A STUDY by orthopaedic surgeons in Southampton has discovered that a screening programme introduced in the 1980s to identify hip problems in babies in England has failed to improve early diagnosis rates.

Currently, babies receive an ultrasound only if potential developmental dysplasia of the hip (DDH) is found on physical examinations around the time of birth or at six weeks, or if the infant has specific risk factors.

If detected early, the problem can be treated by a removable splint worn for two to three months to stabilise the position of the hips and help them develop normally, with 95% success rates.

However, if diagnosed after three months, the condition requires invasive operations, long hospital stays, and long-term complications.

Research published in The Bone and Joint Journal, doctors at Southampton Children's Hospital found the incidence of late-diagnosed DDH remains similar to the figure recorded 35 years ago prior to the introduction of the screening programme in 1986.

"Hip dysplasia is a significant public health issue which, untreated, represents the single largest cause for arthritis and total hip replacement in young adults,” said Alexander Aarvold, a consultant orthopaedic surgeon at Southampton Children's Hospital and study lead.

“Detection in children over one year of age remains a persistent reason for referral to paediatric orthopaedic units."

The study of almost 15 million patients, the largest population study on DDH examined national records of all children from January 1, 1990 to January 1, 2016 who were diagnosed between one and eight years old.

The overall incidence of late diagnosis within England of 1.28 per 1,000 live births is greater than previously reported in Southampton (0.47) from 1965 to 1978 and in Bristol (0.39) from 1970 to 1979.

“The approach of selective screening appears to have failed to impact on incidence rates of late-diagnosed DDH and it remains a still uncontrolled disability across the country,” said Mr Aarvold.

He said Austria and Germany undertake universal screening by performing an ultrasound scan of the hips of all newborns. In these countries, the incidence of late-diagnosed DDH is low.

Tim Theologis, president of the British Society for Children's Orthopaedic Surgery (BSCOS), said: “This study has provided evidence that the current selective screening for neonatal hip dysplasia is ineffective and the percentage of infants diagnosed late is unacceptably high.

“There is a pressing need to present convincing evidence to policy makers for the neonatal hip screening guidelines to change and BSCOS will fully support this effort.”