Gait Analysis of Children with Developmental Dysplasia of The Hip under 2 Years-old after Closed Reduction: A Systematic Review

Introduction: Developmental dysplasia of the hip (DDH) is a common orthopedic condition affecting hip joint development, leading to potential dislocation. While early diagnosis is crucial, treatment typically involves harness therapy or surgical intervention. Despite advancements, postoperative gait abnormalities persist.

Aims: Our study aims to explore the relationship between surgically corrected DDH, postoperative gait deviations, and functional outcomes. We hypothesize specific gait abnormalities will correlate with surgical procedure type, radiological findings, and overall functional outcomes. This study aims to provide insights into optimizing surgical decision-making and improving outcomes in hip surgery for DDH.

Methods: Two reviewers conducted comprehensive searches independently across databases including PubMed, Embase, Cochrane Library, and Web of Science from inception to May 2024. The included studies underwent bias assessment using the RoB 2 and ROBINS-I tools. The evidence was evaluated using the GRADE approach.

Results. Out of 169 initially identified articles, one study met the inclusion criteria after screening. This study involved 203 patients (406 lower limbs) with a mean age of 20.09 months, consisting of 165 females and 38 males. Of these, 143 patients (70.4%) were treated with abduction braces, 32 (15.7%) had surgical hip reduction followed by casting and brace treatment, and 28 (13.7%) were treated for other diagnoses. Evaluated with the ROBINS-I tool, the study had a moderate risk of bias. Gait analysis using the Wee Glasgow Gait Index (WeeGGI) showed a mean score of 6.44 ± 3.84, with a high correlation (r = 0.93) indicating a significant impact of DDH on gait. Significant correlations were found for the right (r = 0.97) and left (r = 0.25) lower limbs. No radiological outcomes or complications were reported.

Conclusion: The included study showed notable gait deviations, emphazing the need for more rigorous research. Future studies should include larger sample sizes, standardized outcome measures, and detailed reporting to better understand the effectiveness of DDH treatments.