{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T01:53:28Z","timestamp":1750902808411},"reference-count":24,"publisher":"Universa BV","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Orthop Belg"],"published-print":{"date-parts":[[2023,3,30]]},"abstract":"<jats:p>There are concerns that selective sonographic screening for developmental dysplasia of the hip (DDH) may be suboptimal. Our aim was to test this hypothesis by identifying trends in presentation and surgical treatment in patients with DDH. This is a retrospective review of children born between 1997-2018 who were treated surgically for DDH at our sub- regional paediatric orthopaedic unit. Demographic data, risk factors, age of diagnosis and surgical treatments were analysed. Late diagnosis was defined as greater than 4 months. 103 children (14 male, 89 female) underwent surgery. 93 hips were operated for dislocation and 21 for dysplasia. 13 patients presented with bilateral hip dislocations. The median age at diagnosis was 10 months (95% CI: 4-15). 62\/103 (60.2%) were diagnosed late (after 4 months) and the median age for diagnosis in this group was 18.5 months (95% CI: 16-20.5). Significantly more patients were referred late (p=0.0077). The presence of risk factors (breech presentation or family history) was associated with early diagnosis. Over the duration of our study the operation rate per 1000 live births gradually increased, and on Poisson regression analysis there was a statistically significant increasing trend towards late diagnosis in recent years (p=0.0237), which necessitated more aggressive surgical management. In the UK, the current selective sonographic screening programme for DDH has shown a deterioration over the years of this study and this questions its current effectiveness. It appears that the majority of irreducible hip dislocations are diagnosed late, with an increased need for surgical management.<\/jats:p>","DOI":"10.52628\/89.1.8636","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T19:55:59Z","timestamp":1686254159000},"page":"15-19","source":"Crossref","is-referenced-by-count":2,"title":["Selective sonographic screening for developmental dysplasia of the hip \u2013 increasing trends in late diagnosis"],"prefix":"10.52628","volume":"89","author":[{"given":"M.N.","family":"SHARROCK","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.R.","family":"WHELTON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.W.","family":"PATON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"27062","published-online":{"date-parts":[[2023,6]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Loder RT, Skopelia EN. The epidemiology and demographics of hip dysplasia. ISRN Orthp. 2011; 2011: 238607.","DOI":"10.5402\/2011\/238607"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Woodacre T, Ball T, Cox P. Epidemiology of developmental dysplasia of the hip within the UK: refining the risk factors. J Child Orthop. 2016;10(6):633-42.","DOI":"10.1007\/s11832-016-0798-5"},{"key":"ref2","unstructured":"Paton RW. Does selective ultrasound imaging of \u2018at risk\u2019 hips and clinically unstable hips, in developmental dysplasia of the hip (DDH) produce an effective screening programme? (PhD thesis) University of Lancaster, 2011."},{"key":"ref3","unstructured":"Vafaee AR, Baghdadi T, Baghdadi A, et al. DDH epidemiology revisited: Do we need new strategies? Arch Bone Jt Surg. 2017;5(6):440-2."},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Sewell MD, Rosendahl K, Eastwood DM. Developmental dysplasia of the hip. BMJ. 2009;339:b44544.","DOI":"10.1136\/bmj.b4454"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Murphy SB, Ganz R, M\u00fcller ME. The prognosis in untreated dysplasia of the hip. A study of radiographic factors that predict the outcome. J Bone Joint Surg Am. 1995;77(7):985-9","DOI":"10.2106\/00004623-199507000-00002"},{"key":"ref6","unstructured":"Aronson J. Osteoarthritis of the young adult hip: etiology and treatment. Instr Course Lect. 1986;35:119-28."},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Furnes O, Lie SA, Espehaug B, et al. Hip disease and the prognosis of total hip replacements. A review of 53,698 primary total hip replacements reported to the Norwegian Arthroplasty Register 1987-99. J Bone Joint Surg Br. 2001;83(4):579-86.","DOI":"10.1302\/0301-620x.83b4.0830579"},{"key":"ref8","unstructured":"NHS Newborn and Infant Physical Examination Programme (NIPE). UK, 2019. Available from: https:\/\/www.gov.uk\/topic\/population-screening-programmes\/newborn-infant-physical-examination [accessed 5\/8\/2020]."