Risk factors for avascular necrosis of the femoral head after surgical treatment of developmental dysplasia of the hip in children: a systematic review and meta-analysis
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Objective This study aims to explore the risk factors for avascular necrosis (AVN) in children with developmental dysplasia of the hip (DDH) after surgical reduction through systematic review and meta-analysis. Methods We searched PubMed, Embase, Cochrane Library, and Web of Science for studies investigating risk factors for postoperative AVN in children with DDH. The search was conducted up to May 1, 2025. Data were analyzed using Stata version 15.1. Results A total of 16 studies involving 1,631 pediatric patients (1,941 hips) with DDH following surgery were included. Among them, AVN occurred in 468 hips. Multivariate meta-analysis showed absence of ossific nucleus [OR = 2.60, 95% CI (1.73, 3.91), P = 0.001], IHDI classification grade III/IV [OR = 2.43, 95% CI (1.46,4.03), P = 0.001] and secondary procedures [OR = 2.56, 95% CI (1.02, 6.46), P = 0.046] as independent risk factors for AVN after surgical treatment of DDH in children. Conclusion Based on current evidence, higher grade dislocations, absence of ossific nucleus and secondary procedures are independent risk factors for AVN following surgical treatment of DDH in children. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/recorddashboard , PROSPERO CRD420251135105.
Source: Frontiers in Pediatrics
Authors: Zhuotao Guo, Xingguang Chen, Guoyu Dai, Mingfeng Xue
Institution: Jiaxing University
Language: English
Topic: Hip disorders and treatments
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7154156931