The Pavlik harness in the treatment of developmentally dislocated hips: Results of Japanese multicenter studies in 1994 and 2008

Ikuo Wada, Eisuke Sakuma, Takanobu Otsuka, Kenjiro Wakabayashi, Kinya Ito, Osamu Horiuchi, Yoshimi Asagai, Makoto Kamegaya, Eiji Goto, Shinichi Satsuma, Daisuke Kobayashi, Susumu Saito, Mayuki Taketa, Kazuharu Takikawa, Yasuharu Nakashima, Tadashi Hattori, Shigeru Mitani, Akifusa Wada

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: It has already been more than 50 years since the Pavlik harness was introduced in Japan, and today the Pavlik harness is widely recognized as the standard initial treatment modality for developmental dysplasia of the hip. We performed a multicenter nationwide questionnaire study concerning the results of Pavlik harness treatment twice in 1994 and 2008. Methods: In 1994 and in 2008, we sent questionnaires to 12 institutes in Japan specializing mainly in pediatric orthopedics. We compare the results of these two studies and discuss differences in reduction rates, incidence of avascular necrosis in the femoral epiphysis and the percentage of joints with acceptable morphology (Severin grade I + II/total) at skeletal maturity. We statistically assessed these results to see whether there were changes in the treatment outcomes over this 14-year period. Results: Reduction of the dislocated hips was obtained by the Pavlik harness in 80.2 % (1990/2481 hips; 1994) and 81.9 % (1248/1523 hips; 2008). The incidences of avascular necrosis of the proximal femoral epiphysis in the dysplastic hips were 14.3 % (119/835 hips; 1994) and 11.5 % (76/663 hips; 2008). The type of avascular necrosis in hips from the 2008 study was determined according to the classification of Kalamchi and MacEwen: 24/69 hips (34.8 %) were classified as group I; 20/69 hips (29.0 %) as group II; 11/69 hips (15.9 %) as group Ill; 14/69 hips (20.3 %) as group IV. The percentages of hips with acceptable outcomes at skeletal maturity discerned from Severin X-ray changes (grade I + II/total) were 72.3 % (604/835 hips; 1994) and 77.7 % (488/628 hips; 2008). Conclusion: Reduction rates and the incidence of avascular necrosis in 2008 were statistically similar to the results in 1994. The rate of acceptable outcome (Severin grade I + II/total) in 2008 was statistically higher than that of 1994.

Original languageEnglish
Pages (from-to)749-753
Number of pages5
JournalJournal of Orthopaedic Science
Volume18
Issue number5
DOIs
Publication statusPublished - Jan 1 2013

Fingerprint

Multicenter Studies
Hip
Necrosis
Epiphyses
Thigh
Incidence
Japan
Hip Dislocation
Orthopedics
Joints
X-Rays
Pediatrics

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Cite this

The Pavlik harness in the treatment of developmentally dislocated hips : Results of Japanese multicenter studies in 1994 and 2008. / Wada, Ikuo; Sakuma, Eisuke; Otsuka, Takanobu; Wakabayashi, Kenjiro; Ito, Kinya; Horiuchi, Osamu; Asagai, Yoshimi; Kamegaya, Makoto; Goto, Eiji; Satsuma, Shinichi; Kobayashi, Daisuke; Saito, Susumu; Taketa, Mayuki; Takikawa, Kazuharu; Nakashima, Yasuharu; Hattori, Tadashi; Mitani, Shigeru; Wada, Akifusa.

In: Journal of Orthopaedic Science, Vol. 18, No. 5, 01.01.2013, p. 749-753.

