between the groups. Multiple logistic regression models were used to analyze factors associated with osteonecrosis and with the McKay classification.
RESULTS: Age at surgery and preoperative Tönnis grade differed significantly between the groups. Forty-five (80.3%) of the patients in the bilateral group and 135 (86.5%) of the patients in the unilateral group had a satisfactory Severin classification (Ia, Ib, or II); the difference between the groups was not significant. According to the McKay classification, twenty-six (46%) of the patients in the bilateral group had an satisfactory outcome compared with 111 (71%) of the patients in the unilateral group (p = 0.006). Osteonecrosis was significantly greater in the bilateral group as well (p = 0.01). Patient age at surgery and Tönnis grade were risk factors for osteonecrosis. Older age and bilaterality were associated with a poorer McKay classification. The logistic regression analysis was repeated after removing the nineteen patients (34%) in the bilateral group who had an asymmetrical outcome, and this analysis confirmed that asymmetrical outcome was a risk factor for a poorer McKay classification.
CONCLUSIONS: Our data confirmed that the clinical outcome of bilateral developmental dysplasia of the hip was worse primarily because of asymmetrical outcomes. Age and Tönnis grade played an important role in the risk of occurrence of osteonecrosis. The radiographic outcome according to the Severin classification did not differ significantly between the groups.
RESULTS: Age at surgery and preoperative Tönnis grade differed significantly between the groups. Forty-five (80.3%) of the patients in the bilateral group and 135 (86.5%) of the patients in the unilateral group had a satisfactory Severin classification (Ia, Ib, or II); the difference between the groups was not significant. According to the McKay classification, twenty-six (46%) of the patients in the bilateral group had an satisfactory outcome compared with 111 (71%) of the patients in the unilateral group (p = 0.006). Osteonecrosis was significantly greater in the bilateral group as well (p = 0.01). Patient age at surgery and Tönnis grade were risk factors for osteonecrosis. Older age and bilaterality were associated with a poorer McKay classification. The logistic regression analysis was repeated after removing the nineteen patients (34%) in the bilateral group who had an asymmetrical outcome, and this analysis confirmed that asymmetrical outcome was a risk factor for a poorer McKay classification.
CONCLUSIONS: Our data confirmed that the clinical outcome of bilateral developmental dysplasia of the hip was worse primarily because of asymmetrical outcomes. Age and Tönnis grade played an important role in the risk of occurrence of osteonecrosis. The radiographic outcome according to the Severin classification did not differ significantly between the groups.
PMID: 23783204 [PubMed - indexed for MEDLINE]
Read more... http://www.ncbi.nlm.nih.gov/pubmed/23783204?dopt=Abstract
