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An April 20, 2023, research study in the Journal of Orthopedic Research confirms that wide-base carriers hold an infant’s hips in a position similar to the Pavlik harness that is used to treat hip dysplasia. [https://onlinelibrary.wiley.com/doi/10.1002/jor.25571] Researchers led by Erin Mannen, PhD, at Boise State University used ultrasound to study infant hips while the infants were in wide-base carriers [thighs supported to the knees] and in narrow-base carriers [narrow support in groin area]. Ten full-term infants with healthy hips and three full-term infants with mild hip dysplasia were studied in both types of carriers. The authors determined that the hips were more fully in the socket with the wide-base carriers compared to the narrow-base carriers. The differences in hip position in the two types of carriers were more noticeable for the babies with hip dysplasia.
This study supports the “Hip Healthy” position for infant carrying that is promoted by the International Hip Dysplasia Institute. Infants with hip dysplasia are known to benefit from the Pavlik harness. This research study shows that the optimum position of the hip in the socket is maintained when infants are carried in an appropriately wide-base carrier. Although there is no evidence that narrow-base carriers cause hip dysplasia, the narrow-base carriers may not promote natural improvement. This is especially important during the first six months of life when the hips are developing rapidly as they prepare for crawling and walking. This study also provides a scientific basis for the observation that cultures have a low incidence of hip dysplasia when infants are commonly carried by the mothers with the hips spread around the mothers’ torso by using a wrap or sling. In contrast, the incidence of hip dysplasia is high in cultures that bind infants’ legs together with tight swaddling during the first few months of life.
In summary, this research provides further support to the advice of the International Hip Dysplasia Institute for parents to use wide-base carriers when carrying infants prior to the age of six months. This advice is similar to recommending healthy nutrition, proper sleep, hydration and exercise to promote optimum health. When choosing between a narrow-base carrier or a carrier that fully supports the thighs around the parent’s torso, the wide-base carrier is more likely to promote healthy hip development. More comprehensive information about Babywearing and infant carriers can be found here [https://juniperpublishers.com/ajpn/AJPN.MS.ID.555876.php]
Straight From The Hip
By pablocastaneda
This podcast is for anyone who wants to learn more about pediatric hip problems, including developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), and other conditions. I’ll be interviewing experts in the field to get their insights on the latest treatments and research.
I aim to empower physicians, providers, and parents with the knowledge they need to make the best decisions.
New episode! 2/15/2024
This week, I am speaking with Eduardo Novais Associate Professor of Orthopedic Surgery Harvard Medical School and part of the Orthopedic Center and the Child and Young Adult Hip Preservation Program at Boston Children’s Hospital
We discuss a paper that he recently coauthored:
Hip Morphology on Post-Reduction MRI Predicts Residual Dysplasia 10 Years After Open or Closed Reduction
We discuss whether it is possible to predict residual acetabular dysplasia based on post-reduction MRI after closed or open reduction for developmental dislocation of the hip, the logistics of obtaining MRI immediately after a procedure, outcomes and the future of research for hip dysplasia.
AT 90 years old SICOT, the Société Internationale de Chirurgie Orthopédique et de Traumatologie, is an international non-profit association incorporated under Belgian law. SICOT’s mission is to promote the advancement of the science and art of orthopaedics and traumatology at an international level, in particular for the improvement of patient care, and to foster and develop teaching, research and education. Société Internationale de Chirurgie Orthopédique et de Traumatologie International Society of Orthopaedic Surgery and Traumatology.
Attending Sponsored Physicians by the IHDI
SICOT is a gathering that encourages international collaboration and promotes research which pushes our mission in the world of DDH.
It acts as a forum for international teaching and hosts general meetings throughout the year for pediatric orthopedists. Pinpointing the international exchange in DDH treatment advancement
What is the difference between IHDI and IHDR research?
The International Hip Dysplasia Registry (IHDR) is managed by the Hip Hope Network to capture treatment data from 23 centers around the globe. This is used to compare current methods of treatment and their outcomes. The IHDR has the stated goals of “…identifying the best practices, standardizing treatment and management, and optimizing clinical and functional outcomes for children with DDH.” This is important work that is why IHDI helped initiate this program and subsequently transferred our registry to this platform.