Research output: Contribution to journalArticle

Wada, I, Sakuma, E, Otsuka, T, Wakabayashi, K, Ito, K, Horiuchi, O, Asagai, Y, Kamegaya, M, Goto, E, Satsuma, S, Kobayashi, D, Saito, S, Taketa, M, Takikawa, K, Nakashima, Y, Hattori, T, Mitani, S & Wada, A 2013, 'The Pavlik harness in the treatment of developmentally dislocated hips: Results of Japanese multicenter studies in 1994 and 2008', Journal of Orthopaedic Science, vol. 18, no. 5, pp. 749-753. https://doi.org/10.1007/s00776-013-0432-z
Wada, Ikuo ; Sakuma, Eisuke ; Otsuka, Takanobu ; Wakabayashi, Kenjiro ; Ito, Kinya ; Horiuchi, Osamu ; Asagai, Yoshimi ; Kamegaya, Makoto ; Goto, Eiji ; Satsuma, Shinichi ; Kobayashi, Daisuke ; Saito, Susumu ; Taketa, Mayuki ; Takikawa, Kazuharu ; Nakashima, Yasuharu ; Hattori, Tadashi ; Mitani, Shigeru ; Wada, Akifusa. / The Pavlik harness in the treatment of developmentally dislocated hips : Results of Japanese multicenter studies in 1994 and 2008. In: Journal of Orthopaedic Science. 2013 ; Vol. 18, No. 5. pp. 749-753.
@article{b00c940f17974ea79d598efffe33bfc7,
title = "The Pavlik harness in the treatment of developmentally dislocated hips: Results of Japanese multicenter studies in 1994 and 2008",
abstract = "Background: It has already been more than 50 years since the Pavlik harness was introduced in Japan, and today the Pavlik harness is widely recognized as the standard initial treatment modality for developmental dysplasia of the hip. We performed a multicenter nationwide questionnaire study concerning the results of Pavlik harness treatment twice in 1994 and 2008. Methods: In 1994 and in 2008, we sent questionnaires to 12 institutes in Japan specializing mainly in pediatric orthopedics. We compare the results of these two studies and discuss differences in reduction rates, incidence of avascular necrosis in the femoral epiphysis and the percentage of joints with acceptable morphology (Severin grade I + II/total) at skeletal maturity. We statistically assessed these results to see whether there were changes in the treatment outcomes over this 14-year period. Results: Reduction of the dislocated hips was obtained by the Pavlik harness in 80.2 {\%} (1990/2481 hips; 1994) and 81.9 {\%} (1248/1523 hips; 2008). The incidences of avascular necrosis of the proximal femoral epiphysis in the dysplastic hips were 14.3 {\%} (119/835 hips; 1994) and 11.5 {\%} (76/663 hips; 2008). The type of avascular necrosis in hips from the 2008 study was determined according to the classification of Kalamchi and MacEwen: 24/69 hips (34.8 {\%}) were classified as group I; 20/69 hips (29.0 {\%}) as group II; 11/69 hips (15.9 {\%}) as group Ill; 14/69 hips (20.3 {\%}) as group IV. The percentages of hips with acceptable outcomes at skeletal maturity discerned from Severin X-ray changes (grade I + II/total) were 72.3 {\%} (604/835 hips; 1994) and 77.7 {\%} (488/628 hips; 2008). Conclusion: Reduction rates and the incidence of avascular necrosis in 2008 were statistically similar to the results in 1994. The rate of acceptable outcome (Severin grade I + II/total) in 2008 was statistically higher than that of 1994.",
author = "Ikuo Wada and Eisuke Sakuma and Takanobu Otsuka and Kenjiro Wakabayashi and Kinya Ito and Osamu Horiuchi and Yoshimi Asagai and Makoto Kamegaya and Eiji Goto and Shinichi Satsuma and Daisuke Kobayashi and Susumu Saito and Mayuki Taketa and Kazuharu Takikawa and Yasuharu Nakashima and Tadashi Hattori and Shigeru Mitani and Akifusa Wada",
year = "2013",
month = "1",
day = "1",
doi = "10.1007/s00776-013-0432-z",
language = "English",
volume = "18",
pages = "749--753",
journal = "Journal of Orthopaedic Science",
issn = "0949-2658",
publisher = "Springer Japan",
number = "5",

