International variance in the treatment of developmental dysplasia of the hip

J Child Orthop. 2014 Oct;8(5):381-6. doi: 10.1007/s11832-014-0622-z. Epub 2014 Oct 29.

Abstract

Introduction: Developmental dysplasia of the hip (DDH) is the most common congenital musculoskeletal abnormality. Recourse to definitive surgical treatment is not typically taken until over the age of 18-24 months. International consensus regarding age at surgery, degree of dysplasia requiring surgery and type of osteotomy is not available in the literature.

Study aims: To determine variation in timing and type of osteotomy for persistent DDH across the world.

Methodology: Senior authors of recent publications pertaining to hip dysplasia were sampled. Participants' practice relating to age and radiological indications for surgery were determined.

Results: Thirty-two surgeons responded from five different geographical regions. No inter-regional consensus was established regarding investigations to determine the need for osteotomy, preferred osteotomy type or ideal age at which to perform an osteotomy.

Conclusion: International agreement regarding the surgical management of DDH does not exist. This common congenital condition warrants development of a treatment algorithm.