Developmental Dysplasia of the Hip: An Examination of Care Practices of Orthopaedic Surgeons in India

Hooper, N.; Aroojis, Alaric; Narasimhan, Ramani; Schaeffer, Emily K.; Habib, Eva; Wu, Junzhou; Taylor, Isabel K; Burlile, Jessica; Agrawal, Aniruddh; Shea, Kevin G.; Mulpuri, Kishore

doi:10.1007/s43465-020-00233-0

Cited by 11 publications

(4 citation statements)

References 32 publications

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“…[29] In India, even though only 30% of institutions follow an international standard care pathway, most physicians support their own implemented care pathway that is multidisciplinary, involving orthopedic surgeons and enhancing the skills of their local practitioners. [30] The present study had several limitations. Firstly, our results are limited to a small convenience sample of PCPs from a single institution primary care health centers in Riyadh and cannot be generalized to reflect the greater population of physicians involved in the screening and management of DDH.…”

Section: Discussionmentioning

confidence: 82%

Knowledge, attitude, and practice of primary care physicians about developmental dysplasia of the hip in a tertiary referral hospital in Riyadh, Saudi Arabia

Alotaibi

Jawadi

Alghamdi

et al. 2021

JMSR

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Objectives: The aim of the study was to determine the current knowledge, attitude, and practice of developmental dysplasia of the hip (DDH) management among primary care physicians (PCP) in Saudi Arabia. Methods: A cross-sectional study on PCP from a single health-care system in Riyadh, Saudi Arabia, was conducted using a survey questionnaire to evaluate the medical knowledge, attitude, and current practice in the clinics, including diagnosis and screening skills. Results: Sixty-five PCPs participated in the survey, 32 (49.2%) were general practitioners and 33 (50.8%) were fellows and consultants. Only six physicians (9.2%) had formal training on DDH management. Twenty respondents (30.8%) had poor knowledge, while 45 (69.2%) had sufficient knowledge of DDH. Most of the respondents believed in the importance of asking about risk factors, the presence of DDH screening protocols and community awareness, and 89.2% of the respondents believed they need to go for further training about DDH. Fifty-nine respondents (90.8%) would refer a DDH case to an orthopedic surgeon when there are positive findings by a radiograph or ultrasound. Forty-two (64.6%) never examined the hip for DDH, and 30 (46.2%) never referred a DDH case. Conclusion: Knowledge of DDH among our PCP directly involved in the screening and management of DDH is sufficient. However, there is a discordance between knowledge to attitude and practice.

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Section: Discussionmentioning

confidence: 82%

Knowledge, attitude, and practice of primary care physicians about developmental dysplasia of the hip in a tertiary referral hospital in Riyadh, Saudi Arabia

Alotaibi

Jawadi

Alghamdi

et al. 2021

JMSR

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“…However, despite combining clinical neonatal screening, use of selective USG screening and a 6-8 wk check, Talbot et al 26 reported late presentations and hence advocated more screening examination down the line. Various strategies to reduce the detection and treatment delay are summarized in Table IV 3 , 4 , 12 , 15 , 18 , 20 , 26 - 34 .…”

Section: Discussionmentioning

confidence: 99%

Causes of late-presenting developmental dislocation of the hip beyond 12 months of age: A pilot study

Pandey,

Johari,

Mahapatra

et al. 2023

Indian J Med Res

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Background & objectives: Developmental dysplasia of the hip (DDH), when detected early, can usually be managed effectively by simple methods. A delayed diagnosis often makes it a complex condition to treat. Late presentation of DDH is fairly common in developing countries, and there is scarcity of literature regarding the epidemiology and reason for late presentation. Through this study, we attempted to identify the reasons for late presentation of DDH in children more than 12 months of age. Methods: Fifty four children with typical DDH and frank dislocation of hip in whom treatment was delayed for 12 months or more were included. Parents were interviewed with a pre-structured questionnaire and data were collected for analysis with Microsoft Excel 2016 and SPSS version 26. Results: Diagnostic delay was the most common reason for late presentation and was observed in 52 children (96.2%). The mean age at diagnosis was 24.7 months. The mean age at treatment was 37.3 months with a mean delay of 12.5 months from diagnosis and 22.1 months from initial suspicion. Physician-related factors contributed 55.3 per cent, while family and social issues accounted for 44.7 per cent of overall reasons for diagnostic and treatment delays. Interpretation & conclusions: Late presentation of DDH in walking age is common. Physician- and family-related factors accounted for most of these cases. Failure or inadequate hip screening at birth by the attending physician is a common reason for late diagnosis. The family members were unaware about the disorder and developed suspicion once child started walking with an abnormal gait.

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“…Surgical options for older children include closed/open reduction, osteotomy, or arthroscopy, aiming to normalize femoral head coverage and address labral injury. Surgical selection considers age, CE angle, and OA grade for optimal outcomes [ 51 ].…”

Section: Treatment Of Underlying Causesmentioning

confidence: 99%

Therapie chondraler und osteochondraler Läsionen der Hüfte

Itha,

Vaishya,

Vaish

et al. 2023

Orthopädie

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Chondral and osteochondral lesions encompass several acute or chronic defects of the articular cartilage and/or subchondral bone. These lesions can result from several different diseases and injuries, including osteochondritis dissecans, osteochondral defects, osteochondral fractures, subchondral bone osteonecrosis, and insufficiency fractures. As the cartilage has a low capacity for regeneration and self-repair, these lesions can progress to osteoarthritis. This study provides a comprehensive overview of the subject matter that it covers. PubMed, Scopus and Google Scholar were accessed using the following keywords: “chondral lesions/defects of the femoral head”, “chondral/cartilage lesions/defects of the acetabulum”, “chondral/cartilage lesions/defects of the hip”, “osteochondral lesions of the femoral head”, “osteochondral lesions of the acetabulum”, “osteochondral lesions of the hip”, “osteochondritis dissecans,” “early osteoarthritis of the hip,” and “early stage avascular necrosis”. Hip osteochondral injuries can cause significant damage to the articular surface and diminish the quality of life. It can be difficult to treat such injuries, especially in patients who are young and active. Several methods are used to treat chondral and osteochondral injuries of the hip, such as mesenchymal stem cells and cell-based treatment, surgical repair, and microfractures. Realignment of bony anatomy may also be necessary for optimal outcomes. Despite several treatments being successful, there is a lack of head-to-head comparisons and large sample size studies in the current literature. Additional research will be required to provide appropriate clinical recommendations for treating chondral/osteochondral injuries of the hip joint.

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Developmental Dysplasia of the Hip: An Examination of Care Practices of Orthopaedic Surgeons in India

Cited by 11 publications

References 32 publications

Knowledge, attitude, and practice of primary care physicians about developmental dysplasia of the hip in a tertiary referral hospital in Riyadh, Saudi Arabia

Knowledge, attitude, and practice of primary care physicians about developmental dysplasia of the hip in a tertiary referral hospital in Riyadh, Saudi Arabia

Causes of late-presenting developmental dislocation of the hip beyond 12 months of age: A pilot study

Therapie chondraler und osteochondraler Läsionen der Hüfte

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