}

TY - JOUR

T1 - The Pavlik harness in the treatment of developmentally dislocated hips

T2 - Results of Japanese multicenter studies in 1994 and 2008

AU - Wada, Ikuo

AU - Sakuma, Eisuke

AU - Otsuka, Takanobu

AU - Wakabayashi, Kenjiro

AU - Ito, Kinya

AU - Horiuchi, Osamu

AU - Asagai, Yoshimi

AU - Kamegaya, Makoto

AU - Goto, Eiji

AU - Satsuma, Shinichi

AU - Kobayashi, Daisuke

AU - Saito, Susumu

AU - Taketa, Mayuki

AU - Takikawa, Kazuharu

AU - Nakashima, Yasuharu

AU - Hattori, Tadashi

AU - Mitani, Shigeru

AU - Wada, Akifusa

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Background: It has already been more than 50 years since the Pavlik harness was introduced in Japan, and today the Pavlik harness is widely recognized as the standard initial treatment modality for developmental dysplasia of the hip. We performed a multicenter nationwide questionnaire study concerning the results of Pavlik harness treatment twice in 1994 and 2008. Methods: In 1994 and in 2008, we sent questionnaires to 12 institutes in Japan specializing mainly in pediatric orthopedics. We compare the results of these two studies and discuss differences in reduction rates, incidence of avascular necrosis in the femoral epiphysis and the percentage of joints with acceptable morphology (Severin grade I + II/total) at skeletal maturity. We statistically assessed these results to see whether there were changes in the treatment outcomes over this 14-year period. Results: Reduction of the dislocated hips was obtained by the Pavlik harness in 80.2 % (1990/2481 hips; 1994) and 81.9 % (1248/1523 hips; 2008). The incidences of avascular necrosis of the proximal femoral epiphysis in the dysplastic hips were 14.3 % (119/835 hips; 1994) and 11.5 % (76/663 hips; 2008). The type of avascular necrosis in hips from the 2008 study was determined according to the classification of Kalamchi and MacEwen: 24/69 hips (34.8 %) were classified as group I; 20/69 hips (29.0 %) as group II; 11/69 hips (15.9 %) as group Ill; 14/69 hips (20.3 %) as group IV. The percentages of hips with acceptable outcomes at skeletal maturity discerned from Severin X-ray changes (grade I + II/total) were 72.3 % (604/835 hips; 1994) and 77.7 % (488/628 hips; 2008). Conclusion: Reduction rates and the incidence of avascular necrosis in 2008 were statistically similar to the results in 1994. The rate of acceptable outcome (Severin grade I + II/total) in 2008 was statistically higher than that of 1994.

AB - Background: It has already been more than 50 years since the Pavlik harness was introduced in Japan, and today the Pavlik harness is widely recognized as the standard initial treatment modality for developmental dysplasia of the hip. We performed a multicenter nationwide questionnaire study concerning the results of Pavlik harness treatment twice in 1994 and 2008. Methods: In 1994 and in 2008, we sent questionnaires to 12 institutes in Japan specializing mainly in pediatric orthopedics. We compare the results of these two studies and discuss differences in reduction rates, incidence of avascular necrosis in the femoral epiphysis and the percentage of joints with acceptable morphology (Severin grade I + II/total) at skeletal maturity. We statistically assessed these results to see whether there were changes in the treatment outcomes over this 14-year period. Results: Reduction of the dislocated hips was obtained by the Pavlik harness in 80.2 % (1990/2481 hips; 1994) and 81.9 % (1248/1523 hips; 2008). The incidences of avascular necrosis of the proximal femoral epiphysis in the dysplastic hips were 14.3 % (119/835 hips; 1994) and 11.5 % (76/663 hips; 2008). The type of avascular necrosis in hips from the 2008 study was determined according to the classification of Kalamchi and MacEwen: 24/69 hips (34.8 %) were classified as group I; 20/69 hips (29.0 %) as group II; 11/69 hips (15.9 %) as group Ill; 14/69 hips (20.3 %) as group IV. The percentages of hips with acceptable outcomes at skeletal maturity discerned from Severin X-ray changes (grade I + II/total) were 72.3 % (604/835 hips; 1994) and 77.7 % (488/628 hips; 2008). Conclusion: Reduction rates and the incidence of avascular necrosis in 2008 were statistically similar to the results in 1994. The rate of acceptable outcome (Severin grade I + II/total) in 2008 was statistically higher than that of 1994.

UR - http://www.scopus.com/inward/record.url?scp=84885470209&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885470209&partnerID=8YFLogxK

U2 - 10.1007/s00776-013-0432-z

DO - 10.1007/s00776-013-0432-z

M3 - Article

C2 - 23812768

AN - SCOPUS:84885470209

VL - 18

SP - 749

EP - 753

JO - Journal of Orthopaedic Science

JF - Journal of Orthopaedic Science

SN - 0949-2658

IS - 5

ER -