Patterns and Characteristics of Children with Developmental Dysplasia of the Hip Treated in Saudi Arabia: Data from the National Saudi Program for Developmental Dysplasia of the Hip

Abstract

The National Hip Dysplasia Program (NHDP) was launched in December 2016 to treat children with developmental dysplasia of the hip (DDH) in Saudi Arabia; however, its outcomes have not been examined or published yet. Therefore, our aim in this study was to report the findings of this unique program. In this retrospective study design, we included data of patients with DDH who received interventions provided by the NHDP, from two major Saudi regions (Northern Borders and Al-Jouf regions), from April 2017 to February 2021. Outcomes reported included age at first surgery, sex, involved side, interventions provided, and recurrence rates for failed surgeries. Independent t-tests compared age differences between Northern Borders region and Al-Jouf region, whereas chi-square tests determined the differences between Northern Borders region and Al-Jouf region regarding sex and the involved side of DDH distributions. Out of 404 children with DDH, 300 (82.3% were females and 17.7% were males) were included and were first seen at the age of 20 months in the Northern Borders region and at the age of 22 months in Al-Jouf region. We found a significant difference in the number of bilateral DDH cases between the Northern Borders (n = 129; 70.1%) and Al-Jouf (n = 59; 51.0%) (P = 0.003) regions. In the Northern Borders region, the majority of children with unilateral DDH were treated by open reduction (right side = 40.7%; left side = 60.7%), with recurrence rates of 14.8% for the right side and 7.1% for left side. In the Al-Jouf region, the majority of children with unilateral DDH were treated by femoral shortening with graft (right side = 69.2%; left side = 54.9%), with a recurrence rate of 7.7% for the right-sided DDH. More than half of the children with bilateral DDH underwent operations for both sides (Northern Borders region = 62.0%; Al-Jouf region = 57.9%). The study provides a detailed analysis of DDH among children in the Northern Borders and Al-Jouf regions, highlighting significant regional differences in both the prevalence and treatment outcomes. Future studies need to develop strategies to prevent and minimize potential long-term effects of DDH.