We questioned whether our modified soft tissue surgical procedure can provide acceptable results with lower complication rates
in developmental dysplasia of the hip (DDH). We retrospectively reviewed 143 patients (185 hips) with a mean age of 11.6 months
at operation and a minimum followup of 5 years (mean, 7.5 years; range, 5–13 years). We used a posteromedial approach and
sectioned the adductor longus and iliopsoas tendons. If we achieved an arthrographically documented anatomic reduction we
closed the incisions; if not, we made an arthrotomy to obtain an anatomic reduction through the same incision at the same
session. A hip score indicating an acceptable outcome was obtained in 168 hips (90.8%). We identified osteonecrosis of the
femoral head (ON) in 36 (19.5%) hips and redislocation in four (2.2%). Both the ossific nucleus and physis were affected in
10 of the 36 hips with ON. We performed secondary operations in 12 hips (6.5%). Hips of the infants after walking age and
hips with higher preoperative dislocation grades, acetabular indices, and ON were more prone to having lower hip scores. Based
on the data, we believe routine arthrotomy is not needed during posteromedial surgery in DDH and this modified procedure was
safe and effective.
Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation
and that all investigations were conducted in conformity with ethical principles of research.