Abstract：
UNASSIGNED: Radiological residual acetabular dysplasia (RAD) has been reported in up to 30% of children who had successful brace treatment of infant developmental dysplasia of the hip (DDH). Predicting those who will resolve and those who may need corrective surgery is important to optimize follow-up protocols. In this study we have aimed to identify the prevalence and predictors of RAD at two years and five years post-bracing.
UNASSIGNED: This was a single-centre, prospective longitudinal cohort study of infants with DDH managed using a published, standardized Pavlik harness protocol between January 2012 and December 2016. RAD was measured at two years\' mean follow-up using acetabular index-lateral edge (AI-L) and acetabular index-sourcil (AI-S), and at five years using AI-L, AI-S, centre-edge angle (CEA), and acetabular depth ratio (ADR). Each hip was classified based on published normative values for normal, borderline (1 to 2 standard deviations (SDs)), or dysplastic (> 2 SDs) based on sex, age, and laterality.
UNASSIGNED: Of 202 infants who completed the protocol, 181 (90%) had two and five years\' follow-up radiographs. At two years, in 304 initially pathological hips, the prevalence of RAD (dysplastic) was 10% and RAD (borderline) was 30%. At five years, RAD (dysplastic) decreased to 1% to 3% and RAD (borderline) decreased to < 1% to 2%. On logistic regression, no variables were predictive of RAD at two years. Only AI-L at two years was predictive of RAD at five years (p < 0.001). If both hips were normal at two years\' follow-up (n = 96), all remained normal at five years. In those with bilateral borderline hips at two years (n = 21), only two were borderline at five years, none were dysplastic. In those with either borderline-dysplastic or bilateral dysplasia at two years (n = 26), three (12%) were dysplastic at five years.
UNASSIGNED: The majority of patients with RAD at two years post-brace treatment, spontaneously resolved by five years. Therefore, children with normal radiographs at two years post-brace treatment can be discharged. Targeted follow-up for those with abnormal AI-L at two years will identify the few who may benefit from surgical correction at five years\' follow-up.
UNASSIGNED: This was a single-centre, prospective longitudinal cohort study of infants with DDH managed using a published, standardized Pavlik harness protocol between January 2012 and December 2016. RAD was measured at two years\' mean follow-up using acetabular index-lateral edge (AI-L) and acetabular index-sourcil (AI-S), and at five years using AI-L, AI-S, centre-edge angle (CEA), and acetabular depth ratio (ADR). Each hip was classified based on published normative values for normal, borderline (1 to 2 standard deviations (SDs)), or dysplastic (> 2 SDs) based on sex, age, and laterality.
UNASSIGNED: Of 202 infants who completed the protocol, 181 (90%) had two and five years\' follow-up radiographs. At two years, in 304 initially pathological hips, the prevalence of RAD (dysplastic) was 10% and RAD (borderline) was 30%. At five years, RAD (dysplastic) decreased to 1% to 3% and RAD (borderline) decreased to < 1% to 2%. On logistic regression, no variables were predictive of RAD at two years. Only AI-L at two years was predictive of RAD at five years (p < 0.001). If both hips were normal at two years\' follow-up (n = 96), all remained normal at five years. In those with bilateral borderline hips at two years (n = 21), only two were borderline at five years, none were dysplastic. In those with either borderline-dysplastic or bilateral dysplasia at two years (n = 26), three (12%) were dysplastic at five years.
UNASSIGNED: The majority of patients with RAD at two years post-brace treatment, spontaneously resolved by five years. Therefore, children with normal radiographs at two years post-brace treatment can be discharged. Targeted follow-up for those with abnormal AI-L at two years will identify the few who may benefit from surgical correction at five years\' follow-up.
摘要：
■据报道，多达30％的儿童成功支撑治疗婴儿发育性髋关节发育不良（DDH）的放射性残余髋臼发育不良（RAD）。预测那些将解决和可能需要矫正手术的人对于优化后续协议很重要。在这项研究中，我们旨在确定支撑后两年和五年RAD的患病率和预测因子。
■这是一个单中心，使用已发表的DDH管理的婴儿的前瞻性纵向队列研究，2012年1月至2016年12月标准化Pavlik线束协议。使用髋臼指数-外侧边缘(AI-L)和髋臼指数-sourcil(AI-S)在平均随访两年时测量RAD,在使用AI-L的五年时间里，AI-S,中心边缘角(CEA),和髋臼深度比（ADR）。每个髋关节都是根据公布的标准值进行分类的，边界线(1到2个标准偏差(SDs))，或基于性别的发育不良(>2个SDs)，年龄,和偏侧性。
■在完成方案的202名婴儿中，181人(90%)接受了两年和五年的随访X光片。两年后,在304个最初的病态臀部中，RAD(发育不良)患病率为10%,RAD(临界)患病率为30%.五年后，RAD(发育不良)降低至1%至3%,RAD(临界)降低至<1%至2%。在逻辑回归中，在2年时没有变量可预测RAD.只有两年的AI-L可以预测五年的RAD（p<0.001）。如果两个臀部在两年的随访中都是正常的（n=96），五年后都保持正常。在那些在两年时(n=21)有双侧临界臀部的人中，五年时只有两个是临界线，都没有发育不良。在那些在两年（n=26）患有临界发育不良或双侧发育不良的患者中，3人（12%）在5年时出现发育不良。
■大多数RAD患者在支架治疗后两年，自发解决了五年。因此,支具治疗后两年X光片正常的儿童可以出院。在两年内对AI-L异常的患者进行有针对性的随访，将确定在五年后可能从手术矫正中受益的少数人。
■这是一个单中心，使用已发表的DDH管理的婴儿的前瞻性纵向队列研究，2012年1月至2016年12月标准化Pavlik线束协议。使用髋臼指数-外侧边缘(AI-L)和髋臼指数-sourcil(AI-S)在平均随访两年时测量RAD,在使用AI-L的五年时间里，AI-S,中心边缘角(CEA),和髋臼深度比（ADR）。每个髋关节都是根据公布的标准值进行分类的，边界线(1到2个标准偏差(SDs))，或基于性别的发育不良(>2个SDs)，年龄,和偏侧性。
■在完成方案的202名婴儿中，181人(90%)接受了两年和五年的随访X光片。两年后,在304个最初的病态臀部中，RAD(发育不良)患病率为10%,RAD(临界)患病率为30%.五年后，RAD(发育不良)降低至1%至3%,RAD(临界)降低至<1%至2%。在逻辑回归中，在2年时没有变量可预测RAD.只有两年的AI-L可以预测五年的RAD（p<0.001）。如果两个臀部在两年的随访中都是正常的（n=96），五年后都保持正常。在那些在两年时(n=21)有双侧临界臀部的人中，五年时只有两个是临界线，都没有发育不良。在那些在两年（n=26）患有临界发育不良或双侧发育不良的患者中，3人（12%）在5年时出现发育不良。
■大多数RAD患者在支架治疗后两年，自发解决了五年。因此,支具治疗后两年X光片正常的儿童可以出院。在两年内对AI-L异常的患者进行有针对性的随访，将确定在五年后可能从手术矫正中受益的少数人。
