Acetabular development following early treatment of hip dysplasia by Pavlik harness.

One hundred sixty-two neonates with sonographically diagnosed developmental dysplasia of the hip (200 hips) according to the method of Graf were treated with a Pavlik harness until sonographic maturation was reached. Eight patients (12 hips) treated with closed reduction and retention in a bilateral hip spica cast were included. When the children started to walk their acetabular indices were assessed and demonstrated low-grade dysplasia in 26% and high-grade dysplasia in 6% according to the criteria of Tönnis and Brunken. We discuss the current sonographic criteria defining treatment-induced normalization and the adequacy of the length of treatment. We conclude that despite normal values at the end of treatment dysplasia may develop, which necessitates further radiological monitoring of all hips initially rated at risk on sonography. When to end monitoring, however, remains to be determined.