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Background: Developmental dysplasia of hip (DDH) is a relatively common disorder of the paediatric age group and can have a significant impact on the quality of life, if left untreated. Some research has been done in this field from India over the past many decades, thereby helping to attain the present state of knowledge about DDH. Through this review, an attempt was made to identify and acknowledge important contributions in this field from India. Purpose: To provide some historical aspects and summarise the evidence developed in India concerning different facets of DDH since 1920. Methods: Information about the evolution of DDH management in India was collated from recollections of the senior author (ANJ), from existing records, and contributions from senior Paediatric Orthopaedic surgeons of the country. The Medline database was searched for Indian literature concerning different aspects of DDH. All studies published in English language were included. Included studies were categorised into original studies, reviews, book chapters, case series and case reports, and their contribution to the understanding of DDH was highlighted. Results: The analysis showed 63 published studies on DDH from India. The majority of publications occurred between 2011 and 2020. Retrospective cohort studies and reviews comprised 46% of the published literature. Conclusion: There is a scarcity of research on DDH from India, with many knowledge gaps still prevalent. The overall quality of published literature is poor, with very few good quality original research. However, an increasing trend for research on different aspects of DDH was observed. [ABSTRACT FROM AUTHOR]

Purpose: To identify literature on variations and knowledge gaps in the incidence, diagnosis, and management of developmental dysplasia of hip (DDH) in India. Methods: Following standard methodology and PRISMA-ScR guidelines, a scoping systematic review of literature on incidence, diagnosis, and treatment of DDH in India was conducted. Studies conducted in India, published in indexed or non-indexed journals between 1975 and March 2021, were included in the search. Results: Of 57 articles which met the inclusion criteria, only 33 studies (57.8%) were PubMed-indexed. Twenty-eight studies (49%) were published in Orthopaedic journals and majority had orthopaedic surgeon as the lead author (59.6%). Sixteen studies were mainly epidemiological, 20 reported screening/diagnosis, and 21 reported treatment of DDH. Almost 90% of the studies (51) were Level 4 or 5 according to the levels of evidence in research. There is lack of clarity in the definition of hip dysplasia and screening/diagnostic guidelines to be used. The incidence of hip dysplasia in India is reported to be 0–75 per 1000 live births, with true DDH between 0 and 2.6/1000. Late-presenting DDH is common in India, with most studies reporting a mean age of > 20 months for children presenting for treatment. The treatment is also varied and there is no clear evidence-based approach to various treatment options, with lack of long-term studies. Conclusion: This systematic scoping review highlights various knowledge gaps pertaining to DDH diagnosis and management in India. High-quality, multicentric research in identified gap areas, with long-term follow-up, is desired in future. [ABSTRACT FROM AUTHOR]

Background: Developmental dysplasia of hip (DDH) is a common disorder of childhood and has a good prognosis when treated at an early age. In spite of being a significant concern, many children with DDH are not picked early and present late at walking age. In our country, it is presumed to be due to absence of a national policy for screening of DDH. Screening programmes including the combination of clinical and radiological methods in different ways have been suggested. However, the exact method of screening is controversial. Purpose: To analyze effectiveness and cost-effectiveness of various screening methods for DDH. Study Design: Systematic review. Methods: This review was conducted in accordance with PRISMA guidelines. Medline database was explored for original case series and randomized clinical trials. Inclusion criteria were English language, screening for DDH in neonates, sample size more than 500, and studies with minimum duration of one year. Results: Thirty-four studies were selected to write the manuscript. This included 23 studies looking for effectiveness of a screening programme and 11 studies comparing various outcomes of different screening strategies. A trend favoring universal ultrasound screening was observed Conclusion: The literature supports universal ultrasound screening and has proved its cost-effectiveness. However, considering the logistic and financial challenges in our country, immediate implementation of universal ultrasound screening seems impractical. In the absence of any current guidelines for screening for DDH in India, we suggest professional organizations involved in the care of children and public health policy-makers to come together to develop national screening guidelines for DDH. [ABSTRACT FROM AUTHOR]