},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Perry DC, Paton RW. Knowing your click from your clunk: is the current screening for developmental dysplasia of the hip fit for purpose? Bone Joint J. 2019;101-B(3):236-7.","DOI":"10.1302\/0301-620x.101b3.bjj-2019-0075"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Paton RW. Screening in Development Dysplasia of the Hip (DDH). Surgeon. 2017;15(5):290-6.","DOI":"10.1016\/j.surge.2017.05.002"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Shorter D, Hong T, Osborn DA. Screening programmes for developmental dysplasia of the hip in newborn infants. Cochrane Database Syst Rev. 2011;(9):CD004595.","DOI":"10.1002\/14651858.cd004595.pub2"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Mulpuri K, Song KM, Goldberg MJ, Sevarino K. Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip in Infants up to Six Months of Age. J Am Acad Orthop Surg. 2015;23(3):202-5.","DOI":"10.5435\/jaaos-d-15-00006"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Broadhurst C, Rhodes AML, Harper P, et al. What is the  incidence of late detection of developmental dysplasia of the hip in England?: a 26-year national study of children diagnosed after the age of one. Bone Joint J. 2019;101-B(3):281-7","DOI":"10.1302\/0301-620x.101b3.bjj-2018-1331.r1"},{"key":"ref14","unstructured":"East Lancashire Hospitals Trust, Annual Report 2018\/19. Available from: https:\/\/elht.nhs.uk\/about-us\/corporate-publications-annual-reports-and-accounts [accessed 5\/8\/2020]"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Boeree NR, Clarke NM. Ultrasound imaging and secondary screening for congenital dislocation of the hip. J Bone Joint Surg Br. 1994;76(4):525-33.","DOI":"10.1302\/0301-620x.76b4.8027133"},{"key":"ref16","unstructured":"Office for National Statistics. Live births. 2022. Available from: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/livebirths [accessed 18\/4\/2022]"},{"key":"ref17","unstructured":"Rosendahl K, Markestad T, Lie RT. Ultrasound screening for developmental dysplasia of the hip in the neonate: the effect on treatment rate and prevalence of late cases. Pediatrics  1994;94:47\u201352."},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Holen KJ, Tegnander A, Bredland T, et al.. Universal or selective screening of the neonatal hip using ultrasound? A  prospective, randomised trial of 15,529 newborn infants. J Bone Joint Surg Br. 2002;84(6):886-90.","DOI":"10.1302\/0301-620x.84b6.0840886"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Biedermann R, Eastwood DM. Universal or selective ultrasound screening for developmental dysplasia of the hip? A discussion of the key issues. J Child Orthop. 2018;12(4):296-301.","DOI":"10.1302\/1863-2548.12.180063"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Thallinger C, Pospischill R, Ganger R, Radler C, Krall C, Grill F. Long-term results of a nationwide general ultrasound screening system for developmental disorders of the hip: the Austrian hip screening program. J Child Orthop. 2014;8(1):3-10.","DOI":"10.1007\/s11832-014-0555-6"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"von Kries R, Ihme N, Oberle D, et al. Effect of ultrasound screening on the rate of first operative procedures for  developmental hip dysplasia in Germany. Lancet. 2003;362(9399):1883-7.","DOI":"10.1016\/s0140-6736(03)14957-4"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Choudry QA, Paton RW. Neonatal screening and selective sonographic imaging in the diagnosis of developmental dysplasia of the hip. Bone Joint J. 2018 Jun 1;100-B(6):806-10.","DOI":"10.1302\/0301-620x.100b6.bjj-2017-1389.r1"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"\u00d6mero\u011flu H, Akceylan A, K\u00f6se N. Associations between risk factors and developmental dysplasia of the hip and ultrasonographic hip type: A retrospective case control study. Journal of Children\u2019s Orthopaedics. 2019;13(2):161-6.","DOI":"10.1302\/1863-2548.13.180174"}],"container-title":["Acta Orthopaedica Belgica"],"original-title":[],"deposited":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T19:56:07Z","timestamp":1686254167000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.actaorthopaedica.be\/archive\/volume-89\/issue-1\/original-studies\/selective-sonographic-screening-for-developmental-dysplasia-of-the-hip-increasing-trends-in-late-dia\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,30]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,6]]},"published-print":{"date-parts":[[2023,3,30]]}},"URL":"https:\/\/doi.org\/10.52628\/89.1.8636","relation":{},"ISSN":["0001-6462"],"issn-type":[{"value":"0001-6462","type":"print"}],"subject":[],"published":{"date-parts":[[2023,3,30]]}}}