Top

International Orthopaedics

Published in:

01-04-2021 | Ultrasound | Original Paper

Early neonatal universal ultrasound screening for developmental dysplasia of the hip: a single institution observational study

Authors: Milena Treiber, Bojan Korpar, Mateja Sirše, Matjaž Merc

Published in: International Orthopaedics | Issue 4/2021

Abstract

Objective

We evaluated the effect of early universal ultrasound (US) screening program for developmental dysplasia of the hip (DDH).

Methods

A total of 21,676 newborns between 2006 and 2015 were included in the study. All hips were examined by US within the first week of life. The incidence of sonographic hip-types according to the Graf method was analyzed, and then followed prospectively. Risk factors for DDH and treatment measures were also recorded, together with the number of first surgical procedures before the age of three years.

Results

Overall, 92.5% of hips were mature (Graf types Ia, Ib) at first examination, 7.2% were mature (Graf type IIa) and 0.3% were pathological (Graf types IIc to IV). A total of 146 pathological hips were detected in 118 of newborns (0.6%). Only 0.26% of screened population was treated with an orthosis. The rate of first surgical procedures and the rate of late detected DDH were 0.23 and 0.09 per 1000 live births, respectively. Regarding risk factors, positive family history, female gender, breech presentation, and high birth weight were significantly more common in newborns with pathological hips.

Conclusion

Early neonatal universal US screening using Graf method is recommended to timely detect DDH and to provide the optimal conservative approach of management. It seems to be effective in reducing the overall treatment rate, together with the rate of surgical procedures and late detected cases.

Dezateux C, Rosendahl K (2007) Developmental dysplasia of the hip. Lancet 5:1541–1552CrossRef

Loder RT, Skopelja EN (2011) The epidemiology and demographics of hip dysplasia. ISRN Orthop. https://doi.org/10.5402/2011/238607

Moraleda L, Bravo C, Forriol F et al (2019) Does orientation of the femoral head affect acetabular development? An experimental study in lamb. J Pediatr Orthop 39:416–421CrossRef

De Hundt M, Vlemmix F, Bais JMJ et al (2012) Risk factors for developmental dysplasia of the hip: a meta-analysis. Eur J Obstet Gynecol Reprod Biol 165:8–17CrossRef

Shorter D, Hong T, Osborn DA (2013) Cochrane Review: screening programmes for developmental dysplasia of the hip in newborn infants. Evid Based Child Health 8:11–54CrossRef

Graf R (1984) Classification of hip joint dysplasia by means of sonography. Arch Orthop Trauma Surg 102:248–255CrossRef

Graf R (2017) Hip sonography: background; technicque and common mistakes; results; debate and politics; challenges. Hip Int 27:215–219CrossRef

American Institute of ultrasound in Medicine (2013) AIUM Practice guideline for the performance of an ultrasound examination for detection and assessment of developmental dysplasia of the hip. J Ultrasound Med 32:1307–1317CrossRef

Thalinger C, Pospischill R, Ganger R et al (2014) Long-term results of a nationwide general ultrasound screening system for developmental disorder of the hip: the Austrian hip screening program. J Child Orthop 8:3–10CrossRef

10.

Biedermann R, Riccabona J, Giesinger JM et al (2018) Results of universal ultrasound screening for developmental dysplasia of the hip: a prospective follow up of 28 092 consecutive infants. Bone Joint J 100-B:1399–1404CrossRef

11.

Güler O, Seker A, Mutlu S et al (2016) Results of a universal ultrasonographic hip screening progam at a single institution. Acta Orthop Traumatol Turc 50:42–48

12.

Holen KJ, Tegnander A, Bredland T et al (2002) Universal or selective screening of the neonatal hip using ultrasound? A prospective, randomised trial of 15,529 newborn infants. J Bone Joint Surg 84:886–890CrossRef

13.

Laborie LB, Engesaeter IO, Lehmann TG et al (2013) Screening strategies for hip dysplasia: long-term outcome of a randomized controlled trial. Pediatrics 132:492–501CrossRef

14.

