Radiographic prediction of the results of long-term treatment with the Pavlik harness for developmental dislocation of the hip

Takao Ohmoria, Hirosuke Endo, Shigeru Mitani, Hiroshi Minagawa, Tomonori Tetsunaga, Toshifumi Ozaki

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

In 1957, Pavlik introduced the Pavlik harness as a useful treatment for developmental dislocation of the hip (DDH), and subsequent studies have documented favorable outcomes among patients treated with this device. However, there are only a few articles reporting how early radiographic measurements can be used to determine the prognosis after treatment with the Pavlik harness. In this study, 217 hips from 192 patients whose DDH treatment with the Pavlik harness was initiated before they were 6 months old and whose follow-up lasted at least 14 years (rate, 63.8%) were analyzed using measurements from radiographs taken immediately before and after harness treatment, and at 1, 2, and 3 years of age. Severin's classification at the final follow-up was I or II in 71.9% and III or IV in 28.1 % of the hips, respectively. Avascular necrosis of the femoral head (AVN) was seen in 10% of the hips. Stepwise multiple regression analysis was performed to retrospectively determine whether any radiographic factors were related to the final classification as Severin I/II or III/IV. Receiver operating characteristic (ROC) curves were drawn for these factors, and a Wiberg OE angle (Point 0 was the middle point of the proximal metaphyseal border of the femur) of 2° on the 3-year radiographs was found to be the most useful screening value for judging the acetabular development of DDH cases after treatment with a Pavlik harness, with a sensitivity of 71% a specificity of 93%, and a likelihood ratio of 10.1.

Original languageEnglish
Pages (from-to)123-128
Number of pages6
JournalActa medica Okayama
Volume63
Issue number3
Publication statusPublished - Jul 1 2009

Keywords

  • Acetabular development
  • Developmental dislocation of the hip
  • Long-term follow up
  • Radiographic measurement
  • Stepwise multiple regression analysis

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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