International variance in the treatment of developmental dysplasia of the hip

INTRODUCTION: Developmental dysplasia of the hip (DDH) is the most common congenital musculoskeletal abnormality. Recourse to definitive surgical treatment is not typically taken until over the age of 18-24 months. International consensus regarding age at surgery, degree of dysplasia requiring surgery and type of osteotomy is not available in the literature. STUDY AIMS: To determine variation in timing and type of osteotomy for persistent DDH across the world. METHODOLOGY: Senior authors of recent publications pertaining to hip dysplasia were sampled. Participants' practice relating to age and radiological indications for surgery were determined. RESULTS: Thirty-two surgeons responded from five different geographical regions. No inter-regional consensus was established regarding investigations to determine the need for osteotomy, preferred osteotomy type or ideal age at which to perform an osteotomy. CONCLUSION: International agreement regarding the surgical management of DDH does not exist. This common congenital condition warrants development of a treatment algorithm.