Hip Dysplasia Update

Hip Dysplasia Update

June 20, 2020

The treatment of hip dysplasia has changed little over the years mainly due to lack of long term studies and inadequate standardisation of treatment regimes.

International Hip Dysplasia Registry

All infants and children who present with hip dysplasia at the Royal Childrens Hospital and in my private practice are enrolled in the IHD registry to follow them up to the age of 12 years. We have developed treatment algorithms to standardise practice so that we can clearly understand how our treatments affect the growing hip. Melbourne is the largest contributor to the registry (nearly 700 patients). We currently have three research projects looking at quality and interpretation of ultrasound examination, effectiveness of different braces and variation in clinical practice

Making Sense of Ultrasounds

The interpretation of the ultrasound study usually is in the hands of the radiologist or orthopaedic surgeon. Obtaining an ultrasound of sufficient quality whereby measurements can be made is difficult and is best performed in centres that undertake frequent examinations.

Each ultrasound needs to be assessed for

  • Quality
  • Positioning in the standard plane
  • Measurements (alpha, beta, coverage)
  • Morphology
  • Dynamic Stability

We have developed an ultrasound training tool, that is currently undergoing assessment, so as to have a shared agreement on each of these factors and will publish this shortly.

Good quality ultrasound taken in the standard plane that demonstrates moderate dysplasia in a 4 month old

Patient Education

Patients generally crave information about hip dysplasia and I have now published fact sheets on the website. It may be useful for parents to look at these prior to a visit but certainly after seeing the Hip Dysplasia team to make sure they have the complete picture of what to expect.

These can be found under either the services tab or the fact sheet dropdown on the website at leodonnan.com.au and cover

Providers Education

If you want to brush up on Hip Dysplasia I have incorporated the training module we developed for clinicians which reviews the anatomy, pathology, risk factors and examination of the child with hip dysplasia. Again this is found under the services tab or directly at https://leodonnan.com.au/hip-dysplasia/ and has been used by over 20,000 clinicians around the world.

Still from the Hip Dysplasia Training Module

“I refuse to answer that question on the grounds that I don’t know the answer”