Total hip arthroplasty preoperative planning for childhood hip disorders' sequelae: Focus on developmental dysplasia of the hip.

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Abstract

Conflict of interest statement: Conflict-of-interest statement: Both authors have nothing to disclose. 15. Eur J Pediatr. 2024 Jul;183(7):2889-2892. doi: 10.1007/s00431-024-05539-x. Epub 2024 Apr 9. Why all newborn hip screening programs have same results-a mini review. Bm MV(1), Pakarinen O(2), Helenius I(3)(4), Uimonen MM(2)(5), Ponkilainen VT(2)(5), Kuitunen I(6)(7). Author information: (1)Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland. matias.vaajala@tuni.fi. (2)Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland. (3)Department of Orthopaedics, New Childrens Hospital, Helsinki University Hospital, Helsinki, Finland. (4)Department of Orthopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland. (5)Department of Surgery, Central Finland Central Hospital Nova, Jyväskylä, Finland. (6)Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland. (7)Institute of Clinical Medicine, Department of Pediatrics, University of Eastern Finland, Kuopio, Finland. All newborns are screened for developmental dysplasia of the hip (DDH), but countries have varying screening practices. The aim of this narrative mini review is to discuss the controversies of the screening and why it seems that all screening programs are likely to have same outcome. Different screening strategies are discussed alongside with other factors influencing DDH in this review. Universal ultrasound (US) has been praised as it finds more immature hips than clinical examination, but it has not been proven to reduce the rates of late-detected DDH or surgical management. Universal US screening increases initial treatment rates, while selective US and clinical screening have similar outcomes regarding late detection rates than universal US. This can be explained by the extrinsic factor affecting the development of the hip joint after birth and thus initial screening during the early weeks cannot find these cases.  Conclusion: It seems that DDH screening strategies have strengths and limitations without notable differences in the most severe outcomes (late-detected cases requiring operative treatment). Thus, it is important to acknowledge that the used screening policy is a combination of values and available resources rather than a decision based on clear evidence. © 2024. The Author(s). DOI: 10.1007/s00431-024-05539-x PMCID: PMC11192804