No abstract

We eagerly await the results of randomised controlled trials. Firm clinical outcome data are expected to emerge in the near future, though data on cost and radiation exposure will be needed before definitive conclusions can be made.

Particulate steroids are not demonstrably better in relieving pain compared to their non-particulate counterparts. In view of the concerns over the safety profile of particulate steroids, it may be prudent to switch to non particulates, or at the very least the dangers and alternatives should be flagged with the patient group as part of a shared decision making process.

IntroductionDevelopmental dysplasia of the hip (DDH) is the most common congenital musculoskeletal abnormality. Recourse to definitive surgical treatment is not typically taken until over the age of 18–24 months. International consensus regarding age at surgery, degree of dysplasia requiring surgery and type of osteotomy is not available in the literature.Study aimsTo determine variation in timing and type of osteotomy for persistent DDH across the world.MethodologySenior authors of recent publications pertaining to hip dysplasia were sampled. Participants’ practice relating to age and radiological indications for surgery were determined.ResultsThirty-two surgeons responded from five different geographical regions. No inter-regional consensus was established regarding investigations to determine the need for osteotomy, preferred osteotomy type or ideal age at which to perform an osteotomy.ConclusionInternational agreement regarding the surgical management of DDH does not exist. This common congenital condition warrants development of a treatment algorithm.