Risk factors for avascular necrosis of the femoral head after surgical treatment of developmental dysplasia of the hip in children: a systematic review and meta-analysis

Objective: This study aims to explore the risk factors for avascular necrosis (AVN) in children with developmental dysplasia of the hip (DDH) after surgical reduction through systematic review and meta-analysis. Methods: We searched PubMed, Embase, Cochrane Library, and Web of Science for studies investigating risk factors for postoperative AVN in children with DDH. The search was conducted up to May 1, 2025. Data were analyzed using Stata version 15.1. Results: = 0.046] as independent risk factors for AVN after surgical treatment of DDH in children. Conclusion: Based on current evidence, higher grade dislocations, absence of ossific nucleus and secondary procedures are independent risk factors for AVN following surgical treatment of DDH in children. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/recorddashboard, PROSPERO CRD420251135105.