The Costs of Late Detection of Developmental Dysplasia of the Hip

Overview

Journal J Child Orthop

Publisher Sage Publications

Specialty Pediatrics

Date 2014 Jun 30

PMID 24973899

Citations 25

Authors

Timothy Woodacre

A Dhadwal

T Ball

C Edwards

P J A Cox

Affiliations

Soon will be listed here.

Abstract

Purpose: Debate currently exists regarding the economic viability for screening for developmental dysplasia of the hip in infants.

Methods: A prospective study of infant hip dysplasia over the period of 1998-2008 (36,960 live births) was performed to determine treatment complexity and associated costs of disease detection and hospital treatment, related to the age at presentation and treatment modality. The involved screening programme utilised universal clinical screening of all infants and selective ultrasound screening of at-risk infants.

Results: One hundred and seventy-nine infants (4.8/1,000) presented with hip dysplasia. Thirty-four infants presented late (> 3 months of age) and required closed or open reduction. One hundred and forty-five infants presented at < 3 months of age, 14 of whom failed early Pavlik harness treatment. A detailed cost analysis revealed: 131 early presenters with successful management in a Pavlik harness at a cost of £601/child; 34 late presenters who required surgery (36 hips, 19 closed/17 open reductions, one revision procedure) at a cost of £4,352/child; and 14 early presenters with failed management in a Pavlik harness requiring more protracted surgery (18 hips, four closed/14 open reductions, seven revision procedures) at a cost of £7,052/child.

Conclusions: Late detection causes increased treatment complexity and a sevenfold increase in the short-term costs of treatment, compared to early detection and successful management in a Pavlik harness.

Discussion: Improved strategies are needed for the 10 % of early presenting infants who fail Pavlik harness treatment and require the most complex and costly interventions.

Citing Articles

Universal ultrasound screening and early treatment of developmental dysplasia of the hip: a critical review.

Alassaf N J Med Life. 2024; 17(8):755-760.

PMID: 39539433 PMC: 11556516. DOI: 10.25122/jml-2024-0251.

Screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip in Brazilian population: a scoping review protocol.

Jaleca P, Liggio D, Lam S, Arora S, Schaeffer E, Grangeiro P BMJ Open. 2024; 14(10):e085403.

PMID: 39401959 PMC: 11474705. DOI: 10.1136/bmjopen-2024-085403.

Environmental and Genetic Risk Factors in Developmental Dysplasia of the Hip for Early Detection of the Affected Population.

Ramirez-Rosete J, Hurtado-Vazquez A, Miranda-Duarte A, Peralta-Cruz S, Cuevas-Olivo R, Martinez-Junco J Diagnostics (Basel). 2024; 14(9).

PMID: 38732313 PMC: 11083091. DOI: 10.3390/diagnostics14090898.

Genetically inspired organoids prevent joint degeneration and alleviate chondrocyte senescence via Col11a1-HIF1α-mediated glycolysis-OXPHOS metabolism shift.

Sun Y, You Y, Wu Q, Hu R, Dai K Clin Transl Med. 2024; 14(2):e1574.

PMID: 38314968 PMC: 10840017. DOI: 10.1002/ctm2.1574.

Costs of abduction treatment in developmental dysplasia of the hip. Analysis of 900 patients.

Lankinen V, Vuorinen R, Helminen M, Bakti K, Valipakka J, Laivuori H Ann Med. 2023; 55(2):2290694.

PMID: 38065688 PMC: 10836239. DOI: 10.1080/07853890.2023.2290694.

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