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Developmental hip dysplasia -- the most common congenital defect in newborns -- occurs when a hip joint is shallow or unstable or when the joint is dislocated. Infants with the condition can develop arthritis of the hip when they're young adults.
Researchers analyzed data from more than 70 studies and clinical trials dating back to 1939 to compare long-term outcomes associated with three hip dysplasia screening strategies:
- Ultrasound screening for all newborns
- A physical exam by a pediatrician for all newborns, with ultrasound screening used for infants with risk factors
- No screening for any newborn
"We found that the best chance for avoiding early arthritis of the hip as a young adult occurs when you screen all babies with physical clinical exam and utilize ultrasound for those who have risk factors," study author Dr. Susan Mahan, a pediatric orthopedic surgeon at Children's Hospital Boston and an instructor in orthopedic surgery at Harvard Medical School, said in a news release from the American Academy of Orthopaedic Surgeons.
Risk factors include a family history of hip dysplasia, an infant delivered breech at birth or a positive physical exam.
The study appears in the July issue of the Journal of Bone and Joint Surgery.
"Our study confirms that pediatricians need to continue their current screening strategies for hip dysplasia," Mahan said. "However, our findings refute a recent report from the United States Preventive Task Force that was unable to recommend screening strategies."
"We are trying to catch the cases that do not get better on their own," she explained. "The younger the child, the easier the condition is to treat. And, with early treatment, it is more likely that long-term complications may be avoided."
Treatment for hip dysplasia in infants most often involves a harness that helps hold the legs in the best position for hip development. In older children, a cast or surgery may be required to reposition the hip in the socket.
-- Robert Preidt
SOURCE: American Academy of Orthopaedic Surgeons, news release, July 2009
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