title: Newborns with sonographically dysplastic and potentially unstable hips: 6-year follow-up of an RCT.
abstract: OBJECTIVE
  To examine the long-term outcome of early abduction splinting versus active sonographic surveillance in newborns with mildly dysplastic hips.
  
  
  METHODS
  Between 1997 and 2003, 128 newborns with mildly dysplastic and potentially unstable hips on ultrasound (43° ≤ α-angle < 50°) were randomly assigned to immediate abduction treatment or sonographic surveillance. All were invited for a radiographic follow-up at 6 years. The radiographs were analyzed by a single radiologist masked to the randomization allocation, and markers of hip dysplasia (acetabular index, center-edge angle of Wiberg) and avascular necrosis were reported.
  
  
  RESULTS
  Eighty-three participants (65%) agreed to participate in the follow-up (42 participants from the treatment group). The mean acetabular index was 14.7° (SD: 5.6°) for the treatment group and 13.9° (SD: 3.9°) for the control group (mean difference: -0.8° [95% confidence interval: -2.9° to 1.3°]). Values were within normal ranges for age for all participants except for 1 female subject from the treatment group. The mean center edge was 26.6° for those treated and 26.4° for the active surveillance group (mean difference: -0.3° [95% confidence interval: -2.5° to 2.0°]). None had markers suggestive of avascular necrosis.
  
  
  CONCLUSIONS
  We found no difference in radiographic outcome at 6 years of age between children allocated to initial splintage for 6 weeks and those offered active sonographic surveillance. The delayed acetabular ossification or persistent dysplasia seen in a third of infants from both groups at 1 year of age had completely resolved in all but 1 of the female subjects from the treatment group.
authors.affiliation: Department of Radiology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Kari Røine
authors.initials: KR
authors.lastname: Brurås
authors.forename: Stein Magnus
authors.initials: SM
authors.lastname: Aukland
authors.forename: Trond
authors.initials: T
authors.lastname: Markestad
authors.forename: Francesco
authors.initials: F
authors.lastname: Sera
authors.forename: Carol
authors.initials: C
authors.lastname: Dezateux
authors.forename: Karen
authors.initials: K
authors.lastname: Rosendahl
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D014463:Ultrasonography