{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T18:24:22Z","timestamp":1787855062311,"version":"build-2784847793"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Developmental dysplasia of the hip (DDH) encompasses a spectrum of hip abnormalities in infants. Early identification enables nonoperative management and improved outcomes. Selective screening uses clinical examination to determine referral for ultrasound (US), whereas universal screening performs routine US in all newborns after birth. Despite widespread use of both strategies, there is no consensus on the optimal approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic review was conducted to evaluate the outcomes of selective vs. universal screening. MEDLINE, Embase, and the Cochrane Library were searched for studies published from 2005 to 2025. The primary outcomes were late diagnosis and surgical intervention rates. Secondary outcomes included screening rates, overall DDH incidence, and nonoperative treatment rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 819,277 infants were identified. Universal screening had higher US utilization (98.5% vs. 8.7%; p &lt; 0.001). Overall DDH incidence was higher with universal screening (11.86 vs. 4.36 per 1,000; p = 0.025). Both groups had similar rates of late diagnosis (0.25 vs. 0.59 per 1,000; p = 0.243). Nonoperative treatment rates were higher for universal screening (10.07 vs. 3.54 per 1,000; p = 0.039), while surgical treatment rates were similar (0.50 vs. 0.32 per 1,000; p = 0.291).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Universal US screening had increased detection and rates of nonoperative treatment but did not reduce late diagnosis or surgical intervention. This highlights a tradeoff between increased detection and treatment burden without clear evidence of improved outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      <jats:underline>Level III<\/jats:underline>\n                      evidence (systematic review and meta-analysis of cohort studies). See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.rvw.26.00126","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T18:00:13Z","timestamp":1787853613000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Preventing Missed Developmental Dysplasia of the Hip: Universal vs. Selective Ultrasound Screening"],"prefix":"10.2106","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1065-8693","authenticated-orcid":false,"given":"Noah David","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, The University of Toledo Medical Center, Toledo, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8286-839X","authenticated-orcid":false,"given":"Mark","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, The University of Toledo Medical Center, Toledo, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2418-7849","authenticated-orcid":false,"given":"Ajay","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, The University of Toledo Medical Center, Toledo, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5895-8276","authenticated-orcid":false,"given":"Jiayong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, The University of Toledo Medical Center, Toledo, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8]]},"reference":[{"issue":"4","key":"r1-20260827","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s11832-014-0599-7","article-title":"The costs of late detection of developmental dysplasia of the hip","volume":"8","author":"Woodacre","year":"2014","journal-title":"J Child Orthop"},{"key":"r2-20260827","doi-asserted-by":"crossref","first-page":"102944","DOI":"10.1016\/j.jcot.2025.102944","article-title":"Impact of age and timing of hip orthosis on treatment outcomes in infants with developmental dysplasia of the hip: a systematic review and meta-analysis","volume":"64","author":"Marletta","year":"2025","journal-title":"J Clin Orthop Trauma"},{"issue":"2","key":"r3-20260827","doi-asserted-by":"crossref","first-page":"149","DOI":"10.3109\/17453674.2011.566146","article-title":"Total hip replacement in young adults with hip dysplasia: age at diagnosis, previous treatment, quality of life, and validation of diagnoses reported to the Norwegian Arthroplasty Register between 1987 and 2007","volume":"82","author":"Engesaeter","year":"2011","journal-title":"Acta Orthop"},{"issue":"9","key":"r4-20260827","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1007\/s00264-011-1257-z","article-title":"Screening and treatment in developmental dysplasia of the hip: where do we go from here?","volume":"35","author":"Sewell","year":"2011","journal-title":"Int Orthop"},{"issue":"10","key":"r5-20260827","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1007\/s00247-023-05666-x","article-title":"The effect of selective ultrasound screening on the incidence of late presentation of developmental hip dysplasia-a meta-analysis","volume":"53","author":"Laborie","year":"2023","journal-title":"Pediatr Radiol"},{"issue":"2","key":"r6-20260827","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1302\/0301-620X.105B2.BJJ-2022-0896.R1","article-title":"Universal screening may reduce the incidence of late diagnosis of developmental dysplasia of the hip: a systematic review and meta-analysis","volume":"105-B","author":"Cheok","year":"2023","journal-title":"Bone Joint J"},{"issue":"8","key":"r7-20260827","doi-asserted-by":"crossref","first-page":"e2227638","DOI":"10.1001\/jamanetworkopen.2022.27638","article-title":"Incidence of neonatal developmental dysplasia of the hip and late detection rates based on screening strategy: a systematic review and meta-analysis","volume":"5","author":"Kuitunen","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"4","key":"r9-20260827","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1007\/s00247-013-2838-3","article-title":"Selective ultrasound screening for developmental hip dysplasia: effect on management and late detected cases. 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