Hip Dysplasia
Conditions
Keywords
hip dysplasia, screening
Brief summary
The aim of the randomized controlled trial was to determine whether the addition of a general or of a selective ultrasound screening program resulted in more appropriate criteria for treatment and a reduced prevalence of late DDH compared with clinical examination alone.
Detailed description
This is a retrospective registration of a RCT carried out in 1988-90, with a IRB approved follow-up at skeletal maturity carried out in 2007-09. Both the RCT and the follow-up study were carried out in the same institution, by the same PI (Prof. Karen Rosendahl) and her co-workers. Detailed information is published in the following paper: 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. A sample of the initial RCT was invited for a maturity review/follow-up at skeletal maturity. The follow-up at skeletal maturity is called: Radiological indices of hip dysplasia and osteoarthritis at skeletal maturity in the Bergen Birth Cohort. Associations with neonatal hip dysplasia, childhood growth and genetic predisposition and is included in the approval by the Regional Ethical Committee for Medical and Health Research (No 3.2006.144). All participants of the follow-up study gave written informed consent according to the 1964 Declaration of Helsinki. The follow-up had the following main aims: 1\) estimate the prevalence of radiologically defined hip dysplasia, femoroacetabular impingement and osteoarthritis assessed at skeletal maturity 2)report the frequency of 4 longitudinal dysplasia phenotypes based on sonographic assessments in the newborn and radiological assessments at skeletal maturity 3)investigate associations of dysplasia as defined in 1 and 2 above in univariate and multivariate models with clinically assessed hip joint mobility/joint hypermobility, weight, height and body mass index (BMI) at age 18/19 years, prepubertal weight, height and BMI trajectories using data from child health records, first degree family history of hip dysplasia with or without hip arthroplasty, perinatal factors, measures of OA including minimum joint space, acetabular depth ratio and reported hip pain 5) establish a genetic resource by obtaining and archiving salivary DNA samples.
Interventions
PROCEDUREhip ultrasound
Standardized single-examiner Hip ultrasound was offered to all babies in the universal group, babies at increased risk in the selective group, and to no babies in the clinical exam only group
Sponsors
Institute of Child Health
University of Bergen
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
No minimum to 20 Years
Healthy volunteers
Yes
Inclusion criteria
* all babies born at our institution during 1/1988-06/1990
Exclusion criteria
* low birthweight \<1500 grams, severe malformations, death within first month
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| prevalence of DDH detected after newborn period | 20 years | prevalence of late cases of DDH, detected after newborn period (after first month of age, including in childhood as assessed in original RCT during 1988-90, with a minimum follow-up time of 27 months, and also at skeletal maturity, as assessed in follow-up study during 2007-09. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| treatment rate | 20 years | abduction treatment and/or surgery during infancy, later childhood and skeletal maturity |
Other
| Measure | Time frame | Description |
|---|---|---|
| avascular necrosis of femoral head (AVN) | 20 years | avascular necrosis of femoral head (AVN) as a complication to treatment |
Countries
Norway
Outcome results
None listed