Research Article

Intraoperative Hip Arthrography During Closed Reduction for Developmental Dysplasia of the Hip in Infants: A Comparative Study of Surgical Decision-Making and Secondary Intervention Risk

Volume: 52 March 17, 2026
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Intraoperative Hip Arthrography During Closed Reduction for Developmental Dysplasia of the Hip in Infants: A Comparative Study of Surgical Decision-Making and Secondary Intervention Risk

Abstract

This study evaluated whether intraoperative hip arthrography performed during closed reduction for developmental dysplasia of the hip (DDH) in infants provides prognostic information regarding treatment failure and the need for secondary surgery and examined the influence of patient age. This retrospective comparative study included 88 hips in 79 patients aged ≤1 year who underwent closed reduction followed by hip spica casting. Patients were grouped according to intraoperative assessment method: fluoroscopy alone (Group 1) or fluoroscopy combined with arthrography (Group 2). The primary outcome was treatment failure, defined as secondary open reduction for redislocation in Group 1 and intraoperative conversion to open reduction due to nonconcentric reduction in Group 2. Secondary outcomes included avascular necrosis (AVN), acetabular index (AI) at 24 months, and lateral center–edge angle (LCEA) at 5 years. Subgroup analyses were performed for patients aged ≤6 months and 6–12 months. Overall failure rates were similar between groups (18.8% vs 20.0%, p=1.000). However, the timing of failure differed: failures in Group 2 were detected and managed intraoperatively, whereas those in Group 1 presented later and required additional surgery. Radiographic outcomes and AVN incidence were comparable (p>0.05). Failure rates were substantially higher in patients older than 6 months. Although arthrography did not reduce overall failure or improve radiographic results, it enabled early identification of nonconcentric reduction and immediate definitive management, thereby supporting intraoperative decision-making and potentially reducing delayed secondary procedures.

Keywords

Supporting Institution

University of Health Sciences, Istanbul Kanuni Sultan Suleyman Training and Research Hospital

Ethical Statement

The study adhered to the ethical principles outlined in the Declaration of Helsinki (1964). Approval was obtained from the Ethics Committee of Kanuni Sultan Suleyman Training and Research Hospital, Istanbul University of Health Sciences (Approval Date: 14.05.2025, Decision No: 124).

Thanks

The authors wish to express their appreciation to their colleagues for their support and to all patients for their participation and cooperation in this study.

References

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Details

Primary Language

English

Subjects

Orthopaedics

Journal Section

Research Article

Publication Date

March 17, 2026

Submission Date

February 21, 2026

Acceptance Date

March 9, 2026

Published in Issue

Year 2026 Volume: 52

APA
Kocak, S., Diril, S. K., Genç, Y., Küçükkaya, Ş. Y., Karadeniz, H., Eren, E., Özyalçın, A., Eken, G., & Ertürk, C. (2026). Intraoperative Hip Arthrography During Closed Reduction for Developmental Dysplasia of the Hip in Infants: A Comparative Study of Surgical Decision-Making and Secondary Intervention Risk. Journal of Uludağ University Medical Faculty, 52, 1894666. https://doi.org/10.32708/uutfd.1894666
AMA
1.Kocak S, Diril SK, Genç Y, et al. Intraoperative Hip Arthrography During Closed Reduction for Developmental Dysplasia of the Hip in Infants: A Comparative Study of Surgical Decision-Making and Secondary Intervention Risk. Journal of Uludağ University Medical Faculty. 2026;52:1894666. doi:10.32708/uutfd.1894666
Chicago
Kocak, Soner, Sabri Kerem Diril, Yasin Genç, et al. 2026. “Intraoperative Hip Arthrography During Closed Reduction for Developmental Dysplasia of the Hip in Infants: A Comparative Study of Surgical Decision-Making and Secondary Intervention Risk”. Journal of Uludağ University Medical Faculty 52 (March): 1894666. https://doi.org/10.32708/uutfd.1894666.
EndNote
Kocak S, Diril SK, Genç Y, Küçükkaya ŞY, Karadeniz H, Eren E, Özyalçın A, Eken G, Ertürk C (March 1, 2026) Intraoperative Hip Arthrography During Closed Reduction for Developmental Dysplasia of the Hip in Infants: A Comparative Study of Surgical Decision-Making and Secondary Intervention Risk. Journal of Uludağ University Medical Faculty 52 1894666.
IEEE
[1]S. Kocak et al., “Intraoperative Hip Arthrography During Closed Reduction for Developmental Dysplasia of the Hip in Infants: A Comparative Study of Surgical Decision-Making and Secondary Intervention Risk”, Journal of Uludağ University Medical Faculty, vol. 52, p. 1894666, Mar. 2026, doi: 10.32708/uutfd.1894666.
ISNAD
Kocak, Soner - Diril, Sabri Kerem - Genç, Yasin - Küçükkaya, Şükrü Yazar - Karadeniz, Hilmi - Eren, Erdal - Özyalçın, Ali - Eken, Gökay - Ertürk, Cemil. “Intraoperative Hip Arthrography During Closed Reduction for Developmental Dysplasia of the Hip in Infants: A Comparative Study of Surgical Decision-Making and Secondary Intervention Risk”. Journal of Uludağ University Medical Faculty 52 (March 1, 2026): 1894666. https://doi.org/10.32708/uutfd.1894666.
JAMA
1.Kocak S, Diril SK, Genç Y, Küçükkaya ŞY, Karadeniz H, Eren E, Özyalçın A, Eken G, Ertürk C. Intraoperative Hip Arthrography During Closed Reduction for Developmental Dysplasia of the Hip in Infants: A Comparative Study of Surgical Decision-Making and Secondary Intervention Risk. Journal of Uludağ University Medical Faculty. 2026;52:1894666.
MLA
Kocak, Soner, et al. “Intraoperative Hip Arthrography During Closed Reduction for Developmental Dysplasia of the Hip in Infants: A Comparative Study of Surgical Decision-Making and Secondary Intervention Risk”. Journal of Uludağ University Medical Faculty, vol. 52, Mar. 2026, p. 1894666, doi:10.32708/uutfd.1894666.
Vancouver
1.Soner Kocak, Sabri Kerem Diril, Yasin Genç, Şükrü Yazar Küçükkaya, Hilmi Karadeniz, Erdal Eren, Ali Özyalçın, Gökay Eken, Cemil Ertürk. Intraoperative Hip Arthrography During Closed Reduction for Developmental Dysplasia of the Hip in Infants: A Comparative Study of Surgical Decision-Making and Secondary Intervention Risk. Journal of Uludağ University Medical Faculty. 2026 Mar. 1;52:1894666. doi:10.32708/uutfd.1894666

ISSN: 1300-414X, e-ISSN: 2645-9027

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