Gait Parameters Associated With Untreated Developmental Dysplasia Of The Hip: A Systematic Review

Developmental dysplasia of the hip (DDH) has been linked to functional disability and altered gait patterns in adults. However, specific gait alterations in patients with DDH are unclear. The objective of this study is to investigate gait parameters associated with untreated DDH in otherwise healthy adults. Electronic databases (PubMed and Embase) were searched systematically for articles reporting the gait patterns in patients with untreated DDH. Outcome measures assessed included spatiotemporal parameters, lower limb kinematics and kinetics, plantar pressure and electromyogram (EMG). Four studies were included consisting of 76 patients and 99 healthy controls. The quality of the studies varied, with Quality Index scores ranging from 9 to 15 out of a possible 17. Three-dimensional gait analysis and a repeated measures design were used in all included studies. Results revealed that patients with untreated DDH walked more slowly with shorter steps compared with controls. The untreated DDH patients also demonstrated a lower value of the maximum hip flexion angle, hip extension angle and external hip flexion moment in the diseased limb. Meanwhile, lots of gait parameters have been shown to correlate with the Harris Hip score. No included study attempt to investigate the dynamic EMG and plantar pressure parameters in patients with untreated DDH. Current evidence suggests the existence of specific gait deviations in patients with untreated DDH. Definitive conclusions are hampered by the heterogeneous nature of the participants and small sample sizes of the included studies. Future well-designed studies with a large sample size on this topic are warranted.