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Low incidence of early developmental dysplasia of the hip in universal ultrasonographic screening of newborns: analysis and evaluation of risk factors

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Abstract

Purpose

Different timing and approaches to screening for developmental dysplasia of the hip (DDH) are used in the orthopaedic community. Thus ultrasonographic screening programs and reports based on clinical examinations produced differing incidence rates of DDH. Furthermore different risk factors and a change of incidence of DDH in the last decades were discussed. The purpose of this study was the evaluation of incidence and risk factors of the very early DDH in a modern cohort based on a universal ultrasound screening program.

Methods

We analysed the results of the screening program performed at our institution: 5,356 consecutive hips of newborns were screened ultrasonographically and clinically according to the system published by R. Graf within the first two postnatal weeks [1]. A set of risk factors was analysed by univariate and multiple linear regression models.

Results

Sonographic signs of developmental dysplasia of the hip were found in 0.24 % of the newborns. A significant negative influence of the risk factors birth weight, family history of DDH and female gender on the α-angle was found. Early or pre-term delivery showed a protective potential for DDH.

Conclusions

Our data show a very low incidence of DDH in the first two postnatal weeks. Despite the significance of the risk factors analysed, it has to be considered that these factors only showed low impact on the risk of early DDH. In conclusion we favour universal ultrasound screening for DDH at the age of six to eight weeks.

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References

  1. Graf R (1983) New possibilities for the diagnosis of congenital hip joint dislocation by ultrasonography. J Pediatr Orthop 3:354–359

    Article  PubMed  CAS  Google Scholar 

  2. Tschauner C, Fürntrath F, Saba Y et al (2011) 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. J Child Orthop 5:415–424. doi:10.1007/s11832-011-0366-y

    Article  PubMed  PubMed Central  Google Scholar 

  3. Lehmann HP, Hinton R, Morello P, Santoli J (2000) Developmental dysplasia of the hip practice guideline: technical report. Pediatrics 105(4):e57

  4. Tönnis D, Storch K, Ulbrich H (1990) Results of newborn screening for CDH with and without sonography and correlation of risk factors. J Pediatr Orthop 10:145–152

    Article  PubMed  Google Scholar 

  5. Dorn U, Neumann D (2005) Ultrasound for screening developmental dysplasia of the hip: a European perspective. Curr Opin Pediatr 17:30–33

    Article  PubMed  Google Scholar 

  6. Dogruel H, Atalar H, Yavuz OY, Sayli U (2008) Clinical examination versus ultrasonography in detecting developmental dysplasia of the hip. Int Orthop 32:415–419. doi:10.1007/s00264-007-0333-x

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  7. Ortiz-Neira CL, Paolucci EO, Donnon T (2012) A meta-analysis of common risk factors associated with the diagnosis of developmental dysplasia of the hip in newborns. Eur J Radiol 81:e344–e351. doi:10.1016/j.ejrad.2011.11.003

    Article  PubMed  Google Scholar 

  8. Dunn PM (1976) Perinatal observations on the etiology of congenital dislocation of the hip. Clin Orthop Relat Res 119:11–22

  9. Dorn U (1990) Hip screening in newborn infants. Clinical and ultrasound results. Wien Klin Wochenschr Suppl 181:3–22

    PubMed  CAS  Google Scholar 

  10. Bache CE, Clegg J, Herron M (2002) Risk factors for developmental dysplasia of the hip: ultrasonographic findings in the neonatal period. J Pediatr Orthop B 11:212–218

    PubMed  Google Scholar 

  11. Ibrahim T, Riaz M, Hegazy A (2015) The prevalence of developmental dysplasia of the hip in idiopathic clubfoot: a systematic review and meta-analysis. Int Orthop. doi:10.1007/s00264-015-2757-z

    Google Scholar 

  12. Zhao D, Rao W, Zhao L et al (2013) Is it worthwhile to screen the hip in infants born with clubfeet? Int Orthop 37:2415–2420. doi:10.1007/s00264-013-2073-4

    Article  PubMed  PubMed Central  Google Scholar 

  13. Nogi J, MacEwen GD (1982) Congenital dislocation of the knee. J Pediatr Orthop 2:509–513

    Article  PubMed  CAS  Google Scholar 

  14. Grundt JH, Nakling J, Eide GE, Markestad T (2012) Possible relation between maternal consumption of added sugar and sugar-sweetened beverages and birth weight—time trends in a population. BMC Public Health 12:901. doi:10.1186/1471-2458-12-901

    Article  PubMed  PubMed Central  Google Scholar 

  15. Thaler M, Biedermann R, Lair J et al (2011) Cost-effectiveness of universal ultrasound screening compared with clinical examination alone in the diagnosis and treatment of neonatal hip dysplasia in Austria. J Bone Joint Surg (Br) 93:1126–1130. doi:10.1302/0301-620X.93B8.25935

