Cheok T

Smith T

Wills K

Jennings MP

Rawat, Jaideep

Foster, Bruce

2023-02-01

AIMS: We investigated the prevalence of late developmental dysplasia of the hip (DDH), abduction bracing treatment, and surgical procedures performed following the implementation of universal ultrasound screening versus selective ultrasound screening programmes. METHODS: A systematic search of PubMed, Embase, The Cochrane Library, OrthoSearch, and Web of Science from the date of inception of each database until 27 March 2022 was performed. The primary outcome of interest was the prevalence of late detection of DDH, diagnosed after three months. Secondary outcomes of interest were the prevalence of abduction bracing treatment and surgical procedures performed in childhood for dysplasia. Only studies describing the primary outcome of interest were included. RESULTS: A total of 31 studies were identified, of which 13 described universal screening and 20 described selective screening. Two studies described both. The prevalence of late DDH was 0.10 per 1,000 live births (95% confidence interval (CI) 0.00 to 0.39) in the universal screening group and 0.45 per 1,000 live births (95% CI 0.31 to 0.61) in the selective screening group. Abduction bracing treatment was performed on 55.54 per 1,000 live births (95% CI 24.46 to 98.15) in the universal screening group versus 0.48 per 1,000 live births (95% CI 0.07 to 1.13) in the selective screening group. Both the universal and selective screening groups had a similar prevalence of surgical procedures in childhood for dysplasia being performed (0.48 (95% CI 0.32 to 0.63) vs 0.49 (95% CI 0.31 to 0.71) per 1,000 live births, respectively). CONCLUSION: Universal screening showed a trend towards lower prevalence of late DDH compared to selective screening. However, it was also associated with a significant increase in the prevalence of abduction bracing without a significant reduction in the prevalence of surgical procedures in childhood for dysplasia being performed. High-quality studies comparing both treatment methods are required, in addition to studies into the natural history of missed DDH.Cite this article: Bone Joint J 2023;105-B(2):198-208.

Department of Trauma and Orthopaedics, Alice Springs Hospital, Alice Springs, Australia.

Department of Orthopaedic Surgery, Palmerston North Hospital, Palmerston North, New Zealand.

Department of Orthopaedic Surgery, Flinders Medical Centre, Adelaide, Australia.

Department of Orthopaedic Surgery, Women's and Children's Hospital, Adelaide, Australia.

Bone Joint J. 2023 Feb;105-B(2):198-208. doi: 10.1302/0301-620X.105B2.BJJ-2022-0896.R1.

0000-0003-1215-9361

0000-0002-9529-2100

0000-0002-3593-1599

https://pubmed.ncbi.nlm.nih.gov/36722053/?otool=iaurydwlib

https://hdl.handle.net/10137/12393

105-B

Humans

*Delayed Diagnosis/prevention & control

Incidence

*Developmental Dysplasia of the Hip

Braces

Databases, Factual

Universal screening may reduce the incidence of late diagnosis of developmental dysplasia of the hip : a systematic review and meta-analysis.

Journal Article

Publication