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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

  • Original Clinical Article
  • Published:
Journal of Children's Orthopaedics

Abstract

Purpose/Background/Introduction

The aim of this study was to retrospectively evaluate the impact of neonatal sonographic hip screening using Graf’s method for the management and outcome of orthopaedic treatment of decentered hip joints with developmental dysplasia of the hip (DDH), using three decades (1978–2007) of clinical information compiled in a medical database.

Methods

Three representative cohorts of consecutive cases of decentered hip joints were selected according to different search criteria and inclusion and exclusion parameters: (1) cohort 1 (1978–1982; n = 80), without sonographic screening; (2) cohort 2.1 (1994–1996; n = 91), with nationwide established general sonographic screening according to the Graf-method; (3) cohort 2.2 (2003–2005; n = 91), with sonographic screening including referred cases for open reduction from non-screened populations. These three cohorts were compared for the following parameters: age at initial treatment, successful closed reduction, necessary overhead traction, necessary adductor-tenotomy, rate of open reduction, rate of avascular necrosis (AVN) and rate of secondary acetabuloplasty.

Results

The age at initial treatment was reduced from 5.5 months in the first cohort to 2 months in the two subsequent two cohorts and the rate of successful closed reduction increased from 88.7 to 98.9 and 95.6%, respectively. There was a statistically significant improvement in six out of seven parameters with sonographic hip screening; only the rate of secondary acetabuloplasty did not improve significantly.

Conclusion

Compared to the era before the institution of a sonographic hip screening programme according to the Graf-method in Austria in 1992, ultrasound screening based-treatment of decentered hip joints has become safer, shorter and simpler: “safer” means lower rate of AVN, “shorter” means less treatment time due to earlier onset and “simpler” means that the devices are now less invasive and highly standardized.

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Acknowledgments

The authors would like to thank Prof. Graf for his pioneering work of a standardized and reproducible ultrasonographic technique to visualize all stages of DDH. This study was made possible by a grant of “Deutsche Arthrosehilfe e.V.” (a scientific non-profit organization with the aim of preventing osteoarthritis).

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Authors and Affiliations

  1. General and Orthopaedic Hospital Stolzalpe, 8852, Stolzalpe, Austria

    Christian Tschauner, Frank Fürntrath & Roman Radl

  2. Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, Graz, Austria

    Yasaman Saba & Andrea Berghold

Authors
  1. Christian Tschauner
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  2. Frank Fürntrath
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  3. Yasaman Saba
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  4. Andrea Berghold
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  5. Roman Radl
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Correspondence to Christian Tschauner.

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Tschauner, C., Fürntrath, F., Saba, Y. et al. 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 (2011). https://doi.org/10.1007/s11832-011-0366-y

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  • DOI: https://doi.org/10.1007/s11832-011-0366-y

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