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Topic:

Developmental Dysplasia of the Hip

Issue:

Hip

Category:

Developmental

Title:

Does Screening Ultrasound Timing in Developmental Dysplasia of the Hip Need to be Adjusted for Moderate Preterm and Near-term Infants: A Prospective Study

Author:

Hockett, Claire BA; Mayfield, Laura M. MPH; Gill, Corey S. MD; Kim, Harry K.W. MD, MS; Sucato, Daniel J. MD, MS; Podeszwa, David A. MD; Jo, Chan-Hee PhD; Morris, William Z. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

January 2024

Reference:

44(1): p e25-e29, DOI: 10.1097/BPO.0000000000002540

Level Of Evidence:

II

# of Patients:

122

Study Type:

Prospective cohort study

Location:

Single-center study (exact location not mentioned)

Summary:

The study evaluates whether screening ultrasounds for developmental dysplasia of the hip (DDH) in high-risk infants need to be adjusted for gestational age in moderate preterm and near-term infants.

Methods:

Inclusion Criteria: Infants referred for screening ultrasound for DDH due to breech presentation, family history of DDH, or hip click, excluding those with known dysplasia or instability. Exclusion Criteria: Known dysplasia or hip instability. Intervention: Screening hip ultrasound between 5 and 8 weeks of age. Sonographic markers of dysplasia (alpha angle and femoral head coverage) were measured, and rates of abnormal ultrasound and Pavlik harness treatment were recorded. Groups: Premature (<37 weeks gestation) vs. Full-term (≥37 weeks gestation)

Exclusions:

Infants with known dysplasia or hip instability.

Results:

Gestational Age: Premature cohort had significantly decreased gestational age (35.4 ± 1.1 vs. 38.5 ± 1.1 weeks, P < 0.001). Demographics: No significant difference between cohorts in sex distribution (69% vs. 75% female, P = 0.39), unadjusted age at ultrasound (6.6 ± 0.7 vs. 6.8 ± 0.7 weeks, P = 0.07), or referral reason (P = 0.14). Hip Ultrasound Results: No significant differences between cohorts in alpha angle (62.6 ± 3.3 vs. 62.2 ± 5.3 degrees, P = 0.41), femoral head coverage (54.9 ± 6.3 vs. 55.1 ± 10.6, P = 0.19), abnormal ultrasound rate (18.3% vs. 20.7%, P = 0.68), or rate of Pavlik harness treatment (0% vs. 5.3%, P = 0.12).

Conclusions:

The study concludes that screening ultrasounds for DDH do not need to be adjusted for prematurity, as there were no significant differences between premature and full-term infants in key ultrasound markers or treatment outcomes.

Relevance:

Limitations:

Perspective:

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