1-year mortality rate in patients with hip fractures in Japan.</p><p><strong>Methods: </strong>This cohort study involved 402 consecutive patients with hip fractures who underwent surgical treatment between January 2013 and September 2019. The exclusion criteria were an age of <60 years and in-hospital injury. A total of 389 patients were included in this study. The patients were divided into two groups: those who underwent early surgery within 48 hours of admission (early group) and those who di not undergo early surgery (delayed group). We compared patient characteristics and treatment outcomes between the 2 groups.</p><p><strong>Results: </strong>A comparison of patient characteristics revealed that the early group had lower hemoglobin levels (P=0.046), lower C-reactive protein levels (<i>P</i> = 0.031), lower numbers of patients with weekend hospitalization, lower numbers of patients with a history of using medications that may cause bleeding (<i>P</i> < 0.01), and who received general anaesthesia (<i>P</i> < 0.01). However, there were no significant differences with regard to the other variables between the 2 groups. A treatment outcome analysis showed that the early group had shorter waiting times for surgery (<i>P</i> < 0.01) and shorter stays in acute-care wards (<i>P</i> < 0.01). However there were no differences in the total hospital stay, Barthel index at discharge, home discharge rates, in-hospital mortality rates, and 1-year mortality.</p><p><strong>Conclusion: </strong>Our findings indicate that early surgery did not reduce the 1-year mortality rate in older patients with hip fractures in Japan.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"660-667"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of risk factors in developmental dysplasia of the hip: a retrospective study on 18,954 cases.","authors":"Gaetano Caruso, Edoardo Gambuti, Elisa Spadoni, Sara Filipponi, Achille Saracco, Francesca Artioli, Ambra Galla, Leo Massari","doi":"10.1177/11207000241248416","DOIUrl":"10.1177/11207000241248416","url":null,"abstract":"<p><strong>Background: </strong>DDH is 1 of the most important causes of childhood disability. A diagnosis of instability can be made in the neonatal period via the Ortolani and Barlow manoeuvres. However, clinical examination, although highly specific, has poor sensitivity as compared to ultrasound. There is controversy between the necessity of universal screening for dysplasia of all newborns or selective screening reserved for those with clinical signs of instability or known risk factors of DDH.</p><p><strong>Aim: </strong>To analyse the risk factors of congenital hip dysplasia in a consecutive case series of children referred for diagnosis and treatment of DDH.</p><p><strong>Materials and methods: </strong>This was a cross-sectional study on infants consecutively examined between January 2000 and December 2019 at the Marino Ortolani Centre in Ferrara, Italy. The first 3 types on Graf's classification were considered physiological (1A, 1B, 2A+), while the last 6 pathological (2A-, 2B, 2C, 2D, 3, 4).</p><p><strong>Results: </strong>18,954 infants met the inclusion criteria and were therefore considered eligible for the study. Of these 18,954 infants, 56% (<i>n</i> = 10,629) were females and 44% (<i>n</i> = 8325) were males. According to Graf classification, 34.9% (<i>n</i> = 6621) were 1A, 52.7% (<i>n</i> = 9999) were 1B, 4.0% (<i>n</i> = 753) were 2A+, 2.5% (<i>n</i> = 478) were 2A-, 1.5% (<i>n</i> = 284) were 2B, 1% (<i>n</i> = 196) were 2C, 1.3% (<i>n</i> = 243) were 2D, 1% (<i>n</i> = 193) were 3 and 1.0% (<i>n</i> = 187) were 4. The most significant risk factor was the female gender (OR 5.36; 95% CI, 4.63-6.20) followed by a family history (OR 2.35; 95% CI, 2.08-2.65), then skeletal pathologies (OR 2.04; 95% CI, 1.21-3.42), oligohydramnios (OR 1.75; 95% CI, 1.44-2.13), and finally breech presentation (OR 1.42: 95% CI, 1.27-1.60).</p><p><strong>Conclusions: </strong>Based on our data, family history, musculoskeletal disease, oligohydramnios and breech presentation are the main risk factors for DDH development, as is the female sex.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"628-632"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141064725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}