Results of universal ultrasound screening for developmental dysplasia of the hip

Biedermann, R.; Riccabona, Jakob R.; Giesinger, Johannes; Brunner, Andrea; Liebensteiner, Michael; Wansch, Jürgen; Dammerer, Dietmar; Nogler, Michaël

doi:10.1302/0301-620x.100b10.bjj-2017-1539.r2

Cited by 60 publications

(69 citation statements)

References 24 publications

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“…Wie bereits durch den Begründer des Säuglingshüftultraschalls festgehalten, ist eine sonografische Ausreifung der Hüfte jedoch auch mit einem sehr guten knöchernen Reifungsprozess der Hüften assoziiert [18]. Deshalb ist die flächendeckende Hüftultraschalluntersuchung der Säuglingshüfte mit entsprechender therapeutischer Konsequenz in den vergangenen 20 Jahren ein Garant für eineim Vergleich zu Ländern ohne Screeningmaßnahmegeringere Prävalenz adulter dysplastischer Hüften und Notwendigkeit diesbezüglicher operativer Maßnahmen geworden [3,19,20].…”

Section: Diskussionunclassified

Closed Reduction as Therapeutic Gold Standard for Treatment of Congenital Hip Dislocation

et al. 2019

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Background Congenital hip dislocation (luxation) has an incidence of 0.4 – 0.7% and is regarded as a prearthrotic deformity. Thus, if not being diagnosed and treated at a very early age, extensive surgical measures are inevitable in childhood and early adulthood. Methods In the time between 01/2013 and 02/2019 we performed 28 600 hips sonographies in babies as part of general screening measures at U2 or U3. There were 71 instable, dysplastic or dislocated hips diagnosed that were treated by arthrographic, closed reduction. After a hip spica cast was applied, reposition was controlled by MRI, estimating the acetabular head index (ACI), the head coverage index (HCI) as well as the femoral headʼs sphericity or by sonography using the Graf method. Results Overall success rate was 91.6% for primary closed reduction. Patients with primarily irreducible hips were significantly older (p < 0.003) than patients with primarily successful reducible hips. Congenital dislocated hips had significantly higher ACIs (p < 0.001) and HCIs (p = 0.03) as well as significantly less well rounded femoral heads (sphericity; p < 0.001) compared to stable hips. Conclusion Early diagnosis and treatment of congenital dislocated hips by closed reduction is essential for a sufficient and regular maturation of the hips without further surgical interventions.

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Section: Diskussionunclassified

Closed Reduction as Therapeutic Gold Standard for Treatment of Congenital Hip Dislocation

et al. 2019

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“…The risks of over‐treatment using abduction bracing are difficult to quantify, although bracing is largely considered to be effective and relatively benign 2,11 . Countries employing universal ultrasound screening, however, have the lowest reported rates of open reduction in the world, reporting between 0.07 and 0.27 cases per 1000 live births 12,13 . In a series of more than 28 000 screened infants using universal ultrasound, Biedermann et al 13 .…”

Section: Discussionmentioning

confidence: 99%

Importance of early diagnosis for developmental dysplasia of the hip: A 5‐year radiological outcome study comparing the effect of early and late diagnosis

George

Kulkarni

Bellemore

et al. 2020

J Paediatrics Child Health

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Aim Australia utilises a selective ultrasound screening programme. The rate of late diagnosis of developmental dysplasia of the hip (DDH) in Australia is increasing. The aim of this study is to quantify the treatment required and compare the 5‐year radiological outcomes between early and late diagnosis in children with DDH with frank dislocation. Methods We performed a case‐matched control study of children with frank DDH dislocations from 2000 to 2010 comparing three groups: children with an early diagnosis successfully treated in a Pavlik harness (SP), children with an early diagnosis who failed Pavlik harness treatment (FP) and children with a late diagnosis (LD). Minimum follow‐up was 4 years. Results A total of 115 hips were included. Patients in the LD group required significantly more open reductions (P < 0.001), acetabular osteotomies (P < 0.001) and femoral osteotomies (P < 0.001). LD was also associated with significantly higher rates of growth disturbance at 46.3%, compared to 20.6% in the FP group and 5% in the SP group (P < 0.001). Overall, there were excellent radiological outcomes in 58.5% of the LD group compared to 79.4% in the FP group and 100% in the SP group. Conclusion In Australia, high rates of LD in DDH persist in the context of selective ultrasound screening. While good radiological outcomes are achievable, a significantly greater level of surgical intervention is required and this is associated with significantly higher rates of growth disturbance. Optimisation of screening in Australia is vital.

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“…Screening for DDH appears to be performed during the neonatal period in Germany and Australia [4,5]. In Japan, it was reported in the article by Tanabe et al in 1972 [6].…”

Section: Discussionmentioning

confidence: 99%

“…In the future, revisions to the Japanese Pediatric Orthopaedic Association's publication may be necessary. [5]. This suggests that 0.4% of infants diagnosed at 1 month of age may worsen thereafter.…”

Section: Discussionmentioning

confidence: 99%

Is Follow-up Needed for Infants with Graf Type I Hip at Screening?

Matsubayashi¹,

Matsuzaki

Tsujimoto

et al. 2020

Preprint

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Background: The purpose was to determine if follow-up of infants with Graf Type I hip at screening is required. Methods: Overall, 526 hips in 263 infants (61 males and 202 females) born between April 2015 and March 2018 who underwent primary screening for hip dislocation and presented to our department for secondary hip dislocation examination were included. Among these, 250 (59 males and 191 females) infants had bilateral Graf Type I hips for a total of 500 hips. Ultrasound results and physical examination at the initial visit and after 3 months were compared. X-rays were taken at the age of 1 year, and the proportion of infants with an acetabular index of 30° or greater was evaluated. Results: There were 0 hips that deteriorated from Graf Type I to II or higher among the infants. There were also 25 infants with abduction limitations in flexion at the initial visit, which was still present in 3 out of 23 infants 3 months later. There were 49 infants with asymmetry of the femoral or inguinal skin creases at the initial visit, which was still present in 9 out of 48 infants 3 months later. At the age of 1 year, an acetabular index of 30° or greater was observed in 35 out of 402 hips (8.7%).Conclusion: Ultrasounds at 3 months later were not required in any of the infants with Graf Type I hip at initial diagnosis. Some infants were diagnosed with acetabular dysplasia at the age of 1 year.

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Results of universal ultrasound screening for developmental dysplasia of the hip

Cited by 60 publications

References 24 publications

Closed Reduction as Therapeutic Gold Standard for Treatment of Congenital Hip Dislocation

Closed Reduction as Therapeutic Gold Standard for Treatment of Congenital Hip Dislocation

Importance of early diagnosis for developmental dysplasia of the hip: A 5‐year radiological outcome study comparing the effect of early and late diagnosis

Is Follow-up Needed for Infants with Graf Type I Hip at Screening?

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