Some patients with developmental dysplasia of the hip (DDH) before 6 months of age successfully treated by Pavlik Harness (PH) still had persistent acetabular dysplasia (PAD). This study aimed to investigate the incidence and risk factors for PAD in patients with DDH treated by PH. We retrospectively reviewed the data of 89 patients (109 hips; mean age, 3.2 ± 1.5 months) with DDH treated by PH. Prior to treatment, all patients underwent ultrasound examination and classified according to Graf’s method. PH was terminated once the hip achieved imaging recovery criteria. At final follow-up, the acetabular index (AI), center-edge angle (CEA) of Wiberg were measured on radiograph. Overall, 67/109 hips (61.5%) had successful PH treatment. Among these 67 hips, 58 hips (86.6%) achieved satisfactory outcome, nine (13.4%) had PAD. Age of the patients with PAD (4.3 ± 1 months) was significantly higher than those without PAD (2.8 ± 1.5 months) (P = 0.001). Hips with PAD had higher mean Graf grade than those with satisfactory outcome (P = 0.014). Logistic regression-confirmed age and Graf classification were risk factors for PAD. Overall, 55/67 (82.1%) met imaging recovery criteria to stop PH treatment, whereas 12/67 hips (17.9%) did not. The rate of PAD at final follow-up in patients achieving recovery criteria (4/55; 7.3%) was significantly lower than those not achieving it (41.7%) (P = 0.007). In conclusion, age and Graf classification are risk factors for PAD. If hips are not normal at the end of PH treatment, the risk of PAD increases further.

一些 6 月龄前患有发育性髋关节发育不良 (DDH) 的患者经 Pavlik Harness (PH) 成功治疗后，仍患有持续性髋臼发育不良 (PAD)。本研究旨在探讨接受 PH 治疗的 DDH 患者 PAD 的发生率和危险因素。我们回顾性分析了 89 例接受 PH 治疗的 DDH 患者（109 髋；平均年龄，3.2 ± 1.5 个月）的数据。治疗前，所有患者均接受超声检查并根据Graf方法进行分类。一旦髋关节达到成像恢复标准，PH 就终止。最终随访时，在X线照片上测量Wiberg的髋臼指数（AI）、中心边缘角（CEA）。总体而言，67/109 髋 (61.5%) 的 PH 治疗取得了成功。在这67个髋关节中，58个髋关节（86.6%）获得满意的结果，9个髋关节（13.4%）患有PAD。患有PAD的患者年龄（4.3±1个月）显着高于非PAD患者的年龄（2.8±1.5个月）（P =0.001）。患有 PAD 的髋部的平均 Graf 等级高于那些结果满意的髋部 ( P = 0.014)。Logistic 回归证实年龄和 Graf 分类是 PAD 的危险因素。总体而言，55/67 (82.1%) 的髋关节符合停止 PH 治疗的影像学恢复标准，而 12/67 的髋关节 (17.9%) 则没有。最终随访时达到恢复标准的患者的 PAD 发生率 (4/55; 7.3%) 显着低于未达到恢复标准的患者 (41.7%) ( P = 0.007)。总之，年龄和 Graf 分级是 PAD 的危险因素。如果 PH 治疗结束时髋部不正常，则 PAD 的风险进一步增加。