Assessment and Management of Residual Acetabular Dysplasia from Age 1 to 5 Years: Defining Normal Acetabular Index Values and Indications for Treatment.

» Persistent abnormal acetabular index values (>25-30° at 4-5 years or > 35° at 2 years of postreduction) may predict poor outcomes and indicate the need for pelvic osteotomy.» Assessment of the acetabular cartilaginous morphology and cartilaginous coverage of the femoral head by magnetic resonance imaging may assist in guiding surgical decisions.» Earlier pelvic osteotomy leverages remodeling potential, but observation until 4 to 5 years may be preferred to minimize risks and allow spontaneous correction.» Routine monitoring is crucial for stable, dysplastic hips, focusing on acetabular index trends over time.» Shared decision-making with families is essential to balance the risks of residual dysplasia and the likelihood of secondary procedures.