{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:02:10Z","timestamp":1785585730681,"version":"3.56.0"},"reference-count":43,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,1,1]]},"abstract":"<jats:p>OBJECTIVE: We conducted a blinded, randomized, controlled trial to examine whether mildly dysplastic but stable or instable hips would benefit from early treatment, as compared with watchful waiting.<\/jats:p><jats:p>PATIENTS AND METHODS: A total of 128 newborns with mild hip dysplasia (sonographic inclination angle [\u03b1 angle] of 43\u00b0\u201349\u00b0) and stable or instable but not dislocatable hips were randomly assigned to receive either 6 weeks of abduction treatment (immediate-treatment group) or follow-up alone (active-sonographic-surveillance group). The main outcome measurement was the acetabular inclination angle, measured by radiograph, at 1 year of age.<\/jats:p><jats:p>RESULTS: Both groups included 64 newborns, and there was no loss to follow-up. With the exception of a small but statistically significant excess of girls in the active-sonographic-surveillance group, there were no statistically significant differences in baseline characteristics between the 2 groups. The mean inclination angle at 12 months was 24.2\u00b0 for both groups (difference: 0.1 [95% confidence interval (CI): \u22120.8 to 0.9]), and all children had improved and were without treatment. The mean \u03b1 angle was 59.7\u00b0 in the treatment group and 57.1\u00b0 in the active-surveillance group for a difference of 2.6\u00b0 evaluated after 1.5 and 3 months (95% CI: 1.8 to 3.4; P &amp;lt; .001). At 1.5 months of age, the hips had improved in all treated children but not in 5 children under active surveillance (P = .06). Among the sonographic-surveillance group, 47% received treatment after the initial surveillance period of 1.5 months.<\/jats:p><jats:p>CONCLUSIONS: Active-sonographic-surveillance halved the number of children requiring treatment, did not increase the duration of treatment, and yielded similar results at 1-year follow-up. Given a reported prevalence of 1.3% for mildly dysplastic but stable hips, a strategy of active surveillance would reduce the overall treatment rate by 0.6%. Our results may have important implications for families as well as for health care costs.<\/jats:p>","DOI":"10.1542\/peds.2009-0357","type":"journal-article","created":{"date-parts":[[2009,12,22]],"date-time":"2009-12-22T01:34:22Z","timestamp":1261445662000},"page":"e9-e16","source":"Crossref","is-referenced-by-count":72,"title":["Immediate Treatment Versus Sonographic Surveillance for Mild Hip Dysplasia in Newborns"],"prefix":"10.1542","volume":"125","author":[{"given":"Karen","family":"Rosendahl","sequence":"first","affiliation":[{"name":"Diagnostic Radiology, Great Ormond Street Hospital for Children, London, United Kingdom"},{"name":"Institute of Surgical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Dezateux","sequence":"additional","affiliation":[{"name":"MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari R\u00f8ine","family":"Fosse","sequence":"additional","affiliation":[{"name":"Departments of Radiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hildegunn","family":"Aase","sequence":"additional","affiliation":[{"name":"Departments of Radiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stein Magnus","family":"Aukland","sequence":"additional","affiliation":[{"name":"Departments of Radiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hallvard","family":"Reigstad","sequence":"additional","affiliation":[{"name":"Pediatrics, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terje","family":"Alsaker","sequence":"additional","affiliation":[{"name":"Pediatrics, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dag","family":"Moster","sequence":"additional","affiliation":[{"name":"Pediatrics, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolv Terje","family":"Lie","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trond","family":"Markestad","sequence":"additional","affiliation":[{"name":"Pediatrics, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2010,1,1]]},"reference":[{"key":"2021120821192791800_R1","doi-asserted-by":"crossref","unstructured":"Aronsson DD, Goldberg MJ, Kling TF Jr, Roy DR. Developmental dysplasia of the hip. Pediatrics.