Screening infants for hip dyplasia may decrease their risk of developing arthritis early in life

A new study published in the July issue of The Journal of Bone and Joint Surgery revealed that screening all infants for hip dysplasia can significantly decrease their chance of developing arthritis in adolescence or early adulthood.

“This study systematically evaluated what we know about hip dysplasia to determine the best screening strategy for newborns,” study author Susan Mahan, MD, a pediatric orthopedic surgeon with Children’s Hospital in Boston and instructor in orthopedic surgery at Harvard Medical School, said in a press release.

“Our study confirms that pediatricians need to continue their current screening strategies for hip dysplasia. However, our findings refute a recent report from The United States Preventive Services Task Force that was unable to recommend screening strategies,” she said.

Symptoms associated with hip dysplasia in infants can include legs that appear asymmetrical during diaper change, or a limp or waddle as a toddler walks.

Mahan and her colleagues analyzed data from more than 70 research studies and clinical trials dating back to 1939. They compared long-term outcomes in the following screening strategies:

ultrasound screening for hip dysplasia for all newborns;
a physical exam by a pediatrician for all newborns, with ultrasound screening used selectively only for infants with risk factors; and
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 a physical clinical exam and utilize ultrasound for those who have risk factors,” Mahan said in the press release. Those risk factors include a family history of hip dysplasia, an infant delivered breech at birth, or a positive physical exam.

Hip dysplasia can be difficult to detect because it is a pain-free condition until adolescence or young adulthood when a patient can experience abnormal wear of the hip joint or hip arthritis.

If the condition is caught early, the most common treatment option for infants is a harness — consisting of a soft brace, straps and Velcro — that helps to hold the legs in an optimal position for hip development, she said in the press release. If the condition is not identified until a child is older, a cast or surgery may be required to reposition the hip in the socket.

“We are trying to catch the cases that do not get better on their own,” Mahan said in the press release. “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.”