O'Beirne JG, Chlapoutakis K, Alshryda S et al (2019) International interdisciplinary consensus meeting on evaluation of developmental dysplasia of the hip. Ultrashall Med 40:454–464CrossRef

15.

Treiber M, Tomažič T, Tekauc-Golob et al (2008) Ultrasound screening for developmental dysplasia of the hip in the newborn: a population-based study in the Maribor region 1997-2005. Wien Klin Wochenschr 120:31–36CrossRef

16.

Kolb A, Schweiger N, Mailath Pokorny M et al (2016) Low incidence of early developmental dysplasia of the hip in universal ultrasonographic screening of newborns: analysis and evaluation of risk factors. Int Orthop 40:123–127CrossRef

17.

Eastwood DM (2003) Neonatal hip screening. Lancet 361:595–597CrossRef

18.

Falliner A, Schwinzer D, Hahne HJ et al (2006) Comparing ultrasound measurements of neonatal hips using the methods of Graf and Terjesen. J Bone Joint Surg 88:104–106CrossRef

19.

Ortiz-Neira CL, Paolucci EO, Donnon T (2012) A meta-analysis of common risk factors associated with the diagnosis of developmental dysplasia of the hip in newborns. Eur J Radiol 81:344–351CrossRef

20.

Schams M, Labruyere R, Zuse A et al (2017) Diagnosing developmental dysplasia of the hip using the Graf ultrasound method: risk and protective factor analysis in 11.820 universally screened newborns. Eur J Pediatr 176:1193–1200CrossRef

21.

Laborie LB, Markestad TJ, Davidsen H et al (2014) Selective ultrasound screening for developmental hip dysplasia: effect on management and late detected cases. A prospective survey during 1991-2006. Pediatr Radiol 44:410–424CrossRef

22.

Riad JP, Cundy P, Gent RJ et al (2005) Longitudinal study of normal hip development by ultrasound. J Pediatr Orthop 25:5–9

23.

Von Kries R, Ihme N, Altenhofen L et al (2012) General ultrasound screening reduces the rate of first operative procedures for developmental dysplasia of the hip: a case control study. J Paediatr 160:271–275CrossRef

24.

Wirth T, Stratmann L, Hinrichs F (2004) Evolution of late presenting developmental dysplasia of the hip and associated surgical procedures after 14 years of neonatal ultrasound screening. J Bone Joint Surg 86:585–589CrossRef

25.

Talbot C, Adam J, Paton R (2017) Late presentation of developmental dysplasia of the hip - a 15-year observational study. Bone Joint J 99:1250–1255CrossRef

Title: Early neonatal universal ultrasound screening for developmental dysplasia of the hip: a single institution observational study
Authors: Milena Treiber
Bojan Korpar
Mateja Sirše
Matjaž Merc
Publication date: 01-04-2021
Publisher: Springer Berlin Heidelberg
Keywords: Ultrasound
Hip Dysplasia
Hip Ultrasound
Orthosis
Ultrasound
Published in: International Orthopaedics / Issue 4/2021
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-020-04915-0

At a glance: The STEP trials

Springer Medicine

Early neonatal universal ultrasound screening for developmental dysplasia of the hip: a single institution observational study

Abstract

Objective

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 4/2021

Inferior performance of established and novel serum inflammatory markers in diagnosing periprosthetic joint infections

Interchangeable neck failures of bi-modular femoral stems in primary total hip arthroplasty cannot be predicted from serum trace element analysis

Macrophages’ contribution to ectopic osteogenesis in combination with blood clot and bone substitute: possibility for application in bone regeneration strategies

Cementless femoral stem fixation and leg-length discrepancy after total hip arthroplasty in different proximal femoral morphological types

Is coating of titanium implants effective at preventing Staphylococcus aureus infections? A meta-analysis of animal model studies

Total hip arthroplasty after acetabular fracture surgery