Residual gait deviations in adolescents treated during infancy for unilateral developmental dysplasia of the hip using Pemberton's osteotomy

Early reduction using Pemberton's osteotomy has been suggested for treating DDH but no data on the long-term residual gait changes in such patients are available in the literature. This study aimed to bridge the gap by performing quantitative gait analysis on eleven females (age: 10.6 ± 1.0 years) who were treated for unilateral DDH using open reduction with Pemberton's osteotomy at 1.6 ± 0.5 years of age, and eleven age-matched healthy controls. Walking at a normal speed, the Pemberton group displayed significantly more anterior tilt, hiking at the affected side and rotation towards the unaffected side of the pelvis, and more knee flexion and ankle dorsiflexion in the affected limb. With this asymmetrical gait, they appeared to reduce the demands on the hip flexors and abductors, and knee extensors in the affected limb, which might have been involved during the osteotomy, but increased compensatory efforts from the hip extensors, ankle plantarflexors and knee flexors in the unaffected limb.

► Residual gait deviations were found in adolescents treated during infancy for DDH. ► Pelvic deviations were the major contributor to the residual gait changes. ► These gait changes increased loading rates at both affected and unaffected hips.