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. 2020 Aug 20;55(1):158-168.
doi: 10.1007/s43465-020-00233-0. eCollection 2021 Feb.

Developmental Dysplasia of the Hip: An Examination of Care Practices of Orthopaedic Surgeons in India

Nikki Hooper  1 , Alaric Aroojis  2 , Ramani Narasimhan  3 , Emily K Schaeffer  4 , Eva Habib  5 , Judy K Wu  5 , Isabel K Taylor  6 , Jessica F Burlile  7 , Aniruddh Agrawal  8 , Kevin Shea  9 , Kishore Mulpuri  4
Affiliations

Developmental Dysplasia of the Hip: An Examination of Care Practices of Orthopaedic Surgeons in India

Nikki Hooper et al. Indian J Orthop. .

Abstract

Background: We evaluated screening, referral and treatment practices for developmental dysplasia of the hip (DDH) in India by surveying Orthopaedic surgeons who treat patients with DDH. The survey assessed the timing of DDH presentation, resource availability, and current state of screening and diagnosis, which would help in the development of a DDH care pathway for India.

Methods: An online survey was distributed to Orthopaedic surgeons practicing in India via email and administered onsite to those attending the annual conference of the Pediatric Orthopaedic Society of India in 2019.

Results: 173 completed surveys were received from surgeons practicing in a predominantly urban setting. 68.8% of respondents had performed initial evaluations on children with DDH aged over 1 year in the past 12 months, and 49.1% had assessed children with DDH aged > 2 years on initial presentation. There was no consistent use of established guidelines, with only 30% of respondents stating that a care pathway was in place at their institution. However, 91.9% would support the implementation of a care pathway developed in India, to decrease the incidence of delayed diagnosis and facilitate earlier intervention. 85% of respondents had ready access to ultrasound scans and 95.4% had access to X-rays.

Conclusions: In India, there is still a large number of late-presenting cases of DDH, which could be improved with effective screening. The development of a care pathway for DDH in India is well-supported by Orthopaedic surgeons and may help decrease the incidence of late presenting cases; potentially improving outcomes, decreasing morbidity, and upskilling local practitioners.

Keywords: Care pathway; Developmental dysplasia of the hip (DDH); Screening; Survey; Ultrasound.

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Conflict of interest statement

Conflicts of interestKM has received research support from Allergan, Pega Medical and Depuy Synthes (Johnson and Johnson). None are directly relevant to the research in this paper. For the remaining authors none were declared.

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