Surveillance Can Reduce Treatment in Mild Hip Dysplasia

Active surveillance strategy reduces treatment rate and health care costs, with similar outcomes
By Eric Metcalf
HealthDay Reporter

TUESDAY, Dec. 22 (HealthDay News) -- In infants with mildly dysplastic hips, active surveillance for six weeks, as opposed to immediate abduction splinting can reduce the need for treatment yet lead to similar results at 1 year of age, according to research published online Dec. 21 in Pediatrics.

Karen Rosendahl, M.D., of the Great Ormond Street Hospital for Children in London, and colleagues analyzed data from 128 newborns with mild hip dysplasia whose hips were not dislocatable. Patients were randomized to immediately receive at least six weeks of abduction splinting treatment or sonographic surveillance followed by treatment after six weeks if necessary.

The researchers found that both groups had the same inclination angle (24.2 degrees) at 1 year of age. However, 100 percent of the immediate-treatment group received treatment compared to 47 percent of the surveillance group. In the immediate-treatment and surveillance groups, 38 and 40 patients, respectively, had normal hips at the age of 1 year.

"Although universal treatment from birth of infants with stable but mildly dysplastic hips may cause more rapid normalization, surveillance and treatment reconsideration at the age of 6 weeks did not result in more abnormal hips at 1 year of age. Given a reported prevalence of 1.3 percent for mildly dysplastic but stable hips, a strategy of active surveillance would reduce the overall treatment rate by 0.6 percent. Our results may have important implications for families as well as for health care costs," the authors conclude.

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