Pediatric Hip Dysplasia Surgery Outcomes by Pediatric Versus Nonpediatric Orthopedists

Sarah Dance; Theodore Quan; Philip M Parel; Benjamin J Farley; Sean Tabaie

doi:10.7759/cureus.55951

Pediatric Hip Dysplasia Surgery Outcomes by Pediatric Versus Nonpediatric Orthopedists

Cureus. 2024 Mar 11;16(3):e55951. doi: 10.7759/cureus.55951. eCollection 2024 Mar.

Authors

Sarah Dance¹, Theodore Quan², Philip M Parel², Benjamin J Farley², Sean Tabaie¹

Affiliations

¹ Orthopaedic Surgery, Children's National Hospital, Washington, DC, USA.
² Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Abstract

Objectives Developmental dysplasia of the hip (DDH) encompasses a spectrum of abnormalities in the immature hip. Surgical intervention is indicated if conservative management fails. Despite the increased supply of pediatric orthopedic surgeons (POSs) over the last few decades, there continues to be a maldistribution of surgeons. The purpose of this study is to determine outcomes following surgical management of hip dysplasia by POSs compared to non-pediatric orthopedic surgeons. Methods Pediatric patients who underwent surgical treatment for hip dysplasia from 2012 to 2019 were identified using a large national database. Patient demographics, comorbidities, and postoperative complications were compared by pediatric versus nonpediatric-trained orthopedic surgeons. Bivariate and multivariable regression analyses were performed. Results Of the 10,780 pediatric patients who underwent hip dysplasia surgery, 10,206 patients (94.7%) were operated on by a POS, whereas 574 (5.3%) were operated on by a non-pediatric orthopedic surgeon. POSs were more likely to operate on patients with a higher American Society of Anesthesiologists class (p<0.001) and those with a greater number of medical comorbidities, including cardiac (p=0.001), gastrointestinal (p=0.017), and neurological (p<0.001). Following analysis using multivariable regression models to control for patient baseline characteristics, there were no differences in any postoperative complications between patients treated by pediatric-trained and nonpediatric-trained orthopedic surgeons. Conclusions Compared to non-pediatric orthopedic surgeons, POSs were more likely to operate on younger patients with increased medical comorbidities. However, there were no differences in postoperative complications following surgical management for DDH in patients treated by nonpediatric and pediatric orthopedic surgeons.

Keywords: developmental dysplasia of the hip; developmental dysplasia of the hip (ddh); hip surgery; nonpediatric orthopedic surgery; pediatric orthopedic surgery.