\u20081994;94:201\u2013208","DOI":"10.1542\/peds.94.2.201"},{"key":"2021120821192791800_R2","unstructured":"Le Damany P. La luxation conge\u0301nitale de la hanche. E\u0301tudes d'anatomie compare\u0301e d'anthropogenie normale et pathologique, deductions therapeutique. Alcan, Paris 1912"},{"key":"2021120821192791800_R3","unstructured":"Ortolani M. Un segno noto e sua importanza per la diagnosi precoce di prelussazione congenita dell'anca. Pediatria (Napoli).\u20081937;45:129\u2013136"},{"key":"2021120821192791800_R4","unstructured":"Marx VO. New observations in congenital dislocation of the hip in the newborn. J Bone Joint Surg.\u20081938;20:1095"},{"key":"2021120821192791800_R5","doi-asserted-by":"crossref","unstructured":"Palme\u0301n K. Preluxation of the hip joint. Diagnosis and treatment in the newborn and the diagnosis of congenital dislocation of the hip joint in Sweden during the years 1948\u20131960. Acta Paediatr Suppl.\u20081961;50:1\u201371","DOI":"10.1111\/j.1651-2227.1961.tb08057.x"},{"key":"2021120821192791800_R6","doi-asserted-by":"crossref","unstructured":"Barlow TG. Early diagnosis and treatment of congenital dislocation of the hip. Proc R Soc Med.\u20081962;56:804\u2013806","DOI":"10.1177\/003591576305600920"},{"key":"2021120821192791800_R7","unstructured":"Barlow TG. Congenital dislocation of the hip. Nurs Mirror Midwives J.\u20081968;126(13):25"},{"key":"2021120821192791800_R8","doi-asserted-by":"crossref","unstructured":"Catford JC, Bennet GC, Wilkinson JA. Congenital hip dislocation: an increasing and still uncontrolled disability?Br Med J.\u20081982;285(6354):1527\u20131530","DOI":"10.1136\/bmj.285.6354.1527"},{"key":"2021120821192791800_R9","doi-asserted-by":"crossref","unstructured":"Chan A, Cundy PJ, Foster BK, Keane RJ, Byron-Scott R. Late diagnosis of congenital dislocation of the hip and presence of a screening programme: South Australian population-based study. Lancet.\u20081999;354(9189):1514\u20131517","DOI":"10.1016\/S0140-6736(98)12469-8"},{"key":"2021120821192791800_R10","doi-asserted-by":"crossref","unstructured":"Burger BJ, Burger JD, Bos CF, Obermann WR, Rozing PM, Vandenbroucke JP. Neonatal screening and staggered early treatment for congenital dislocation or dysplasia of the hip. Lancet.\u20081990;336:1549\u20131553","DOI":"10.1016\/0140-6736(90)93317-I"},{"key":"2021120821192791800_R11","doi-asserted-by":"crossref","unstructured":"Mitchell GP. Problems in the early diagnosis and management of congenital dislocation of the hip. J Bone Joint Surg Br.\u20081972;54:4\u201312","DOI":"10.1302\/0301-620X.54B1.4"},{"key":"2021120821192791800_R12","doi-asserted-by":"crossref","unstructured":"Hiertonn T, James U. Congenital dislocation of the hip. Experiences of early diagnosis and treatment. 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Committee on Quality Improvement, and Subcommittee on Developmental Dysplasia of the Hip. Pediatrics.\u20082000;105:E57","DOI":"10.1542\/peds.105.4.e57"},{"key":"2021120821192791800_R29","doi-asserted-by":"crossref","unstructured":"Rosendahl K, Markestad T, Lie RT. Ultrasound in the early diagnosis of congenital dislocation of the hip: the significance of hip stability versus acetabular morphology. Pediatr Radiol.\u20081992;22:430\u2013433","DOI":"10.1007\/BF02013504"},{"key":"2021120821192791800_R30","doi-asserted-by":"crossref","unstructured":"Rosendahl K, Aslaksen A, Lie RT, Markestad T. Reliability of ultrasound in the early diagnosis of developmental dysplasia of the hip. Pediatr Radiol.\u20081995;25:219\u2013224","DOI":"10.1007\/BF02021541"},{"key":"2021120821192791800_R31","unstructured":"Tonnis D, Brunken D. [Differentiation of normal and pathological acetabular roof angle in the diagnosis of hip dysplasia. Evaluation of 2294 acetabular roof angles of hip joints in children]. Arch Orthop Unfallchir.64:197\u2013228, 1968"},{"key":"2021120821192791800_R32","doi-asserted-by":"crossref","unstructured":"Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet.\u20082001;357:1191\u20131194","DOI":"10.1016\/S0140-6736(00)04337-3"},{"key":"2021120821192791800_R33","doi-asserted-by":"crossref","unstructured":"Altman DG, Schulz KF, Moher D, et al. The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med.\u20082001;134:663\u2013694","DOI":"10.7326\/0003-4819-134-8-200104170-00012"},{"key":"2021120821192791800_R34","doi-asserted-by":"crossref","unstructured":"Wood MK, Conboy V, Benson MK. 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