New-born hip checks ‘have failed to prevent late diagnosis’

  • April 5, 2019
  • Screening for new-born babies introduced in the 1980s hasn’t improved early hip dysplasia diagnosis rates, a study by orthopaedic surgeons in Southampton has discovered.

    Hip dysplasia, where the ball and socket joint of the hip does not form properly, generally occurs in new-born babies or during early development. It can be treated using a removable splint worn for two to three months – if it is picked up early, treatment has a 95% success rate.

    Lack of treatment leads to long-term problems

    Without treatment, developmental dysplasia of the hip (DDH) can lead to problems later in life, including walking with a limp, hip pain (especially during the teenage years) and painful and stiff joints (osteoarthritis).

    All new-borns in England have their hips examined but only those at risk or with problems receive a scan. Babies’ hips are checked as part of a physical examination within 72 hours of being born and again at six to eight weeks old.

    No advance in early diagnosis

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

    The study of almost 15m patients, the largest population study on DDH, examined national records of all children from 1990 to 2016 who were diagnosed between one and eight years old.
    Tim Theologis, president of the British Society for Children’s Orthopaedic Surgery, 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.”

    A delay in diagnosis of up to a year or more can lead to a shortened leg, surgery and the risk of continuing hip pain and long-term complications. In some extreme cases, children younger than 10 are going under the knife for a hip replacement.

    Why doesn’t screening work?

    Alexander Aarvold, study author and consultant orthopaedic surgeon at Southampton, said untreated hip dysplasia was “a significant public health issue” and the current approach had “failed to impact” on late diagnoses in children. He said: “The signs are easily missed. They can be subtle. Doctors, midwives and nurses may be doing the checks and if they are not used to seeing hip dysplasia, it is hard to pick up.”

    Amrit Dhaliwal, an Associate Solicitor at the Medical Accident Group said: “I am disappointed to hear that that there is a possibility that a delay in diagnosing and treating DDH can lead to long-term effects in later life.”

    But Prof Anne Mackie, director of screening at Public Health England, said: “Offering a universal scan can cause more harm, and evidence shows that it can lead to 20 times more babies being unnecessarily treated compared to the UK programme.” PHE said it was planning to introduce some changes to the screening process and looking at more training for clinicians carrying out the examinations.

    If you or a family member have suffered from poor treatment or late diagnosis of dysplasia of the hip, Medical Accident Group can help. We have a team of dedicated clinical negligence solicitors who will guide you through the process of making a claim. Call the team now on 0800 050 1668 or email us at info@medicalaccidentgroup.co.uk.

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