Hip arthroplasty for bilateral pathologic hip dislocation in children

BACKGROUND: Pathologic hip dislocation is a severe complication of septic arthritis and hematogenous osteomyelitis of the proximal femoral metaphysis in young children. Bilateral involvement of the hip joints results in more severe anatomical and functional impairments, requiring greater treatment efforts. In such cases, rehabilitation may take years and involves staged surgical correction and continuous conservative management. Meeting these requirements is crucial, as insufficient or inadequate treatment may result in contractures, restricted hip mobility, and progression of secondary deformities. AIM: To analyze the outcomes of surgical treatment in children with bilateral pathologic hip dislocations treated with hip arthroplasty using demineralized osteochondral allografts and highlight rehabilitation aspects required to achieve favorable short- and long-term postoperative outcomes. METHODS: Surgical outcomes in 11 children (22 hip joints) aged 1.5–10 years with bilateral destructive pathologic hip dislocations who underwent hip arthroplasty using demineralized osteochondral allografts were analyzed. RESULTS: Long-term follow-up (1–12 years) demonstrated radiologically confirmed joint stability in 86.4% of cases and preservation of at least 80 of hip flexion range. CONCLUSION: Hip arthroplasty with demineralized osteochondral allografts in children with destructive pathologic hip dislocations is an effective method for restoring hip joint function, providing stability and preserving range of motion over the long term. A consistent, systematic, and comprehensive treatment approach is critical for successful rehabilitation and for restoration and long-term preservation of hip function in children with bilateral hip involvement.