Authors' objectives:

This report aims to synthesize the evidence on risks and benefits of screening for developmental dysplasia of the hip (DDH).

Authors' results and conclusions: No published trials directly link screening to improved functional outcomes. Clinical examination and ultrasound identify somewhat different groups of newborns at risk for DDH; the lack of an untreated cohort or definitive gold standard made it impossible to estimate sensitivity and specificity for the different tests. Few studies examine the functional outcomes of patients who have undergone therapy for DDH. Due to the high rate and unpredictable nature of spontaneous resolution of DDH and the absence of comparative studies of intervention vs. no intervention, the effectiveness of interventions is not known. Avascular necrosis (AVN) of the hip, the most common and most severe harm of all treatments for DDH, can result in growth arrest of the hip and eventual joint destruction with significant disability. Reported rates of AVN very widely.

Authors' recommendations: Screening with clinical examination or ultrasound can identify newborns at risk for DDH, but due to the high rate of spontaneous resolution of neonatal hip instability and dysplasia and the lack of evidence of the effectiveness of interventions on functional outcomes, the net benefits of screening are not clear.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/serfiles.htm#files

Year Published: 2006

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)