{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T07:54:17Z","timestamp":1774338857947,"version":"3.50.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>To evaluate and quantify the intraoperative effect of capsulorrhaphy on the deep seating of femoral head within the acetabulum as measured by medial joint space, a surrogate measure of acetabular-head contact.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In order to determine the exact effect of capsulorrhaphy, we prospectively scrutinized a consecutive sample of 18 patients with unilateral dysplastic hips aging &gt;\u200918\u2009months and followed them for a period of at least 12\u2009months. The procedure of open reduction is described in detail. Two pediatric orthopedists carried out the operations from August 2014 to January 2019 at a tertiary pediatric hospital. Intraoperatively, AP radiographs of the pelvis were obtained before and after capsulorrhaphy. The distance between the inferomedial edge of the proximal femoral metaphysis and the lateral edge of the obturator foramen was recorded. To determine if there were differences in medial joint space due to capsulorrhaphy, a generalized linear model was run on the study sample. All patients were followed for at least 12\u2009months to determine the rate of re-dislocation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Mean age (\u00b1standard deviation) of the participants was 37.5 (\u00b124.7) months. All cases underwent Salter osteotomy, 5 cases needed femoral shortening (27.8%) and none needed derotational osteotomy. Capsulorrhaphy lead to a statistically significant decrease in the mean medial joint space from 1.59\u2009cm before (95% CI: 1.12\u20132.05) to 0.76\u2009cm after (95% CI: 0.50\u20131.02) the capsulorrhaphy (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). When we took the effect of age into account the corresponding figures were 1.47 (95% CI: 1.22\u20131.75) and 0.67 (95% CI: 0.39\u20130.94), respectively (P\u2009&lt;\u20090.001). After follow up periods of 1 to 5.5\u2009years, none of the patients experienced instability or re-dislocation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Capsulorrhaphy, independently, of age was associated with a 1-cm decrease in the mean medial hip joint space and a more deeply seated femoral head. Furthermore, this study presents a successful experience with capsulorrhaphy to prevent hip instability.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12891-021-04065-3","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T18:03:03Z","timestamp":1613671383000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The path to minimizing instability in developmental dysplasia of the hip: is Capsulorrhaphy a necessity or a futile habit?"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8332-6353","authenticated-orcid":false,"given":"Ramin","family":"Zargarbashi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammadreza","family":"Bozorgmanesh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Behnam","family":"Panjavi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9136-0479","authenticated-orcid":false,"given":"Fardis","family":"Vosoughi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,2,17]]},"reference":[{"issue":"2","key":"4065_CR1","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.ocl.2005.12.001","volume":"37","author":"MC Lee","year":"2006","unstructured":"Lee MC, Eberson CP. Growth and development of the child's hip. Orthop Clin North Am. 2006;37(2):119\u201332 v.","journal-title":"Orthop Clin North Am"},{"issue":"4","key":"4065_CR2","doi-asserted-by":"publisher","first-page":"232","DOI":"10.5435\/00124635-200007000-00004","volume":"8","author":"JT Guille","year":"2000","unstructured":"Guille JT, Pizzutillo PD, MacEwen GD. Development dysplasia of the hip from birth to six months. J Am Acad Orthop Surg. 2000;8(4):232\u201342.","journal-title":"J Am Acad Orthop