As a result, the research of the International Hip Dysplasia Institute focuses on innovative technology, basic science knowledge, and new methods that have the potential to displace current treatments that are being used globally. While the work of IHDR has the potential to determine the most successful current methods, it is the opinion of IHDI that new methods are needed that are different from current methods. Only through innovation, can surgery be eliminated so that current methods are no longer necessary. Preventing DDH and eliminating invasive treatment is the goal of IHDI. This can only be accomplished by innovations that are outside the current methods of care.
The following excerpts are from our latest findings in the DDH field. All reading materials are downloadable.
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Pao surgery was developed over 20 years ago. New methods of imaging with MRI & CT scans have improved results. These imaging technique’s also help identify patients who benefit most from pao surgery…
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It should come as no surprise to anyone with arthritis from hip dysplasia that their back is often painful too. In fact, a study published in August, 2021 showed that…
Some doctors are reporting successful brace treatment of older infants that are diagnosed with hip dislocation after six months of age. The success rate before six months is approximately five out of six when the hip is completely dislocated. Some doctors may quote a success rate greater than…
Our Director, Charles T. Price, MD represented the IHDI during this years congress and had the following personal recount to share…
“As an online participant of the SICOT meeting this morning, it was deeply satisfying to see the impact that IHDI has had, and continues to have. SICOT is a highly respected global orthopedic society that meets annually. This year’s meeting was in Budapest as a combined ‘virtual’ and an in-person meeting with respect to the well-being of all its members during this trying time. We actually had good attendance for the Zoom session I had the pleasure of moderating from 2:00 AM to 6:00 AM EDT …….ugh!….I haven’t been up at that hour since I stopped taking trauma calls fifteen years ago. However, four cups of coffee helped, and old habits kicked in quickly. Papers and invited presentations came from every continent except Antarctica and the entire session was about DDH. Four of the first five papers (and some others) had used the IHDI Classification to analyze their outcomes based on severity. It blew my mind to see it so widely adopted…beyond our wildest expectation! Prior to the IHDI Classification, these papers would have lumped all cases together and blurred the findings. Treatments across the board are being modified and improved to fit the severity of the problem instead of “one size fits all”…. Who Knew?… And why did it take so long for doctors to think that way? Maybe a Mom with patience and fervor enough to champion her child’s health asked the doctor to do something about it.
A presenter from India showed how they had used IHDI position statements and educational materials to begin a program for decreasing the practice of traditional swaddling. They did a survey and found that 99% of nurses and the majority of pediatricians in India didn’t know that hips are at risk from tight swaddling. Now, they are using our materials and our strategies to partner with their national pediatric association to educate pediatricians and nurses in newborn nurseries. It was heartwarming to see the IHDI logo and information used and promoted throughout this unsolicited presentation. Another presenter from India gave a paper based on IHDR data analysis. That’s very reassuring because this means that the IHDR (International Hip Dysplasia Registry) is coming alive and that bodes well for the future. As you know, several years ago IHDI transferred all of our data to Kishore Mulpuri, MD along with several hundred thousand dollars to get their registry started. We also sponsored their organizational meetings for some time and provided consultants to help them develop their data collection process. Up until now, about fifteen published clinical research studies have been from the original IHDI data because we had an adequate length of follow-up to see what worked and what didn’t for 800 infants with totally dislocated hips. It’s taken a while for the newer IHDR Data to mature, but now it’s coming into its own and has more volume than we could have ever developed. Kudos to the University of Vancouver, Kishore Mulpuri, MD, and his group for taking what IHDI started and giving it jet engines to progress and discovery. It is one of the IHDI’s missions to nurture impact points like the IHDR in order to advance how we view and treat DDH.
SICOT has taken the reins to provide an annual gathering of international hip dysplasia experts. This was our goal three years ago when IHDI sponsored a specific session and provided three speakers, including Jim Kasser from Harvard, to kick off a specific hip dysplasia section that was independent of other pediatric hip conditions. There seems to be an increasing awareness by SICOT leadership that hip dysplasia is a global problem that they could influence. IHDI had the honor of sponsoring two symposia in Beijing and provided speakers to initiate importance to the cause. Innovative papers based on IHDI concepts have been published as a result, and they’ve continued to have an annual research meeting to discuss hip dysplasia research.
We’ve had a few misfires… but not many…and a lot of wheels are turning in the right direction….That’s because the Whitney family, our most significant benefactors, have given us the resources and the marching orders to elevate hip dysplasia as an important topic. Scientific progress is incredibly slow, but the blinders are coming off after fifty years of stagnation and complacency. It’s been a journey of enlightenment.
