Introduction: Ideally any screening system should use a simple reliable test with good intraobserver reproducibility. This is important in DDH as once there is an established abnormality surgical intervention is frequently required. The aim of early detection (within six weeks) is to increase the number of children that may be treated nonoperatively. We have evaluated the effectiveness of our selective screening program by determining the late presentation rate of DDH in our region.

Methods: Between January 2001 and December 2003 we looked retrospectively at all patients presenting with DDH in our region. We recorded their age at scan and presentation, the Graf classification if recorded, their management, the presence of risk factors for DDH, referral source and presence of a positive clinical examination. All these were entered into a database and analyzed specifically with regard to patients presenting late.

Results: In the period between January 2001 and June 2002 prior to selective ultrasound screening (Group 1) there were 9441 live births and 26 cases of DDH (incidence of 2.75). There were 11 late presenters with an incidence of 1.12 per 1000 per year. Between July 2002 and December 2003 (Group 2) there were 9428 live births and 20 cases of DDH (incidence of 2.12). There were 3 late presenters with an incidence of 0.3 per 1000 per year.

Discussion: We have shown that a program of selective ultrasound screening in our region has decreased the number of children presenting late with DDH. It must be remembered however, that in the absence of any risk factors, clinical examination remains critical in identifying those with DDH in a selective screening program.

Purpose: About 1% of the children are born with neonatal hip instability (NHI). By combining data from the Medical Birth Registry of Norway (MBRN) with that of the Norwegian Arthroplasty Register (NAR), the influence of NHI on the risk for total hip arthroplasty (THA) before 37 years of age are studied.

Materials and Methods: Since 1967 medical data, included stability of the hips, on all new-borns in Norway (2 092 536 babies) have been compiled. Since 1979 all THA performed in Norway are reported to the NAR. Until 2004 85,120 primary THAs were registered, of these 492 were performed on patients under 37 years of age. These two national registries were linked by using the unique person identification number assigned to each inhabitant of Norway.

Results: Of those 20 668 born with NHI (1%), 9 had received a THA before 37 years of age (43/100 000). Since only 18 of 100 000 new-borns without NHI had had THA, new-borns with NHI had 2,5 times increased risk for having a THA before they become 37 years.

Of the 492 THA in patients younger than 37 years in the NAR, 101 THA (20.5%) were, according to the surgeon, operated because of developmental dysplasia of hip (DDH). Since 13 of these were bilateral THA, the number of patients were 88. Only 9 of these 88 DDH-patients were, however, reported to have NHI. This is surprisingly few, since their dysplasia should be anticipated to be rather severe. Does this indicate that the hip-screening for new-borns in Norway should be changed?

Conclusions: New-borns with NHI has 2.5 times increased risk for THA before the age of 37 years compared to those with stable hips at birth. The absolute risk is, however, low, only 43/100 000. Of those 88 who received THA because of DDH before 37 years, 79 had, however, reported normal hips at birth.

Aims

We aimed to determine hip-related quality of life and clinical findings following treatment for neonatal hip instability (NHI) compared with age- and sex-matched controls. We hypothesized that NHI would predispose to hip discomfort in long-term follow-up.

Aims

Despite the presence of screening programmes, infants continue to present with late developmental dysplasia of the hip (DDH), the impact of which is significant. The aim of this study was to assess infants with late presenting dislocation of the hip despite universal clinical neonatal and selective ultrasound screening.