{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:43:26Z","timestamp":1787755406755,"version":"build-2784847793"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n As interest in hip resurfacing arthroplasty (HRA) expands to complex pathologies, developmental dysplasia of the hip (DDH) has emerged as a challenging but increasingly considered indication. Although severe DDH often precludes resurfacing because of distorted anatomy, mild cases (Crowe I and II) may provide favorable conditions. This review evaluates outcomes of HRA in mild DDH, compares them with outcomes of total hip arthroplasty (THA) in DDH and HRA in primary osteoarthritis (OA) and assesses the potential of HRA to improve long-term function in this population.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A systematic search of PubMed, Embase, and Scopus identified studies reporting outcomes of HRA in DDH. Titles and abstracts were screened, followed by full-text review. Data on demographics, outcomes, and radiographic findings were extracted. Pooled complication and survivorship rates were calculated. A random-effects meta-analysis compared revision risk in HRA-treated patients with DDH vs. OA, and in patients with DDH treated with HRA vs. THA. Statistical significance was defined as a 95% confidence interval (CI) excluding 1. A separate meta-analysis compared mean postoperative flexion in patients with DDH treated with HRA vs. THA, with significance defined as a 95% CI excluding 0.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n From 65 screened articles, 11 met inclusion criteria, totaling 895 patients and 1,006 hips with DDH. The mean age was 45.26 years, with an average follow-up of 7.06 years. The pooled survivorship was 93%, and the complication rate was 13%. No significant difference in revision risk was found between DDH and OA HRA cohorts, or between HRA and THA in DDH, although both trends favored OA and THA. Patients with HRA-treated DDH had significantly greater postoperative flexion (standardized mean difference \u22121.21, 95% CI \u22121.54 to \u22120.87).<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Despite anatomical challenges and a potential for higher revision or complication rates in patients with DDH, mid-term outcomes, including patient-reported outcome, were comparable with those in primary osteoarthritis and THA cohorts. This review supports the selective use of HRA in patients with Crowe I and II DDH, particularly when modern surgical techniques and DDH-specific implants are used.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n \n Level III<\/jats:underline>\n , systematic review of\n Level I<\/jats:underline>\n ,\n III<\/jats:underline>\n , and\n IV<\/jats:underline>\n studies. See Instructions for Authors for a complete description of levels of evidence.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.rvw.25.00091","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T18:00:26Z","timestamp":1752861626000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Balancing Risk and Reward in Hip Resurfacing for Developmental Dysplasia of the Hip"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4983-7677","authenticated-orcid":false,"given":"Jean","family":"Shanaa","sequence":"first","affiliation":[{"name":"California Northstate University College of Medicine, Elk Grove, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7510-2246","authenticated-orcid":false,"given":"Ethan","family":"Bernstein","sequence":"additional","affiliation":[{"name":"California Northstate University College of Medicine, Elk Grove, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3630-8224","authenticated-orcid":false,"given":"Natalie","family":"Shanaa","sequence":"additional","affiliation":[{"name":"California Northstate University College of Medicine, Elk Grove, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9830-5394","authenticated-orcid":false,"given":"Maani","family":"Bahador","sequence":"additional","affiliation":[{"name":"California Northstate University College of Medicine, Elk Grove, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodor","family":"Di Pauli von Treuheim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Marwin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7]]},"reference":[{"issue":"4","key":"r1-20250718","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.rco.2007.12.009","article-title":"Return to sport after hip resurfacing or total hip arthroplasty: a randomized study [in French]","volume":"94","author":"Lavigne","year":"2008","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"issue":"suppl 