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Treatment Patterns and Outcomes of Stable Hips in Infants With Ultrasonic Dysplasia

Kim, Harry K. W., MD, MS; Beckwith, Terri, MPH, CCRP, CPH; De La Rocha, Adriana, PhD, CCRP; Zepeda, Erica, RN, BSN, CPNP-PC; Jo, Chan-Hee, PhD; Sucato, Dan, MD, MS

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: January 15, 2019 - Volume 27 - Issue 2 - p 68–74
doi: 10.5435/JAAOS-D-17-00233
Research Article

Introduction: No clear practice guideline exists for the management of stable hip with ultrasonic dysplasia (UD). This study assessed the treatment patterns for stable UD and determined the outcomes of Pavlik harness (PH) treatment or observation (OB).

Methods: This is a prospective study of 80 infants (107 hips) aged ≤12 weeks at presentation diagnosed with stable UD.

Results: Sixty-five hips were treated with PH, whereas 42 hips were observed. Patients who were older at the time of initial sonogram and those with lower head coverage were more likely to be treated with PH. The mean head coverage was lower in the PH group, indicating more severe UD. At a 2-year follow-up period, 93% of patients in the OB group and 87% in the PH group had a good radiographic outcome.

Discussion: Head coverage and age at first sonogram had a significant influence on the treatment decision for PH. A milder ultrasonic hip dysplasia can be observed because 93% of the patients who were observed had a good outcome.

Level of Evidence: Level II: prospective cohort study

From the Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital for Children, Texas Scottish Rite Hospital for Children, Dallas, TX.

Correspondence to Dr. Kim:

Dr. Kim or an immediate family member has received research or institutional support from Medivir and has received nonincome support (such as equipment or services), commercially derived honoraria, or other non–research-related funding (such as paid travel) from 3D Matrix and Genentech. Dr. Sucato or an immediate family member has received royalties from Globus Medical and serves as a board member, owner, officer, or committee member of the Pediatric Orthopaedic Society of North America. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Ms. Beckwith, Dr. De La Rocha, Ms. Zepeda, and Dr. Jo.

© 2019 by American Academy of Orthopaedic Surgeons
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