Reduced effectiveness of the selective hip dysplasia screening programme over time

Area of Science:

• Pediatric Orthopedics
• Diagnostic Imaging
• Public Health Screening

Background:

• Developmental dysplasia of the hip (DDH) screening implemented in North Denmark Region in 2010.
• The program's effectiveness and impact on DDH incidence required evaluation.
• No prior evaluation of the selective screening program existed.

Purpose of the Study:

• Evaluate the selective hip screening program in North Denmark Region from 2010 to 2021.
• Analyze trends in referral rates for hip ultrasound.
• Determine the incidence of DDH and common referral causes.

Main Methods:

• Retrospective study of 3,812 infants referred for hip ultrasound.
• DDH defined as Graf type IIb or worse.
• Analysis of referral rates, DDH incidence, and causes over a 12-year period.

Main Results:

• Annual referral rate doubled from 3.3% in 2010 to 6.8% in 2021.
• DDH incidence increased minimally from 0.15% to 0.22%.
• Breech position (41.4%) and positive clinical exam (27.8%) were primary referral causes.

Conclusions:

• Increased referral rates without a corresponding rise in DDH incidence indicate decreased screening efficiency.
• The screening program's evolution may contribute to the region's low DDH incidence.
• Further investigation into screening protocols is warranted.