About DDH

Developmental dysplasia of the hip (DDH) describes a spectrum of hip abnormalities ranging in severity from mild instability of a reduced hip to severe dysplasia in a complete and irreducibly dislocated hip. DDH is the most common pediatric hip condition, with 1-3% of all newborns diagnosed at birth [1,2].

As infant hip joints are made mostly of soft, pliable cartilage, rather than hard bone in adults, the femoral head can more easily become unstable and misaligned or dislocate completely. Clinical examination for hip instability is a universal standard; however, not all cases are detectable by this method, leading to potential missed diagnoses or late-presentations that are more difficult to treat [7-10].

Defined risk factors that have currently been deemed to warrant further screening and monitoring include breech presentation, family history of DDH or a clinical history of hip instability [11-14]. 

When detected during infancy, many patients are treated with a brace. There are wide variations in treatment, types of braces, and duration of brace wear. When dislocations are detected after the age of six months, surgery is generally the option, but there are differences in opinions on which surgical methods to perform and when. If left untreated, hip dysplasia may lead to early hip joint arthritis and complete dislocations may lead to life-long disability. Even when treated, DDH is a major cause of early hip replacement or osteoarthritis of the hip in young adults [14]. 

For more information on DDH prevention, screening, and treatment practices, please visit: hipdysplasia.org

Visit the International Hip Dysplasia Institute for tips on Hip-Healthy Swaddling.

 

  1. Godward S, Dezateux C. Surgery for congenital dislocation of the hip in the UK as a measure of outcome screening. MRC Working Party on Congenital Dislocation of the Hip. Medical Research Council. Lancet. 1998;351:1149–1152.
  2. Tibrewal S, Gulati V, Ramachandran N. The Pavlik method: a systematic review of current concepts. J Pediatr Orthop B. 2013;22:516–520.
  3. Mahan ST, Katz JN, Kim YJ. To screen or not to screen? A decision analysis of the utility of screening for developmental dysplasia of the hip. J Bone Joint Surg Am. 2009;91:1705–1719.
  4. Sharpe P, Mulpuri K, Chan A, Cundy PJ. Differences in risk factors between early and late diagnosed developmental dysplasia of the hip. Arch Dis Child Fetal Neonatal Ed. 2006;91:F158–162.
  5. Shipman SA, Helfand M, Moyer VA, Yawn BP. Screening for developmental dysplasia of the hip: a systematic literature review for the US Preventive Services Task Force. Pediatrics. 2006;117:e557–576.
  6. Tredwell SJ. Neonatal screening for hip joint instability. Its clinical and economic relevance. Clin Orthop Relat Res.1992;281:63–68.
  7. Ilfeld FW, Westin GW, Makin M. Missed or developmental dislocation of the hip. Clin Orthop Relat Res. 1986;203:276–281.
  8. Laborie LB, Markestad TJ, Davidsen H, Bruras KR, Aukland SM, Bjorlykke JA, Reigstad H, Indrekvam K, Lehmann TG, Engesaeter IO, Engesaeter LB, Rosendahl K. Selective ultrasound screening for developmental hip dysplasia: effect on management and late detected cases. A prospective survey during 1991–2006. Pediatr Radiol. 2014;44:410–424.
  9. Lennox IA, McLauchlan J, Myrali R. Failures of screening and management of congenital dislocation of the hip. J Bone Joint Surg Br. 1993;75:72–75.
  10. Sink EL, Ricciardi BF, Torre KD, Price CT. Selective ultrasound screening is inadequate to identify patients who present with symptomatic adult acetabular dysplasia. J Child Orthop. 2014;8:451–455.
  11. Tibrewal S, Gulati V, Ramachandran N. The Pavlik method: a systematic review of current concepts. J Pediatr Orthop B. 2013;22:516–520.
  12. Rosendahl K, Markestad T, Lie RT. Ultrasound screening for developmental dysplasia of the hip in the neonate: the effect on treatment rate and prevalence of late cases. Pediatrics. 1994;94:47–52.
  13. Sewell MD, Rosendahl K, Eastwood DM. Developmental dysplasia of the hip. BMJ. 2009;339:b4454.
  14. Engesaeter I, Lie SA, Lehmann TG, Furnes O, Vollset SE, Engesaeter LB. Neonatal hip instability and risk of total hip replacement in young adulthood. Acta Orthop. 2008;117:898-901.