AND….we’re not done yet! We still have some more tactics and ploys up our sleeves! Stay tuned…for many more years to come.”
Dr. Charles Price
If you want to know more about becoming an IHDI Streamer visit us on our Tiltify page & click “Contact Us” or Apply Here.
#Games4Hips #Miles4hips #IHDI #HipDysplasia #Tiltify #Twitch
Embry Riddle Aeronautical University and IHDI are highlighted by WFTV News in their efforts to keep babies born with Hip Dysplasia from developing serious issues that lead to surgery over the course of their lifetime. The medical dilemma of diagnosis in infants can soon become easier as identifying DDH within an infant is incredibly difficult due to their inability to speak and follow direction for signs of physical indications. The students at Embry Riddle are utilizing 3D printing as a means to accurately create a model that mimics the hips of an infant and that can help physicians identify the 1 in 6 babies effected by Developmental Dysplasia of the Hip.
Watch ERAU’s Dr. Victor Huayamave, ERAU PhD Student Tamara Chambers, and our Director Dr. Charles T. Price, discuss the project and it’s impact with WFTV anchors HERE.
More emphasis on babywearing may be coming because of a new study showing improved breastfeeding percentages [c1] at six months of age as a result of ergonomic babywearing. The International Hip Dysplasia encourages “Hip-Healthy” babywearing and acknowledges infant carriers that are “Hip-Healthy” because ergonomic carrying may also benefit hips [c2] that are at risk for dysplasia.
According to authors of the recent study, “Suboptimal breastfeeding rates in the United States are associated with an estimated $3 billion in medical costs and $14,2 billion in costs related to premature infant deaths.” These are staggering statistics, especially considering that babywearing may help decrease this burden in the USA and globally. Breastfeeding has numerous benefits for infant development, but rates of breastfeeding in the USA and elsewhere fall below medical recommendations.
The authors of this study randomized 50 infants into one group that received an ergonomic infant carrier during a prenatal visit and another group of 50 infants that received the same carrier when the infant was six months old. The infants who used the carrier from birth has significantly higher rates of breastfeeding than the infants who received their carrier at six months of age. These higher rates are closer to the recommendations for longer duration of breastfeeding recommended by the American Academy of Pediatrics.
The benefits of ergonomic babywearing for hip development are not as clearly established although there is considerable biomechanical and circumstantial evidence that infant hips can benefit from optimum positioning during babywearing. The International Hip Dysplasia Institute is actively supporting research that increases our understanding of babywearing as a potential method to decrease the burden of hip dysplasia globally.
As more benefits of babywearing are known, this simple intervention may become standard parenting advice to improve infant and parent well-being, decrease infant crying, promote breastfeeding, and decrease the risk of hip dysplasia and plagiocephaly (asymmetrical skull development).
[c1]https://pubmed.ncbi.nlm.nih.gov/34193622/
[c2][https://www.jposna.org/ojs/index.php/jposna/article/view/131]
This year’s first ever International Hip Health Day has shown us that collaboration and information have never looked more digital and easily accessible than ever before. The online event was hosted by The Hip Hope Network under the leadership of our colleague, Kishore Mulpuri, MD and his team. The power of connecting through virtual avenues, as an International Organization has immeasurable potential for DDH collaboration and research.
The International Hip Dysplasia Institute began using this emerging technology just one year after the introduction of the first iPhone – an eon ago in the digital world. This journey to battle DDH began with hand written documents and cumbersome online tools to collect data in copious amounts from centers in five different countries. That precursor of data registration continues to provide a wealth of information for analysis. However, the new International Hip Dysplasia Registry managed by Kishore Mulpuri at the University of British Columbia has continued to maintain the original data while adding more centers and collecting an even wider variety of cases to study current methods of treatment. Thus, the future is bright as we have unbridled access to learn more about hip dysplasia and as we continue to work together towards common goals.
During this process, the research focus of IHDI has changed to develop innovative technology that could eliminate the need for many of today’s treatment methods that are being studied and refined. These IHDI efforts include new findings that would enhance prevention, inexpensive reliable hand-held technology for diagnosis and screening, biomechanical engineering for new types of harnesses or braces that could be effective up to age 18 months without the need for casts or surgery. All of these aspirational goals are within reach and could change the nature of hip dysplasia treatment for the future.
Onward and Upward. We hope you join us for #HipHealthDay2022, as we continue to share our research and findings together…
