Data Sheet 1_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.docx

ObjectiveThis 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.
MethodsWe 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.
ResultsA total of 16 studies involving 1,631 pediatric patients (1,941 hips) with DDH following surgery were included. Among them, AVN occurred in 468 hips. Multivariate meta-analysis showed absence of ossific nucleus [OR = 2.60, 95% CI (1.73, 3.91), P = 0.001], IHDI classification grade III/IV [OR = 2.43, 95% CI (1.46,4.03), P = 0.001] and secondary procedures [OR = 2.56, 95% CI (1.02, 6.46), P = 0.046] as independent risk factors for AVN after surgical treatment of DDH in children.
ConclusionBased 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 Registrationhttps://www.crd.york.ac.uk/PROSPERO/recorddashboard, PROSPERO CRD420251135105.