Related Experiment Video
Updated: Mar 6, 2026
Author Spotlight: A Novel 3D-Printed Titanium Implant for Minimally Invasive Treatment of Hip Dysplasia in Young Dogs
Published on: April 19, 2024
Pavlik harness treatment for pathological developmental dysplasia of the hip: meeting the standard?
Qaisar Choudry1, Robin W Paton
1aDepartment of Orthopaedics, Royal Blackburn Teaching Hospital, East Lancashire Hospitals NHS Trust, Blackburn bSchool of Medicine, University of Central Lancashire, Preston cUniversity of Manchester, Manchester, UK.
Insights
The Pavlik harness effectively treats developmental dysplasia of the hip in infants. This study found a 96.8% success rate for pathological hip types III and IV, exceeding the standard requirement.
Area of Science:
- Orthopaedic Surgery
- Paediatric Medicine
- Medical Imaging
Background:
- The Pavlik harness is the standard treatment for infant hip dysplasia in the UK.
- A 2013 guideline set an 80% success rate benchmark for Pavlik harness treatment.
Purpose of the Study:
- To evaluate the effectiveness of the Pavlik harness for pathological hip dysplasia (Graf types III and IV) in a district general hospital.
- To compare outcomes against the British Society of Children's Orthopaedic Surgery benchmark.
Main Methods:
- A 10-year prospective observational study of 2826 infants undergoing ultrasound screening.
- Identified and treated 31 Graf type III and 95 Graf type IV hips with Pavlik harnesses.
- Excluded cases of irreducible hip dislocation.
Main Results:
- The Pavlik harness achieved a 96.8% success rate for Graf type III and IV hips.
- Only 3.2% of cases required surgery due to disease progression.
- This success rate meets and exceeds the 80% benchmark.
Conclusions:
- The Pavlik harness demonstrates acceptable and effective outcomes for Graf type III and IV hip dysplasia in a district general hospital setting.
- The treatment is a viable option for pathological hip conditions diagnosed via ultrasound.
Abstract:
In the UK, the Pavlik harness is generally the accepted treatment technique for the treatment of neonatal and infant pathological developmental dysplasia of the hip. In 2013, the success rate of the Pavlik harness became an outcome measure from the British Society of Children's Orthopaedic Surgery for appraisal and revalidation with the GMC for paediatric orthopaedic surgery. The standard set requires an 80% success rate, with less than 20% requiring surgery. This study evaluated the outcomes of Pavlik harness treatment in neonates/infants with 'pathological hips' diagnosed by ultrasound imaging in a district general hospital setting. In a 10-year prospective observational longitudinal cohort study, modified Graf type III and IV hips (excluding those presenting with irreducible hip dislocation) were classified as pathological and splinted. A total of 2826 neonates/infants underwent ultrasound assessment in the paediatric orthopaedic 'screening clinic'. Neonates and infants were referred as 'at-risk' or as clinically unstable by the Paediatric Department and by general practitioners. Thirty-one Graf type III and 95 Graf type IV hips were identified and treated with a Pavlik harness. One Graf type III (30/31=success rate 96.8%) and three clinically unstable Graf type IV hips progressed to irreducible hip dislocations (92/95=96.8%). The success rate of the Pavlik harness in Graf type III and IV dysplasia was 96.8%, with 3.2% requiring surgery because of progression of the condition, confirming acceptable results for this technique in a district general hospital setting.