Surg"},{"issue":"6","key":"4065_CR3","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1016\/j.pcl.2014.08.008","volume":"61","author":"RM Schwend","year":"2014","unstructured":"Schwend RM, Shaw BA, Segal LS. Evaluation and treatment of developmental hip dysplasia in the newborn and infant. Pediatr Clin N Am. 2014;61(6):1095\u2013107.","journal-title":"Pediatr Clin N Am"},{"issue":"3","key":"4065_CR4","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1302\/1863-2548.12.180034","volume":"12","author":"C Alves","year":"2018","unstructured":"Alves C, Truong WH, Thompson MV, Suryavanshi JR, Penny CL, Do HT, et al. Diagnostic and treatment preferences for developmental dysplasia of the hip: a survey of EPOS and POSNA members. J Child Orthop. 2018;12(3):236\u201344.","journal-title":"J Child Orthop"},{"issue":"3","key":"4065_CR5","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1302\/0301-620X.84B3.0840418","volume":"84","author":"J Cashman","year":"2002","unstructured":"Cashman J, Round J, Taylor G, Clarke N. The natural history of developmental dysplasia of the hip after early supervised treatment in the Pavlik harness: a prospective, longitudinal follow-up. J Bone Joint Surg Br. 2002;84(3):418\u201325.","journal-title":"J Bone Joint Surg Br"},{"issue":"5","key":"4065_CR6","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1097\/BPO.0000000000000313","volume":"35","author":"V Pavone","year":"2015","unstructured":"Pavone V, Testa G, Riccioli M, Evola FR, Avondo S, Sessa G. Treatment of developmental dysplasia of hip with Tubingen hip flexion splint. J Pediatr Orthop. 2015;35(5):485\u20139.","journal-title":"J Pediatr Orthop"},{"key":"4065_CR7","unstructured":"Cigala F, Lotito FM, De Felice D. \"CONSERVATIVE TREATMENT OF DDH.\" Orthopaedic Proceedings. No. SUPP_III. The British Editorial Society of Bone & Joint Surgery, 2002;84."},{"issue":"4","key":"4065_CR8","doi-asserted-by":"publisher","first-page":"260","DOI":"10.5371\/hp.2018.30.4.260","volume":"30","author":"I Qadir","year":"2018","unstructured":"Qadir I, Ahmad S, Zaman AU, Khan CM, Ahmad S, Aziz A. One-stage hip reconstruction for developmental hip dysplasia in children over 8 years of age. Hip Pelvis. 2018;30(4):260\u20138.","journal-title":"Hip Pelvis"},{"issue":"3","key":"4065_CR9","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/s11832-015-0659-7","volume":"9","author":"Y Iyetin","year":"2015","unstructured":"Iyetin Y, Turkmen I, Saglam Y, Akcal MA, Unay K, Unsac B. A modified surgical approach of the hip in children: is it safe and reliable in patients with developmental hip dysplasia? J Child Orthop. 2015;9(3):199\u2013207.","journal-title":"J Child Orthop"},{"key":"4065_CR10","doi-asserted-by":"crossref","unstructured":"Cheung, JPY, Chow W, To M. Osteonecrosis and femoro acetabular impingement: sequelae of developmental dysplasia of the hip. BMJ Case Rep. 2012(2012):bcr1220115455.","DOI":"10.1136\/bcr.12.2011.5455"},{"issue":"2","key":"4065_CR11","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.ocl.2005.11.005","volume":"37","author":"E Forlin","year":"2006","unstructured":"Forlin E, Munhoz da Cunha LA, Figueiredo DC. Treatment of developmental dysplasia of the hip after walking age with open reduction, femoral shortening, and acetabular osteotomy. Orthoped Clin North Am. 2006;37(2):149\u201360 vi.","journal-title":"Orthoped Clin North Am"},{"issue":"1, Supplement","key":"4065_CR12","first-page":"S147","volume":"104","author":"C Glorion","year":"2018","unstructured":"Glorion C. Surgical reduction of congenital hip dislocation. Orthop Traumatol. 