COPENHAGEN – According to a study conducted by
British investigators, the rate of
developmental dysplastic hip is likely closer to 4 or 5 cases
per 1,000 births. However, they found that late presentations of this condition
have decreased during the period between 1998 and 2008.
Female babies, infants born in the breech position or
after 38 weeks, during a woman’s first or second pregnancy, and with
vaginal deliveries all positively correlated with an increased risk of
developmental dysplastic hip (DDH) in a study conducted by Thomas Ball and
“Family history is associated with a 15 times
increased risk of DDH,” Ball said in a presentation at the
12th EFORT 2011 Congress, here. “What we really ought to
do is calculate the risk, case by case.”
The investigation, spearheaded by pediatric orthopaedic
surgeon Peter J.A. Cox, FRCS, compared 182 children in the study group with
controls consisting of other births in the area. The study was conducted from
1998 to 2008 in the Exeter region of England. Cox and colleagues collected the
data prospectively for the study, which was designed to assess the screening
skills of their existent DDH screening program.
Standard protocol is to screen all newborns for DDH and
then perform a hip exam or ultrasound selectively in children with a positive
family history or those who were born in breech position, but Ball suggested
this may soon change based on these results.
- Ball T, Day C, Strain D, Cox P. Developmental dysplasia of the hip
in the Exeter Region: An analysis of epidemiology and risk factors over 11
years. Paper #2929. Presented at the 12th EFORT Congress 2011. June 1-4.
There is quite a bit of bias because you do not know about all the other
children who have had no imaging like ultrasound or X-rays because we know
there are many of them below the age 10 that have significant dysplasia
undetected and clinically we find them so far. So there is some concern about
this and I feel that 4% or 5% or 4.9 per 1,000 is rather low compared to
figures from Germany or Austria. But, it was a great study and you should keep
on in this field.
— Rüdiger Krauspe, MD, PhD
Department of Orthopedics, Heinrich-Heine University Dusseldorf
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