Hip dysplasia screening proposed for arthritis

Mariecar Jara-Puyod, Senior Reporter

A paediatric orthopaedician believes stakeholders must consider the inclusion of the screening of newborns in hospital protocols for the necessary early interventions against hip dysplasia (DDH), which, if neglected would not only deteriorate into serious arthritis through old age but have pre-teens become arthritic as well.

Dr. Marc Sinclair explained DDH in the simplest of terms as the “instability or looseness of the hip joint (that) ranges from mild instability to complete dislocation of the hip.”

He associated it with pregnancy as “the looseness is due to the hormones produced by the mother to help ligaments relax during the birth process.” He said it also has to do with the positioning of the foetus in the womb, plus the possibility that it would surface “shortly” after delivery.

The King’s College Hospital London Dubai Hill Hospital-Lead Orthopaedic Surgery brought up the importance of screening when Gulf Today asked for the advice he could give, particularly to expectant mothers in helping their babies in the foetal position that will prevent DDH.

“The most important is that we identify the problem. As paediatric orthopaedic surgeons we generally favour a universal screening approach, since an ultrasound of the hip is reliable, reproducible and bares a very low cost. It is essential that every child born should have an ultrasound at the age of six weeks, or earlier, if any risk factors are identified.”

This reporter asked Sinclair of his take on the customary practice in the Philippines for pregnant women to go for periodic consultations with the manghihilot, adept in having the unborn child changed position through a technical way of massage. He had mentioned that among the DDH risk factors are the breech position of the foetus and “any condition with limited space in the uterus” such as multiple births.

Sinclair’s answer: “There are no specific or special precautions during the pregnancy or delivery that would prevent (DDH). This is mostly a problem with loose ligaments that develop around the time of birth in all infants.”

On DDH developing “shortly” after birth, Sinclair warned against swaddling, wrapping of the newborns in which their hips and knees get to be extended for hours, “a common practice in the region and elsewhere around the world.”

He said the “healthier technique” is having the newborns, while asleep, have enough room for their legs “being able to bend up and out at the hips for the natural development of the hip joints.”