2018;104(1, Supplement):S147\u201357.","journal-title":"Orthop Traumatol"},{"issue":"6","key":"4065_CR13","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1097\/BPB.0000000000000528","volume":"27","author":"P Guti\u00e9rrez Carbonell","year":"2018","unstructured":"Guti\u00e9rrez Carbonell P. Arthrodiastasis followed by open reduction associated with pelvic and femoral osteotomies for the treatment of high inveterate congenital hip dislocation. J Pediatr Orthop B. 2018;27(6):479\u201384.","journal-title":"J Pediatr Orthop B"},{"issue":"1","key":"4065_CR14","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1097\/01241398-199501000-00021","volume":"15","author":"T Lejman","year":"1995","unstructured":"Lejman T, Strong M, Michno P. Capsulorrhaphy versus capsulectomy in open reduction of the hip for developmental dysplasia. J Pediatr Orthop. 1995;15(1):98\u2013100.","journal-title":"J Pediatr Orthop"},{"key":"4065_CR15","volume-title":"Tachdjian\u2018s Pediatric Orthopaedics","author":"J Herring","year":"2002","unstructured":"Herring J. Tachdjian\u2018s Pediatric Orthopaedics. Philadelphia London New York St Louis Sydney Toronto: WB Saunders; 2002."},{"issue":"4","key":"4065_CR16","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1007\/s12178-016-9369-0","volume":"9","author":"S Pun","year":"2016","unstructured":"Pun S. Hip dysplasia in the young adult caused by residual childhood and adolescent-onset dysplasia. Curr Rev Musculoskelet Med. 2016;9(4):427\u201334.","journal-title":"Curr Rev Musculoskelet Med"},{"issue":"3","key":"4065_CR17","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1148\/rg.2016150159","volume":"36","author":"DG Rosenbaum","year":"2016","unstructured":"Rosenbaum DG, Servaes S, Bogner EA, Jaramillo D, Mintz DN. MR imaging in Postreduction assessment of developmental dysplasia of the hip: goals and obstacles. RadioGraphics. 2016;36(3):840\u201354.","journal-title":"RadioGraphics"},{"key":"4065_CR18","doi-asserted-by":"crossref","unstructured":"Aghaghazvini L, et al. Sonography: a sensitive and specific method for detecting trochlear cartilage pathologies. J Ultrasound. 2020;23.3:259\u201363.","DOI":"10.1007\/s40477-020-00488-1"},{"issue":"2","key":"4065_CR19","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1097\/01241398-198305000-00004","volume":"3","author":"C Race","year":"1983","unstructured":"Race C, Herring JA. Congenital dislocation of the hip: an evaluation of closed reduction. J Pediatr Orthop. 1983;3(2):166\u201372.","journal-title":"J Pediatr Orthop"},{"key":"4065_CR20","first-page":"299","volume":"63","author":"SL Weinstein","year":"2014","unstructured":"Weinstein SL, Mubarak SJ, Wenger DR. Fundamental concepts of developmental dysplasia of the hip. Instr Course Lect. 2014;63:299\u2013305.","journal-title":"Instr Course Lect"},{"issue":"6","key":"4065_CR21","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1097\/01241398-198911000-00001","volume":"9","author":"WP McCluskey","year":"1989","unstructured":"McCluskey WP, Bassett GS, Mora-Garcia G, MacEwen GD. Treatment of failed open reduction for congenital dislocation of the hip. J Pediatr Orthop. 1989;9(6):633\u20139.","journal-title":"J Pediatr Orthop"},{"issue":"3","key":"4065_CR22","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1097\/BPO.0b013e31820c9b31","volume":"31","author":"WN Sankar","year":"2011","unstructured":"Sankar WN, Young CR, Lin AG, Crow SA, Baldwin KD, Moseley CF. Risk factors for failure after open reduction for DDH: a matched cohort analysis. J Pediatr Orthop. 2011;31(3):232\u20139.","journal-title":"J Pediatr Orthop"},{"issue":"3","key":"4065_CR23","first-page":"438","volume":"2","author":"K Ludloff","year":"1913","unstructured":"Ludloff K. The open reduction of the congenital hip dislocation by an anterior incision. JBJS. 1913;2(3):438\u201354.","journal-title":"JBJS"},{"key":"4065_CR24","doi-asserted-by":"crossref","unstructured":"Alter AH: Primary open reduction of congenital dislocation of the hip, using median adductor approach: AB Ferguson. J. Bone Joint Surg. 55A 671\u2013689 (June), 1973. Journal of Pediatric Surgery 1974, 9(2):270.","DOI":"10.1016\/S0022-3468(74)80198-3"},{"key":"4065_CR25","first-page":"312","volume":"43","author":"Z Troli\u00e6","year":"2002","unstructured":"Troli\u00e6 Z, Ljubi\u00e6 B, Gavrankapetanovi\u00e6 I, Prli\u00e6 J, Moro G, Latinci\u00e6 A. Open reduction of congenital hip dislocation by medial approach: case series. Croat Med J. 2002;43:312\u20138.","journal-title":"Croat Med J"},{"issue":"6","key":"4065_CR26","doi-asserted-by":"publisher","first-page":"401","DOI":"10.5435\/00124635-200111000-00005","volume":"9","author":"MG Vitale","year":"2001","unstructured":"Vitale MG, Skaggs DL. Developmental dysplasia of the hip from six months to four years of age. JAAOS. 