Screening for developmental dysplasia of the hip (DDH) is often performed by pediatricians or other primary care providers at newborn and infant exams. Early detection of DDH is crucial to for early treatment, to prevent complications, and to optimize long-term hip health into adulthood.
This article provides an overview of trends and recommendations for screening and treatment of DDH based on age, severity of DDH, and other factors. The information in this article is published by the American Academy of Pediatrics (AAP) and is meant to be used by pediatricians and other primary care providers in the United States. The information in this supports early detection so babies can be promptly referred to specialists for earlier evaluation and treatment if needed.
The authors provide guidelines for DDH screening including physical examination and imaging studies such as ultrasound and x-ray. The optimal screening method for DDH remains controversial. Pediatricians are recommended to do physical examinations at birth and throughout the first year of life and look for signs of hip dysplasia. Universal screening with ultrasound or x-rays is recommended in some countries but is not currently recommended in the United States. This is because it can be hard to differentiate between an unstable hip that needs treatment, and an immature hip that just needs extra time to develop, and there can be risks with over-treating. The article also provides treatment algorithms that include conservative and surgical management, depending on age and severity of the dysplasia.
- Click here to learn more about signs and symptoms of infant and screening tests: Infant Diagnosis – International Hip Dysplasia Institute
- Click here to learn more about conservative/non-surgical and surgical treatment of hip dysplasia: Planning Treatment for Children – International Hip Dysplasia Institute
How can this information be used?
The information in this article may be helpful to pediatrician screening for DDH during newborn examinations. Proper screening may decrease the number of missed cases of hip dislocations or dysplasia. This article provides a clear pathway for care and the importance of early detection and early referral to a hip specialist. It also creates awareness about treatment complications so babies and children can be monitored for these, and they can be addressed quickly. Further, early detection by pediatricians and other primary care providers, and treatment by specialists, can hopefully reduce the number of late diagnoses and reduced the number of total hip replacements performed in adulthood due to DDH. The information in this article should be shared with patients and families since it may be helpful in outlining goals and expectations for DDH screening and treatment.
What are limitations of this study that should be considered when using this information?
This article provides recommendations for DDH screening modalities and trends in treatments, but there is limited consensus on the most optimal screening methods, and recommended treatment may differ from the proposed algorithm depending the healthcare system and on individual patient and family variables. For these reasons, medical providers, researchers, and groups like the International Hip Dysplasia Institute are working to learn more about hip dysplasia diagnosis, treatment, and outcomes.
In addition to the work being done to improve early diagnosis and treatment of infants and young children with hip dysplasia, many adolescent and young adult patients with hip dysplasia benefit from the relatively new field of hip preservation surgeries, such as periacetabular osteotomy (PAO) surgery. Many young adult patients have reduced pain, improved function, and improved quality of life after PAO surgery, but ongoing research is needed to follow long-term outcomes and to continue to determine patient characteristics that result in the best outcomes for this surgery.
This review article highlights why it is important to raise awareness about hip dysplasia risk factors and symptoms in everyone from birth through adulthood to make sure that patients can get a timely and proper diagnosis and the individualized and specialized treatment they need. This can help reduce the physical, mental, emotional, financial, and social burdens of hip dysplasia for patients, their families, and their friends.
Link to the full Article: https://publications.aap.org/pediatrics/article/143/1/e20181147/37329/Developmental-Dysplasia-of-the-Hip
Yang, S., Zusman, N., Lieberman, E., & Goldstein, R. Y. (2019). Developmental Dysplasia of the Hip. Pediatrics, 143(1), e20181147. https://doi.org/10.1542/peds.2018-1147
Disclaimer: All of the information on this site is peer reviewed, as well as reviewed by our medical advisor. The information on the Miles4Hips website is meant for informational purposes only. While our goals are to promote understanding and knowledge of hip dysplasia and to empower patients and their families in healthcare decision making, we cannot guarantee accuracy or appropriateness of the information for your specific condition or circumstances. The information on this site is not meant to take the place of the professional judgment of your medical providers. Individuals should always seek the advice of your physician/surgeon, physical therapists, and other qualified health care provider with any questions you may have regarding a medical condition or treatment. Individuals should never disregard the advice of your medical providers or delay in seeking it because of something you have read on this website.