Impact of Multiple Factors on the Incidence of Developmental Dysplasia of the Hip: Risk Assessment Tool

Abstract

Background and Objectives: Developmental dysplasia of the hip (DDH) is one of the most common musculoskeletal conditions in children. If not treated, it leads to disability, gait abnormalities, limb shortening, and chronic pain. Our study aims to determine the impact of multiple risk factors on the incidence of DDH and to develop an interactive risk assessment tool. Materials and Methods: We conducted a retrospective cohort study in the Outpatient Clinic for Children of the Medical University of Warsaw Hospital. The Graf classification system was used for universal ultrasonographic screening. In total, 3102 infants met the eligibility criteria. Results: The incidence of DDH in the study group was 4.45%. The incidence of DDH in the Warsaw population, Poland, during the study period was 3.73 to 5.17 (95% CI). According to the multivariate analysis, the risk factors for DDH were birth weight (OR = 2.17 (1.41–3.32)), week of delivery (OR = 1.18 (1.00–1.37)), female sex (OR = 8.16 (4.86–13.71)), breech presentation (OR = 5.92 (3.37–10.40)), physical signs of DDH (25.28 (8.77–72.83)) and positive family history in siblings (5.74 (2.68–12.31)). Our results support the recent hypothesis that preterm infants (<37 weeks) have a lower rate of DDH. Conclusions: A multivariate logistic regression predictive model was used to build the risk calculator. The DDH risk calculator will be evaluated in a prospective validation study.

A Novel Technique for Autograft Preparation Using Patient-Specific Instrumentation (PSI) Assistance in Total Hip Arthroplasty in Developmental Dysplasia of Hip (DDH)

“…Several studies demonstrate the epidemiology of DDH. The incidence of DDH varies from an average of 0.006% in Africans in Africa in the period 1966–1977, 0.076% in Japan in 2011–2013, 4.45% in Poland in 2013–2018, and 7.6% in Native Americans in 1950–1982 due to ethnicity, race, age of the population, diagnostic criteria, and screening protocol (physical examination, X-ray, or ultrasound) [ 16 , 17 , 18 ].…”

“…The patients suited for this study are all females, which is one of the risk factors for DDH. The known risk factors also include firstborn, breech position, family history of hip abnormalities, oligohydramnios, macrosomia, limited hip abduction, talipes, and swaddling [ 18 ]. DDH appears more common in females with a female-to-male ratio of 6:1 [ 19 ].…”

Screening of Developmental Dysplasia of the Hip in Europe: A Systematic Review

“…There are no official guidelines or recommendations for DDH screening in Poland. The initial ultrasound is typically conducted within the first 1 to 12 weeks after birth [47].…”

“…In the study by Pulik et al [47], universal ultrasound screening was performed. The authors recommended the first ultrasound at 6 weeks of life or in case of a positive physical examination, which included hip orthopaedic examinations and general examinations (performed at birth) or present risk factors (female sex, caesarean section, breech presentation, family history, and physical signs) in the first weeks of life.…”

The importance of systematic rehabilitation over 45 years of a patient with developmental dysplasia of the hip joint (case study)

“…Pregnancy hormones have a relaxing effect on the ligaments, which in physiological conditions strengthen the walls of the joint capsule [3,4]. The most common symptoms of hip dislocation include: the absence of the femoral head in the acetabulum, which can www.fizjoterapiapolska.pl be felt by palpation: at the intersection of the femoral vessels with the inguinal ligament, the shift of the femoral trochanter above the line connecting the ischial tubercle with the anterior superior iliac spine, the socalled the Roser-Nelaton line; shortening of the relative length of the limb (measured from the anterior superior iliac spine to the medial malleolus), asymmetry of the gluteal folds, significant limitation of abduction and external rotation movements in the hip joint, positive pumping sign (moving of the thigh along the pelvic axis), positive Allis (Galleazzi) sign characterized by the asymmetry of the position of the horizontal line above the bent knee joints in the chair position, raised lower limbs, the child lying on his back (hips and knees bent to the angle of 90 degrees) [5]. Nowadays, the progress of technology in the fields of medicine gives us access to a variety of diagnostic imaging tests, in particular the popular and already obligatory prelux examination using ultrasound.…”