2001;9(6):401\u201311.","journal-title":"JAAOS"},{"issue":"4","key":"4065_CR27","first-page":"247","volume":"38","author":"M Sener","year":"2004","unstructured":"Sener M, Baki C, Aydin H, Yildiz M, Saruhan S. The results of open reduction through a medial approach for developmental dysplasia of the hip in children above 18 months of age. Acta Orthop Traumatol Turc. 2004;38(4):247\u201351.","journal-title":"Acta Orthop Traumatol Turc"},{"issue":"4","key":"4065_CR28","first-page":"233","volume":"37","author":"A Johari","year":"2003","unstructured":"Johari A, Wadia F. Revision surgery for developmental dysplasia of the hip. Indian J Orthopaed. 2003;37(4):233.","journal-title":"Indian J Orthopaed"},{"key":"4065_CR29","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.2106\/00004623-196648070-00016","volume":"48","author":"RB Salter","year":"1966","unstructured":"Salter RB. Role of innominate osteotomy in the treatment of congenital. J Bone Joint Surg Am. 1966;48:1413\u201339.","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"4065_CR30","doi-asserted-by":"publisher","first-page":"810","DOI":"10.2106\/00004623-199706000-00002","volume":"79","author":"JA Morcuende","year":"1997","unstructured":"Morcuende JA, Meyer MD, Dolan LA, Weinstein SL. Long-term outcome after open reduction through an anteromedial approach for congenital dislocation of the hip. JBJS. 1997;79(6):810\u20137.","journal-title":"JBJS"},{"issue":"1","key":"4065_CR31","doi-asserted-by":"publisher","first-page":"e12","DOI":"10.4081\/or.2012.e12","volume":"4","author":"H Heep","year":"2012","unstructured":"Heep H, Xu J, L\u00f6chteken C, Wedemeyer C. A simple and convenient method guide to determine the magnification of digital X-rays for preoperative planning in total hip arthroplasty. Orthop Rev (Pavia). 2012;4(1):e12.","journal-title":"Orthop Rev (Pavia)"},{"issue":"8","key":"4065_CR32","doi-asserted-by":"publisher","first-page":"1799","DOI":"10.1007\/s00264-018-4120-7","volume":"43","author":"CK Boese","year":"2019","unstructured":"Boese CK, Wilhelm S, Haneder S, Lechler P, Eysel P, Bredow J. Influence of calibration on digital templating of hip arthroplasty. Int Orthop. 2019;43(8):1799\u2013805.","journal-title":"Int Orthop"},{"key":"4065_CR33","unstructured":"Herring, John A. Tachdjian's pediatric orthopaedics e-book: from the Texas Scottish Rite Hospital for Children. Elsevier, 2020"}],"container-title":["BMC Musculoskeletal Disorders"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-021-04065-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12891-021-04065-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-021-04065-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T18:05:05Z","timestamp":1613671505000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-021-04065-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,17]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["4065"],"URL":"https:\/\/doi.org\/10.1186\/s12891-021-04065-3","relation":{},"ISSN":["1471-2474"],"issn-type":[{"value":"1471-2474","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,17]]},"assertion":[{"value":"9 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by the Institutional Review Board of Tehran University of Medical Sciences. Written informed consent was obtained from the patients\u2019 parents or legal guardians.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that there were no competing interests for this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"199"}}