Ultrasound surveillance appropriate for mild hip dysplasia

January 01, 0001

Ultrasound surveillance appropriate for mild hip dysplasia

These British and Norwegian researchers performed a blinded, randomized, controlled trial to examine whether mild congenital hip dysplasia should have early treatment compared with watchful waiting. One hundred twenty eight newborns with mild hip dysplasia were randomly assigned to either 6 weeks of abduction treatment or follow-up with ultrasound.

The investigators found: "Both groups included 64 newborns, and there was no loss to follow-up. With the exception of a small but statistically significant excess of girls in the active-sonographic-surveillance group, there were no statistically significant differences in baseline characteristics between the 2 groups. The mean inclination angle at 12 months was 24.2 degrees for both groups (difference: 0.1), and all children had improved and were without treatment. The mean angle was 59.7 degrees in the treatment group and 57.1 degrees in the active-surveillance group for a difference of 2.6 degrees evaluated after 1.5 and 3 months. At 1.5 months of age, the hips had improved in all treated children but not in 5 children under active surveillance. Among the sonographic-surveillance group, 47% received treatment after the initial surveillance period of 1.5 months."

The investigators concluded: "Active-sonographic-surveillance halved the number of children requiring treatment, did not increase the duration of treatment, and yielded similar results at 1-year follow-up. Given a reported prevalence of 1.3% for mildly dysplastic but stable hips, a strategy of active surveillance would reduce the overall treatment rate by 0.6%. Our results may have important implications for families as well as for health care costs."

This important study finds that ultrasound surveillance for up to six weeks is appropriate for mild hip dysplasia in newborns.

For the full abstract, click here.

Pediatrics 125(1):e9-e16, January 2010
© 2010 to the American Academy of Pediatrics
Immediate Treatment Versus Sonographic Surveillance for Mild Hip Dysplasia in Newborns. Karen Rosendahl, Carol Dezateux, Kari Røine Fosse, et al.

Category: M. Musculoskeletal. Keywords: congenital hip dyplasia, mild hip dysplasia, ultrasonography, surveillance, immediate treatment, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 3 February 2010 2009

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