The incidence of late-detected developmental dysplasia of the hip and its functional outcomes: a 17-year cohort study using selective ultrasound screening

Abstract

Background and purpose: We aimed to establish the incidence of late-detected developmental dysplasia of the hip (DDH) with a selective ultrasound (US) examination over 17 years using the femoral head coverage (FHC) as a US measurement. The secondary aim was to establish the everyday function using patient-reported outcome measures (PROMs).Patients and methods: The incidence of late-detected DDH was based on 60,844 children. Patients diagnosed for the first time after 3 months and before the age of 8 years were included. In the second part of the study, consent to participate was mandatory. PROMIS-25 Pediatric, PROMIS-25 Parent, and EQ-5D-5L were used according to the patient’s age to assess everyday function.Results: The incidence of late-detected DDH was 0.48/1,000. The median age at diagnosis was 8 months (range 4–41 months), with a tendency to require repeated treatment with open surgery if DDH was diagnosed later. Most children reported no or minor health problems with a mean of 18 years’ follow-up.Conclusion: We found that selective US examination of the hips by measuring the FHC is a reliable method to examine newborns for DDH resulting in a low incidence of late-detected DDH amounting to 0.48/1,000 newborn children.