    Article  CAS  Google Scholar 

  16. Clegg J, Bache CE, Raut VV (1999) Financial justification for routine ultrasound screening of the neonatal hip. J Bone Joint Surg (Br) 81(5):852–857. doi:10.1302/0301-620X.81B5.9746

  17. Graf R (1997) Hip ultrasonography. Basic principles and current aspects. Orthopade 26:14–24

    PubMed  CAS  Google Scholar 

  18. Ortolani M (1976) Congenital hip dysplasia in the light of early and very early diagnosis. Clin Orthop Relat Res 119:6–10

  19. Barlow M (1937) Um segno poco noto e sua importanza per la diagnosi precoce di prelussazione congenita dell’anca. Pediatria (Santiago) 26:136

  20. Graf R (1997) Ultrasonography-guided therapy. Orthopade 26:33–42

    PubMed  CAS  Google Scholar 

  21. Bialik V, Bialik GM, Blazer S et al (1999) Developmental dysplasia of the hip: a new approach to incidence. Pediatrics 103:93–99. doi:10.1542/peds.103.1.93

    Article  PubMed  CAS  Google Scholar 

  22. Holen KJ, Tegnander A, Bredland T et al (2002) Universal or selective screening of the neonatal hip using ultrasound? A prospective, randomised trial of 15,529 newborn infants. J Bone Joint Surg (Br) 84(6):886–890. doi:10.1097/00013644-200303000-00026

  23. Rosendahl K, Toma P (2007) Ultrasound in the diagnosis of developmental dysplasia of the hip in newborns. The European approach. A review of methods, accuracy and clinical validity. Eur Radiol 17:1960–1967. doi:10.1007/s00330-006-0557-y

    Article  PubMed  Google Scholar 

  24. Roposch A, Graf R, Wright JG (2006) Determining the reliability of the Graf classification for hip dysplasia. Clin Orthop Relat Res 447:119–124. doi:10.1097/01.blo.0000203475.73678.be

    Article  PubMed  Google Scholar 

  25. Gunay C, Atalar H, Dogruel H et al (2009) Correlation of femoral head coverage and Graf alpha angle in infants being screened for developmental dysplasia of the hip. Int Orthop 33:761–764. doi:10.1007/s00264-008-0570-7

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  26. Lee CB, Mata-Fink A, Millis MB, Kim Y-J (2013) Demographic differences in adolescent-diagnosed and adult-diagnosed acetabular dysplasia compared with infantile developmental dysplasia of the hip. J Pediatr Orthop 33:107–111. doi:10.1097/BPO.0b013e3182745456

    Article  PubMed  Google Scholar 

  27. Rosendahl K, Markestad T, Lie RT (1994) Ultrasound screening for developmental dysplasia of the hip in the neonate: the effect on treatment rate and prevalence of late cases. Pediatrics 1:47–52

  28. Terjesen T, Holen KJ, Tegnander A (1996) Hip abnormalities detected by ultrasound in clinically normal newborn infants. J Bone Joint Surg (Br) 78:636–640. doi:10.1097/01241398-199701000-00040

    CAS  Google Scholar 

  29. Chan A, McCaul KA, Cundy PJ et al (1997) Perinatal risk factors for developmental dysplasia of the hip. Arch Dis Child Fetal Neonatal Ed 76:F94–F100. doi:10.1136/fn.76.2.F94

    Article  PubMed  CAS  PubMed Central  Google Scholar 

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Acknowledgments

Conflict of interests

The authors declare that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Orthopaedics and Orthopaedic Surgery, Medical University of Vienna, Waehringer Gürtel 18-20, 1090, Vienna, Austria

    Alexander Kolb, Nina Schweiger, Gerhard Hobusch, Catharina Chiari & Reinhard Windhager

  2. Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Waehringer Gürtel 18-20, 1090, Vienna, Austria

    Mariella Mailath-Pokorny

  3. Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria

    Alexandra Kaider

Authors
  1. Alexander Kolb
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  2. Nina Schweiger
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  3. Mariella Mailath-Pokorny
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  4. Alexandra Kaider
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  5. Gerhard Hobusch
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  6. Catharina Chiari
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  7. Reinhard Windhager
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Correspondence to Alexander Kolb.

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Kolb, A., Schweiger, N., Mailath-Pokorny, M. et al. Low incidence of early developmental dysplasia of the hip in universal ultrasonographic screening of newborns: analysis and evaluation of risk factors. International Orthopaedics (SICOT) 40, 123–127 (2016). https://doi.org/10.1007/s00264-015-2799-2

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  • DOI: https://doi.org/10.1007/s00264-015-2799-2

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