Developmental dysplasia of the hip: Impact of sonographic newborn hip screening on the outcome of early treated decentered hip joints—a single center retrospective comparative cohort study based on Graf's method of hip ultrasonography

Tschauner, Christian; Fürntrath, Frank; Saba, Yasaman; Berghold, Andrea; Radl, Roman

doi:10.1007/s11832-011-0366-y

Cited by 50 publications

(37 citation statements)

References 51 publications

(76 reference statements)

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“…In Norway, it has been estimated that 9% of all primary hip replacements are caused by DDH [19]. Our study’s successful treatment and follow-up strategy is supported by a recent publication by Tschauner et al that concluded that “ultrasound screening based-treatment of decentered hip joints has become safer, shorter and simpler: ‘‘safer’’ means lower rate of avascular necrosis, ‘‘shorter’’ means less treatment time due to earlier onset and ‘‘simpler’’ means that the devices are now less invasive and highly standardized” [20]. …”

Section: Discussionsupporting

confidence: 57%

Incidence and Treatment of Developmental Hip Dysplasia in Mongolia: A Prospective Cohort Study

et al. 2013

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BackgroundIn Mongolia, adequate early diagnosis and treatment of developmental hip dysplasia (DDH) have been unavailable and its incidence was unknown. We determined the incidence of ultrasonographic DDH in newborns and established adequate procedures for diagnosis and treatment of DDH at the largest maternity hospital in Ulaanbaatar, Mongolia.Methodology/Principal FindingsDuring one year (Sept 2010 – Aug 2011) we assessed the hips newborns using ultrasound and Graf’s classification of DDH. 8,356 newborns were screened; median age at screening was 1 day. We identified 14,873 Type 1 (89.0%), 1715 Type 2a (10.3%), 36 Type 2c (0.2%), 70 Type D (0.4%), 14 Type 3 (0.08%), and 4 Type 4 hips (0.02%). Children with Type 1 hips (normal) were discharged. Children with Type 2a hips (physiologically immature) received follow-up ultrasounds at monthly intervals. Children with Type 2c to 4 (DDH; deformed or misaligned hip joint) hips were treated with a Tubingen hip flexion splint and also followed up. The hip abnormalities resolved to mature hips in all children who were followed up. There was no evidence for severe treatment related complications.Conclusion/SignificanceThis study suggests that the incidence of DDH in Mongolian neonates is comparable to that in neonates in Europe. Early ultrasound-based assessment and splinting treatment of DDH led to mature hips in all children followed up. Procedures are feasible and will be continued.

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Section: Discussionsupporting

confidence: 57%

Incidence and Treatment of Developmental Hip Dysplasia in Mongolia: A Prospective Cohort Study

et al. 2013

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“…The increase in late DDH cases in Australia and abroad contrasts with the experience of centres that practise universal ultrasound screening of all neonates 1 , 2 . Evidence for the value of universal ultrasound screening includes reduced rates of surgery, hospitalisation, and late diagnoses in screened children 1 , 2 . A variety of ultrasound methods have been successfully employed for screening, and, although variation in interpretation has been reported, this tends to occur with degrees of dysplasia of lesser clinical relevance 23 .…”

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 95%

“…Late diagnosed DDH is considered a significant public health issue because late diagnosis and treatment is associated with a lower likelihood of success, higher rates of surgery, increased complications (such as avascular necrosis of the femoral head 1 , 2 ), and increased health care costs, including those associated with hospital admission, general anaesthesia, and the fact that 44% of such patients require major operative procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Early detection and treatment of developmental dysplasia of the hip (DDH) in newborns is important because late diagnosis (later than 3 months of age) is associated with a significant risk of poorer outcomes. This includes increased likelihood of surgery, more invasive surgical procedures, longer hospital stays, and early osteoarthritis of the hip, as well as increased health care costs 1 , 2 …”

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confidence: 99%

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Increase in late diagnosed developmental dysplasia of the hip in South Australia: risk factors, proposed solutions

Studer

Williams

Antoniou

et al. 2016

Medical Journal of Australia

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Using 3‐dimensional ultrasound islice technology for the diagnosis of developmental dysplasia of the hip

Geng

Zhan

et al. 2019

J of Ultrasound Medicine

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Objectives-This study aimed to investigate the reliability of 3-dimensional (3D) ultrasound in screening for developmental dysplasia of the hip (DDH) by comparing the results with those of 2-dimensional (2D) ultrasound.Methods-One hundred five infants who were younger than 6 months were enrolled in this study. All of the infants underwent 2D and 3D ultrasound scanning for DDH by novices and experts, and the images were graded by a lead expert. The scanning time and image grades were analyzed by Student t tests (P < .05). The consistency of the α angle measurement between the novices and experts was evaluated by the intraclass correlation coefficient (ICC).Results-The 105 infants included 34 boys and 71 girls. On 2D scanning, there was agreement between the experts about the correct diagnosis, whereas in the novice group, 41 infants had misdiagnoses. There were no misdiagnoses with 3D scanning in either group. In the novice group, the mean image grades AE SD were 4.2 AE 1.3 (2D ultrasound) and 8.1 AE 0.7 (3D ultrasound; P < .05). In the expert group, the mean image grades were 7.4 AE 1.0 (2D ultrasound) and 8.2 AE 1.0 (3D ultrasound; P < .05). There was no statistically significant difference between the groups in the grades for 3D ultrasound (P = .83). The scanning time for 3D ultrasound was shorter than that for 2D ultrasound in both groups (P < .05). In the novice group, the ICC of the α angle between the 2D and 3D ultrasound results was 0.34, and in the expert group, it was 0.92. The ICCs were 0.35 and 0.84, respectively when comparing 2D and 3D ultrasound results in the groups.Conclusions-Three-dimensional ultrasound required less time and showed greater inter-rater reliability than 2D ultrasound for detecting DDH.

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Developmental dysplasia of the hip: Impact of sonographic newborn hip screening on the outcome of early treated decentered hip joints—a single center retrospective comparative cohort study based on Graf's method of hip ultrasonography

Cited by 50 publications

References 51 publications

Incidence and Treatment of Developmental Hip Dysplasia in Mongolia: A Prospective Cohort Study

Incidence and Treatment of Developmental Hip Dysplasia in Mongolia: A Prospective Cohort Study

Increase in late diagnosed developmental dysplasia of the hip in South Australia: risk factors, proposed solutions

Using 3‐dimensional ultrasound islice technology for the diagnosis of developmental dysplasia of the hip

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