2","key":"r2-20250718","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1007\/s11420-019-09729-4","article-title":"What are the benefits of hip resurfacing in appropriate patients? A retrospective, propensity score-matched analysis","volume":"16","author":"McLawhorn","year":"2020","journal-title":"HSS J"},{"issue":"1","key":"r3-20250718","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.3928\/01477447-20241016-02","article-title":"Clinical and radiographic outcomes with minimum 2-year follow-up and sub-analysis of navigation vs non-navigation for hip resurfacing","volume":"48","author":"Quesada-Jimenez","year":"2025","journal-title":"Orthopedics"},{"key":"r4-20250718","doi-asserted-by":"crossref","first-page":"243","DOI":"10.22203\/eCM.v021a19","article-title":"Hip resurfacing arthroplasty: current status and future perspectives","volume":"21","author":"Corten","year":"2011","journal-title":"Eur Cell Mater"},{"issue":"3","key":"r5-20250718","first-page":"e81410","article-title":"Bony morphological features of the proximal femur in patients with developmental dysplasia of the hip","volume":"17","author":"Shozen","year":"2025","journal-title":"Cureus"},{"key":"r6-20250718","first-page":"523","article-title":"Developmental hip dysplasia and dislocation: Part I","volume":"53","author":"Weinstein","year":"2004","journal-title":"Instr Course Lect"},{"key":"r7-20250718","doi-asserted-by":"crossref","first-page":"1","DOI":"10.12968\/hmed.2020.0476","article-title":"Developmental dysplasia of the hip","volume":"81","author":"Zhang","year":"2020","journal-title":"Br J Hosp Med"},{"issue":"3","key":"r8-20250718","first-page":"130","article-title":"Reconstruction of the acetabulum in developmental dysplasia of the hip in total hip replacement","volume":"2","author":"Sakellariou","year":"2014","journal-title":"Arch Bone Jt Surg"},{"issue":"8","key":"r9-20250718","first-page":"e43207","article-title":"Developmental dysplasia of the hip (DDH): etiology, diagnosis, and management","volume":"15","author":"Bakarman","year":"2023","journal-title":"Cureus"},{"issue":"1","key":"r10-20250718","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1186\/s12887-023-03935-0","article-title":"Known risk factors of the developmental dysplasia of the hip predicting more severe clinical presentation and failure of Pavlik harness treatment","volume":"23","author":"Lankinen","year":"2023","journal-title":"BMC Pediatr"},{"issue":"suppl 3","key":"r11-20250718","doi-asserted-by":"crossref","first-page":"12","DOI":"10.2106\/JBJS.H.00711","article-title":"Improved survivorship of hybrid metal-on-metal hip resurfacing with second-generation techniques for Crowe-I and II developmental dysplasia of the hip","volume":"90","author":"Amstutz","year":"2008","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"r12-20250718","doi-asserted-by":"crossref","first-page":"22955","DOI":"10.1038\/s41598-021-02448-z","article-title":"Bone defect map of the true acetabulum in hip dysplasia (Crowe type II and III) based on three-dimensional image reconstruction analysis","volume":"11","author":"Wen","year":"2021","journal-title":"Sci Rep"},{"issue":"4","key":"r13-20250718","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/s00264-016-3248-6","article-title":"Study of three-dimensional morphology of the proximal femur in developmental adult dysplasia of the hip suggests that the on-shelf modular prosthesis may not be an ideal choice for patients with Crowe type IV hips","volume":"41","author":"Liu","year":"2017","journal-title":"Int Orthop"},{"issue":"4","key":"r14-20250718","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1007\/s11999-016-5154-z","article-title":"CORR Insights: femoral morphology in the dysplastic hip: three-dimensional characterizations with CT","volume":"475","author":"Garcia-Cimbrelo","year":"2017","journal-title":"Clin Orthop Relat Res"},{"issue":"6","key":"r15-20250718","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1111\/os.13733","article-title":"Total hip arthroplasty in patients with Crowe III\/IV developmental dysplasia of the hip: acetabular morphology and reconstruction techniques","volume":"15","author":"Qian","year":"2023","journal-title":"Orthop Surg"},{"issue":"8","key":"r16-20250718","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.2106\/00004623-198668080-00015","article-title":"Femoral head autografting to augment acetabular deficiency in patients requiring total hip replacement. 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