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. 2023 Feb 1;43(2):105-110.
doi: 10.1097/BPO.0000000000002312. Epub 2022 Dec 5.

Caregiver Experiences Using Orthotic Treatment Options for Developmental Dysplasia of the Hip in Children

Georgia Grzybowski  1 , Emily Bliven  1 , Luke Wu  2 , Emily K Schaeffer  3   4 , Marissa Gibbard  2 , Bryn O Zomar  3   4 , Alice Casagrande Cesconetto  1 , Claire Mundy  1 , Kishore Mulpuri  3   4 ; International Hip Dysplasia Registry Knowledge Translation Advisory Board
Affiliations

Caregiver Experiences Using Orthotic Treatment Options for Developmental Dysplasia of the Hip in Children

Georgia Grzybowski et al. J Pediatr Orthop. .

Abstract

Background: Developmental dysplasia of the hip (DDH) is a common condition affecting 5 in 1000 newborns. The standard first line of treatment is the use of an orthotic, which has generally high success rates, but can pose substantial difficulties and put undue burden on caregivers. The general experience of caregivers using these orthotics has not been well documented on an orthotic-specific basis. The purpose of this study was to investigate caregiver experience using prescribed DDH orthotics to identify challenges, differences between treatment options, and areas of improvement.

Methods: A survey assessing treatment prescription, respondent demographics, and caregiver experience was distributed online to caregivers whose child/children were treated for DDH with an orthotic. Seven-point positively phrased Likert scale statements and open-ended questions were included to assess caregiver experience. The results were analyzed using summary statistics and orthotics with more than 30 responses were selected for more in-depth analysis.

Results: A total of 530 survey responses were collected with 63% (334/530) of respondents using a Pavlik harness, 45% (236/530) a Rhino brace, and 13% (67/530) a Denis Browne Bar. The overall weighted average score across all Likert Scale statements was positive for the Pavlik harness, Rhino brace, and Denis Browne Bar at 4.19 (95% CI, 3.83 to 4.54), 4.63 (95% CI, 4.27 to 4.99) and 4.91 (95% CI, 4.58 to 5.24), respectively. In the open-ended responses, all 3 orthotics were perceived as easy to use and not hindering child-caregiver bonding, but raised concerns of discomfort and skin irritation, as well as preventing the ability to cuddle their child the way they desired. The Pavlik harness respondents consistently brought up concerns regarding cleanability.

Conclusions: The results show that the DDH orthotics analyzed are generally easy to use and perceived positively by caregivers, but have orthotic-specific challenges that should be a focus of future improvement work.

Clinical relevance: This study evaluated opinions and attitudes of caregivers for children being treated with DDH orthotics, revealing experiences, concerns, and challenges associated with the use of commonly prescribed options.

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Conflict of interest statement

K.M. receives funding support from the I’m a HIPpy Foundation, the Peterson Fund for Global Hip Health, IHDI, BC Children’s Hospital Foundation, the Canadian Orthopaedic Foundation, POSNA, Divi’s Foundation for Gifted Children, Johnson & Johnson, Pega Medical and OrthoPediatrics. The remaining authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Survey structure overview and breakdown of orthotics indicated as recommended for developmental dysplasia of the hip treatment. Respondents were instructed to select all applicable options.
See this image and copyright information in PMC

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