{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:25:57Z","timestamp":1791203157785,"version":"4.2.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,5]]},"abstract":"\n Background:<\/jats:title>\n Despite widespread use of single-stage open reduction and pelvic osteotomy for treatment of developmental dysplasia of the hip (DDH) after walking age, this aggressive strategy remains controversial. We directly compared dislocated hips treated with closed reduction (CR) to those treated with open reduction and Salter innominate osteotomy (OR\/IO) to estimate the relative hazard of total hip arthroplasty (THA) and the THA-free survival time.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n In a series of patients 18 to 60 months of age, 45 patients (58 hips) underwent CR and 58 patients (78 hips) were treated with OR\/IO and followed to a minimum 40 years post-reduction. Observations in the survival analysis were censored if no THA had occurred by 48 years. Multivariate Cox regression analysis was used to estimate the hazard of THA given treatment, age, and bilaterality. Complications and additional procedures were noted.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n At 48 years of follow-up, 29 (50%) of the hips survived after CR compared with 54 (69%) after OR\/IO. At 45 years, the survival probability after OR\/IO was 0.63 (95% confidence interval [CI] = 0.50 to 0.78) compared with 0.55 (95% CI = 0.43 to 0.72) after CR. The hazard ratio (HR) of THA was modeled as a function of treatment, age at reduction, and bilaterality. The effect of age and treatment on the outcome of hips in patients with unilateral involvement was minimal. However, age did significantly alter the relationship between treatment and outcome in bilateral cases. In the bilateral group, the predicted HR of THA was lower after CR in hips that were reduced at the age of 18 months (HR = 0.16, 95% CI = 0.04 to 0.64) but higher in those that were reduced at 36 months (HR = 4.23, 95% CI = 2.00 to 8.95). Additional procedures were indicated for 17% and 22% of hips after CR and OR\/IO, respectively.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Osteoarthritis and THA was more likely after CR than OR\/IO, but the data do not indicate a difference in unadjusted hip-survival time. In patients with bilateral disease, an older age at reduction was associated with an increased hazard of THA after CR than after OR\/IO. Both treatments provided substantial benefit relative to the natural history of DDH, but THA is the expected outcome in middle adulthood.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n \n Therapeutic\n Level III<\/jats:underline>\n . See Instructions for Authors for a complete description of levels of evidence.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.19.01278","type":"journal-article","created":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T19:27:25Z","timestamp":1586892445000},"page":"1351-1357","source":"Crossref","is-referenced-by-count":30,"title":["Closed Vs. Open Reduction\/Salter Innominate Osteotomy for Developmental Hip Dislocation After Age 18 Months"],"prefix":"10.2106","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1238-1931","authenticated-orcid":false,"given":"Elizabeth J.","family":"Scott","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery and Rehabilitation, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2455-2187","authenticated-orcid":false,"given":"Lori A.","family":"Dolan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Rehabilitation, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3676-6687","authenticated-orcid":false,"given":"Stuart L.","family":"Weinstein","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Rehabilitation, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,4,15]]},"reference":[{"issue":"8","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"e360","DOI":"10.5435\/JAAOS-D-18-00522","article-title":"Management of developmental dysplasia of the hip in infants up to six months of age: intended for use by orthopaedic specialists","volume":"27","author":"Samora","year":"2019","journal-title":"J Am Acad Orthop Surg."},{"key":"bib2-20230810","first-page":"154","article-title":"The natural history of congenital dislocation of the hip: a critical review","volume":"137","author":"Wedge","year":"1978","journal-title":"Clin Orthop Relat Res."},{"key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/00003086-198712000-00007","article-title":"Natural history of congenital hip dislocation (CDH) and hip dysplasia","volume":"225","author":"Weinstein","year":"1987","journal-title":"Clin Orthop Relat Res."},{"issue":"6","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"e20163107","DOI":"10.1542\/peds.2016-3107","article-title":"Evaluation and referral for developmental dysplasia of the hip in infants","volume":"138","author":"Shaw","year":"2016","journal-title":"Pediatrics."},{"issue":"4","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1302\/0301-620X.86B4.14586","article-title":"Evolution of late presenting developmental dysplasia of the hip and associated surgical procedures after 14 years of neonatal ultrasound screening","volume":"86","author":"Wirth","year":"2004","journal-title":"J Bone Joint Surg Br."},{"issue":"4","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1302\/1863-2548.12.180063","article-title":"Universal or selective ultrasound screening for developmental dysplasia of the hip? A discussion of the key issues","volume":"12","author":"Biedermann","year":"2018","journal-title":"J Child Orthop."},{"issue":"5","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1007\/s11999.0000000000000164","article-title":"The 2018 Nicholas Andry Award: the evidence base for the treatment of developmental dysplasia of the hip: the Iowa Contribution","volume":"476","author":"Weinstein","year":"2018","journal-title":"Clin Orthop Relat Res."},{"issue":"3","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1302\/0301-620X.43B3.518","article-title":"Innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip","volume":"43","author":"Salter","year":"1961","journal-title":"J Bone Joint Surg Br."},{"issue":"6","key":"bib9-20230810","doi-asserted-by":"crossref","first-page":"401","DOI":"10.5435\/00124635-200111000-00005","article-title":"Developmental dysplasia of the hip from six months to four years of age","volume":"9","author":"Vitale","year":"2001","journal-title":"J Am Acad Orthop Surg."},{"issue":"9","key":"bib10-20230810","doi-asserted-by":"crossref","first-page":"615","DOI":"10.5435\/JAAOS-D-15-00154","article-title":"Surgical management of pediatric developmental dysplasia of the hip","volume":"24","author":"Murphy","year":"2016","journal-title":"J Am Acad Orthop Surg."},{"issue":"5","key":"bib11-20230810","doi-asserted-by":"crossref","first-page":"734","DOI":"10.2106\/00004623-198971050-00015","article-title":"One-stage treatment of congenital dislocation of the hip in older children, including femoral shortening","volume":"71","author":"Galpin","year":"1989","journal-title":"J Bone Joint Surg Am."},{"key":"bib12-20230810","first-page":"60","article-title":"Combined procedure of open reduction and shortening of the femur in treatment of congenital dislocation of the hips in older children","volume":"119","author":"Klisic","year":"1976","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib13-20230810","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1007\/s11999-015-4491-7","article-title":"Have changes in treatment of late-detected developmental dysplasia of the hip during the last decades led to better radiographic outcome?","volume":"474","author":"Terjesen","year":"2016","journal-title":"Clin Orthop Relat Res."},{"issue":"9","key":"bib14-20230810","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.2106\/00004623-199274090-00008","article-title":"One-stage correction of the spastic dislocated hip. 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