Has There Been a Change in the Age of Presentation of Patients With DDH After the Implementation of a Dedicated Ultrasound-screening Program?

Abstract

We sought to determine if the age of patients presenting to a tertiary subspecialty hospital dedicated to pediatric orthopaedics has changed over the last 21 years and determine if a dedicated ultrasound-screening program implemented in 2006 made any difference. We reviewed the hospital charts for 9299 patients diagnosed with developmental dysplasia of the hip (DDH) and determined the age at the time of presentation; this was a consecutive series of all patients presenting between 1998 and 2019. We determined the diagnosis and age from the chart, 8011 were female (86.15%), and 1288 were male (13.85%). The left hip was affected in 4588 cases (49.34%), the right hip in 1824 cases (19.62%), and there were 2887 bilateral cases (31.05%). Over the 21 years, the mean age of presentation was 2.36 years (range, 0.1 to 17 y). In 1998, the mean age was 2.49 years (range, 0.1 to 16 y). In 2006, a dedicated ultrasound-screening clinic was instituted. The mean age decreased to 1.70 years in 2019 (range, 0.1 to 14 y). The mean age at presentation decreased significantly from 2.65 years, between 1998 and 2005, to 2.19 between 2006 and 2019 (P=0.0067). The implementation of a dedicated ultrasound-screening protocol was significantly correlated with a decrease in the mean age of diagnosis of DDH. The results of treatment of DDH are known to be better the sooner the diagnosis is made. Given that the age of presentation remains a challenge, especially in developing countries, a dedicated ultrasound-screening program is one step to improve our ability to detect DDH in patients at a younger age. Level IV-diagnostic.