From the Guidelines
Mild developmental dysplasia of the hip (DDH) can resolve spontaneously in a significant percentage of cases, with 60% to 80% of abnormalities identified on physical examination and >90% identified on ultrasound resolving on their own. This natural resolution is more likely in cases identified during the newborn period, which often represent hip laxity and immaturity 1. The potential for spontaneous resolution decreases with age, and severe dysplasia is more likely to present clinically during childhood. In cases where spontaneous resolution is expected, regular monitoring with a healthcare provider is essential to prevent progression to more severe joint problems or early-onset arthritis. Key factors influencing the likelihood of spontaneous resolution include:
- Age at diagnosis, with younger patients having a higher chance of resolution
- Severity of the dysplasia, with milder cases more likely to resolve
- Individual factors affecting bone development, such as overall health and genetic predispositions It is crucial to note that while spontaneous resolution is possible, early detection and intervention can significantly improve outcomes, especially in cases where the hip joint's ability to remodel is still present, typically before age 4-6.
From the Research
Resolution of Mild Developmental Dysplasia of the Hip
- Some mild cases of developmental dysplasia of the hip (DDH) can resolve without requiring intervention 2, 3
- The exact percentage of mild cases that resolve spontaneously is not specified in the provided studies
- Factors that influence the resolution of mild DDH are not clearly outlined in the studies, but early detection and monitoring are considered important for effective management 2, 3
Treatment and Management of DDH
- Treatment options for DDH include non-operative and operative methods, depending on the severity of the condition and the age of the patient 2, 4, 5
- A comprehensive non-operative treatment protocol for infant DDH has been developed, which includes brace treatment and has shown high rates of success and low rates of residual dysplasia 5
- Surgical treatment may be necessary for residual hip dysplasia or cases where non-operative treatment is not effective 6, 4
Diagnosis and Screening of DDH
- Hip ultrasound is the gold standard diagnostic and monitoring tool for DDH in newborns and infants under 6 months of age 2
- Clinical hip instability occurs in 1% to 2% of full-term infants, and up to 15% have hip instability or hip immaturity detectable by imaging studies 3
- Newborn and periodic screening have been practiced for decades, but there is controversy surrounding the effectiveness of current screening programs and techniques 3