Developmental dysplasia of the hip screening programme in Chile

Sepúlveda, Matías; Pérez, Juan Antonio; Saban, Esteban A.; Castañeda, Luis E.; Sepúlveda, Dalia F.; Birrer, Estefanía

doi:10.1302/1863-2548.15.200240

Cited by 7 publications

(16 citation statements)

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“…A total of 30 studies 6 , 8 , 20 , 22 , 23 , 29 , 34 , 37 , 38 , 39 , 42 , 43 , 44 , 46 , 47 , 48 , 50 , 52 , 56 , 62 , 63 , 74 , 77 , 79 , 80 , 82 , 85 , 88 , 89 with 6 497 382 newborns assessed the incidence of operatively treated DDH. Of these, 3 studies 29 , 34 , 82 with 64 559 newborns used clinical screening, 16 studies 6 , 37 , 38 , 39 , 42 , 43 , 44 , 46 , 47 , 48 , 50 , 52 , 77 , 79 , 85 , 88 with 855 109 newborns used selective screening, and 11 studies 8 , 20 , 22 , 23 , 56 , 62 , 63 , 74 , 80 , 89 with 5 577 714 newborns use...…”

Section: Resultsmentioning

confidence: 99%

“…Our initial search retrieved 1899 results, and we assessed 203 full texts. Ultimately, 76 studies with 16 901 079 patients were included for analysis (eTable 1 in Supplement 1). Of these studies, 15 concerned clinical screening, 29 concerned selective ultrasound, and 32 concerned universal ultrasound (eTable 2 in Supplement 1).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 30 studies 6,8,20,22,23,29,34,[37][38][39][42][43][44][46][47][48]50,52,56,62,63,74,77,79,80,82,85,88,89 operations per 1000 newborns (Figure 3). The total incidence estimates in the random-effects models were 0.4 (95% CI, 0.2-0.7) operations per 1000 newborns with universal ultrasonographic screening, 0.5 (95% CI, 0.4-1.7) operations per 1000 newborns with selective ultrasonographic screening, and 0.2 (95% CI, 0.0-0.9) operations per 1000 newborns with clinical screening (Figure 5).…”

Section: Incidence Of Operatively Treated Ddhmentioning

confidence: 99%

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Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy

et al. 2022

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ImportanceUniversal ultrasonographic screening for developmental dysplasia of the hip (DDH) has gained increasing popularity despite the lack of benefit in terms of reducing the rates of late-detected cases (age ≥12 weeks) in randomized clinical trials.ObjectiveTo report the reported incidence of DDH in the English scientific literature and compare rates of late-detected cases in settings with different DDH screening strategies.Data SourcesPubMed, Scopus, and Web of Science databases were searched on November 25 and 27, 2021. No time filters were used in the search.Study SelectionAll observational studies reporting the incidence of early-detected or late-detected (age ≥12 weeks) DDH were included. Non-English reports were excluded if the abstract did not include enough information to be included for analysis.Data Extraction and SynthesisThe number of newborns screened and the detection rates were extracted. Meta-analysis calculated the pooled incidence of DDH per 1000 newborns with 95% CIs using a random- or fixed-effects model. This study is reported according to the PRISMA and MOOSE guidelines.Main Outcomes and MeasuresThe main outcome measures were early detection, early treatment, late detection, and operative treatment incidences.ResultsA total of 1899 studies were identified, 203 full texts were assessed, and 76 studies with 16 901 079 infants were included in final analyses. The early detection rate was 8.4 (95% CI, 4.8-14.8) infants with DDH per 1000 newborns with clinical screening, 4.4 (95% CI, 2.4-8.0) infants with DDH per 1000 newborns with selective ultrasonographic screening, and 23.0 (95% CI, 15.7-33.4) infants with DDH per 1000 newborns with universal ultrasonographic screening. Rates for nonoperative treatment were 5.5 (95% CI, 2.1-14) treatments per 1000 newborns with clinical screening, 3.1 (95% CI, 2.0-4.8) treatments per 1000 newborns with selective ultrasonographic screening, and 9.8 (95% CI, 6.7-14.4) treatments per 1000 newborns with universal ultrasonographic screening. The incidence of late-detected DDH was 0.5 (95% CI, 0.2-1.5) infants with DDH per 1000 newborns with clinical screening, 0.6 (95% CI, 0.3-1.3) infants with DDH per 1000 newborns with selective ultrasonographic screening, and 0.2 (95% CI, 0.0-0.8) infants with DDH per 1000 newborns with universal ultrasonographic screening. The corresponding incidences of operative treatment were 0.2 (95% CI, 0.0-0.9) operations per 1000 newborns with clinical screening, 0.5 (95% CI, 0.4-0.7) operations per 1000 newborns with selective ultrasonographic screening, and 0.4 (95% CI, 0.2-0.7) operations per 1000 newborns with universal ultrasonographic screening.Conclusions and RelevanceThis meta-analysis found that early detection rates and nonoperative treatments were higher with universal screening. The late detection and operative treatment rates with universal screening were similar to those among selectively and clinically screened newborns. Based on these results, universal screening may cause initial overtreatment without reducing the rates of late detection and operative treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Incidence Of Operatively Treated Ddhmentioning

