Prevalence of developmental dysplasia of the hip (DDH) in infants: a systematic review and meta-analysis
Zhongbin Tao, Jie Wang, Yanming Li, Yanming Li, Yongkang Zhou, Xiaoli Yan, Junqiang Yang, Huili Liu, Bowen Li, Jizu Ling, Yijie Pei, Jianglin Zhang, Yuanyuan Li, Yuanyuan Li
Abstract
Objective To estimate the prevalence of developmental dysplasia of the hip (DDH) in infants with a systematic review and meta-analysis. Method A literature search was conducted in April 2023, using databases such as Cochrane Library, PubMed, MEDLINE, CNKI, and SinoMed, without language restrictions. Eligible studies included cross-sectional studies reporting the prevalence of DDH among infants aged 0–12 months. Two independent reviewers manually selected and coded the studies, with any disagreements resolved by a third reviewer. Meta-analysis was performed using a random-effects model to calculate the prevalence of DDH. Regression analysis examined the trend of DDH prevalence, and stratification analysis explored heterogeneity between studies. Results A total of 65 studies involving 3 451 682 infants were included in the meta-analysis. None of the studies were classified as high quality, four were medium-to-high quality, 50 were low-to-medium quality, and eight were low quality. The pooled prevalence of DDH was 1.40% (95% CI: 0.86 to 2.28, I 2 =100%), and prevalence of dysplasia, subluxation, and dislocation was 1.45% (95% CI: 0.93 to 2.24, I 2 =97%), 0.37% (95% CI: 0.22 to 0.60, I 2 =94%), and 0.21% (95% CI: 0.13 to 0.34, I 2 =92%), respectively. Notably, the overall prevalence has a slight upward trend in the last three decades (β=0.24, p=0.35), but the dysplasia was downward trend (β=−0.48, p<0.01). Girls have higher risk of DDH than boys (1.46% vs 0.66%; Q=5.83, df=1, p=0.02). There were no significant differences based on gender, country, setting, or screening technique. Conclusion The prevalence of DDH among infants is approximately one in a 100, with girls being at higher risk. Though the prevalence of dysplasia has decreased, there is a slight upward trend in overall DDH. Therefore, routine screening for DDH in infants is recommended to prevent more serious developmental problems.