confidence: 99%

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Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy

et al. 2022

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“…Currently, multiple factors such as the child's body mass, breech pregnancy, foot deformity, family history of Evidence-Based Complementary and Alternative Medicine hip dysplasia, and skeletal muscle deformity are considered to be strongly associated with the development of hip dysplasia. Children with congenital dysplasia benefit from early diagnosis and reasonable treatment to achieve a favorable prognosis [17,18], but there are still some cases with delayed diagnosis or poor conservative treatment efficacy that require surgical treatment. Surgical treatment is mainly to restore the concentric relationship between the femoral head and the acetabulum, whilst avoiding femoral head necrosis and reoperation [19,20].…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy and Safety of Ibuprofen plus Traction, Reposition, and Hip Spica Cast in the Treatment of Developmental Dysplasia of the Hip

Feng

Liu

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To assess the clinical efficacy and safety of ibuprofen plus traction, reposition, and hip spica cast in the treatment of developmental dysplasia of the hip (DDH). Methods. Between January 2019 and July 2020, 60 children with DDH treaded in department of orthopedics of our institution were assessed for eligibility and recruited. They were assigned at a ratio of 1 : 1 to receive either traction + reposition + hip spica cast plus analgesia pump (observation group) or traction + reposition + hip spica cast plus analgesia pump and oral ibuprofen (control group). The outcome measures included clinical efficacy, pain scores, unexpected pain calls, the dosage of analgesia pump, and adverse events. Results. The two groups had similar clinical efficacy ( P > 0.05 ). The patients given oral ibuprofen were associated with significantly lower pain scores at 24 h and 72 h postoperatively versus those without oral ibuprofen ( P < 0.05 ). Analgesics with oral ibuprofen resulted in fewer unexpected pain calls versus analgesics without oral ibuprofen within 72 h postoperatively ( P < 0.05 ). The application of oral ibuprofen in the analgesia pump showed great improvement in lowering the dosage of analgesia pump versus the absence of ibuprofen ( P < 0.05 ). The incidence of adverse events was similar between the two groups of patients ( P > 0.05 ). Conclusion. Traction + reposition + hip spica cast plus analgesia pump and oral ibuprofen effectively mitigated postoperative pain in children with DDH and reduces analgesic drug dosage with a high safety profile.

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“…Además, el GES determina plazos para la confirmación diagnóstica por especialista e inicio de tratamiento, definiendo la edad de inicio máximo a los 5,5 meses si se cumplen estos plazos 3 . Luego de la implementación de este programa, la incidencia de procedimientos mayores por DLC (reducción abierta y osteotomías) se estima en 0,18 por 1000 RNV, mostrando una reducción significativa de estos procedimientos respecto a cirugías menores para DLC 5 . Esta metodología de detección concuerda con la propuesta por la Sociedad Latinoamericana de Ortopedia y Traumatología Infantil (SLAOTI) el año 2016 6 .…”

Section: Introductionunclassified

Edad de inicio del tratamiento de la displasia de caderas con correas de Pavlik y displasia residual

et al. 2022

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El éxito del tratamiento de la displasia de caderas consiste en lograr una reducción concéntrica y evitar la displasia residual. Uno de los factores esenciales es el diagnóstico y tratamiento precoz. Objetivo: evaluar la relación entre la edad de inicio de tratamiento de displasia de caderas y la presencia de displasia residual al año de edad. Pacientes y Método: Estudio pronóstico retrospectivo. Se seleccionaron pacientes con displasia de cadera tratados con correas de Pavlik en un centro terciario. Se definió displasia residual como un índice acetabular mayor a 28 grados al año de edad. Se determinó asociación de displasia residual con edad de inicio de tratamiento, bilateralidad e índice acetabular mayor a 36 grados. Se utilizaron las pruebas de T-Student, ChiCuadrado e índice de Youden. Se consideró significativo un valor-p < 0,05. Se utilizó el programa STATA v.16. Resultados: Se incluyeron 153 pacientes (262 caderas), 84,3% (129) mujeres, 71,2% (109) con displasia bilateral. Cincuenta y nueve caderas (22,52%) presentaron displasia residual, encontrándose asociación significativa con la edad de inicio de tratamiento (p = 0,03), displasia bilateral (p < 0,01) e índice acetabular mayor a 36 grados (p = 0,01). La edad de inicio posterior a los 4.5 meses aumentó el riesgo de displasia residual en 2.5 veces. (IC95% 1,25-5,03) Conclusión: Se observó aumento de la displasia residual en inicio de tratamiento mayor a 4,5 meses. Es relevante considerar este resultado en las guías clínicas locales para lograr un diagnóstico y tratamiento exitosos.

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Developmental dysplasia of the hip screening programme in Chile

Cited by 7 publications

References 32 publications

Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy

Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy

Clinical Efficacy and Safety of Ibuprofen plus Traction, Reposition, and Hip Spica Cast in the Treatment of Developmental Dysplasia of the Hip

Edad de inicio del tratamiento de la displasia de caderas con correas de Pavlik y displasia residual

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