The Epidemiology and Demographics of Hip Dysplasia

Table 2

Incidence of DDH in the clinical screening period era (1950s–1980s).

(a) Indigenous peoples

Study	Year	Location	Ethnicity	Dx	No. Pts	No. DDH	Incidence (per 1000)
Native Americans
Corrigan and Segal [36]	1950	Island Lake, Manitoba	Cree-Ojibwa	Documented DDH	1253	45	35.9
Walker [37]	1977	Island Lake, Manitoba	Cree-Ojibwa	All DDH	1248	420	336.5
				Dislocation		243	194.7
				Dysplasia		123	98.6
				Other		54	43.3
Houston and Buhr [38]	1966	Northern Saskatchewan	Cree	All DDH	4453	59	13.2
				Likely DDH	1253	71	56.7
Salter [39]	1968	Ontario, Canada	—	All DDH
				Used cradleboard	2032	250	123.0
				No cradleboard	1347	17	12.6
Rabin et al. [40]	1965	Many Farms District, AZ	Navajo	Adults—All	270	9	33.3
				Dislocation		7	25.9
				Dysplasia		2	7.4
				Children—All	548	22	40.1
				Dislocation		4	7.3
				Dysplasia		18	32.8
				Adults and Children—All	818	31	37.9
				Dislocation		11	13.4
				Dysplasia		20	24.4
Pratt et al. [41]	1982	Many Farms District, AZ	Navajo	Children
				All DDH	548	18	32.8
				Dislocation		14	25.5
				Dysplasia		4	7.3
				Adults
				All DDH	270	89	330
				Dislocation		70	259
				Dysplasia		19	70
Coleman [42]	1968	Fort Defiance, Ship Rock, Gallup	Navajo	All DDH ≤ 3 months old	1155	77	66.7
Kraus and Schwartzman [43]	1957	Fort Apache	Apache	Dislocation	3500	107	30.6
Weighted avg.				All DDH	14553	1108	76.1
Sámi and Australian Aboriginals
Bower et al. [44]	1987	Western Australia	Australian Aboriginals	All DDH	*	22	37
Getz [45]	1955	Sámpi (Circumpolar Europe)	Sámi	All DDH	*		40
Mellbin [46]	1962	Sweden	Sámi	All DDH	813	20	24.6

(b) Africans, Indo-Mediterranean, and mixed peoples

Study	Year	Location	Ethnicity	No. Pts	No. DDH	Incidence (per 1000)
Africans—Blacks
Edelsetin [47]	1966	South Africa	Bantu	16678	0	0
Roper [48]	1976	Rhodesia (Zimbabwe)	Bantu	40000	1	0.025
Pompe van Meerdervoort [49]	1977	South Africa	—	10000	3	0.3
Weighted avg.				66678	4	0.06
Burke et al. [50]	1985	United States	—	28261*	13	0.46
Finley et al. [51]	1994	Jefferson County, Alabama, USA	—	9654	2	0.2
Weighted avg.				37915	15	0.40
Indo- Mediterranean
Kulshrestha et al. [52]	1983	Ballabhgarh, India	Indian	2409	1	0.42
Singh and Sharma [53]	1980	New Delhi, India	Indian	7274	7	1.0
Boo and Rajaram [54]	1984	Kuala Lumpur	Indian	8109	10	1.23
Gupta et al. [55]	1992	New Delhi, India	Indian	6209	16	2.65
Ang et al. [56]	1997	Singapore	Indian	2810	13	4.6
Kaushal et al. [57]	1976	Chandigarh, Northern India	Indian	2500	23	9.2
Şahin et al. [58]	2004	Ankara, Turkey	Turkish	5798	10	1.7
Kutlu et al. [59]	1992	Konya, Turkey	Turkish	4173	56	13.4
Doğruel [60]	2008	Ankara, Turkey	Turkish	3541	167	47.2
Alkalay [61]	1972	Tamra, Galilee, Israel	Arabic	450	21	46.7
Alkalay [61]	1972	Western Galilee, Israel	Arabic/Druze	3625	109	30.0
Moosa et al. [62]	2009	Dubai, UAE	Arabic	3786	12	3.17
Mirdad [63]	2002	Aseer, Saudi Arabia	Saudi	79548	300	3.8
Danielsson [64]	2000	Malmö, Sweden	Iraqi/Iranian	1604	7	4.4
Mamouri et al. [65]	2004	Mashhad, Iran	Iranian	6576	10	1.5
Abdinejad et al. [34]	1996	Shiraz, Iran	Iranian	8024	30	3.6
Pashapour and Golmaham- madlou [66]	2007	Urmia, Iran	Iranian	1100	10	9.1
Paterson [67]	1976	Western Australia	Indo-Mediterra- nean, not otherwise specified	2964	9	3.0
Weighted avg.			All	150500	811	5.4
			Indian	29311	70	2.4
			Arabic	118225	732	6.2
Mixed/ Unknown—All Geographic Locations
Rao and Thurston [68]	1986	Wellington, New Zealand	Not specified	15174	60	4.0
Lowry et al. [69]	1989	Alberta, Canada	North America	813^@	30347	2.68
			Not specified	34956	342	9.8
Medalie et al. [70]	1966	Jerusalem, Israel	Dislocation		107	3.1
			Subluxation		235	6.7
Harlap et al. [71]	1971	Jerusalem, Israel	Jewish/Arabic	18017	104	5.7

@calculated from the given incidence and total number of births.

(c) Indo-Malay peoples

Study	Year	Location	Ethnicity	No. Pts	No. DDH	Incidence (per 1000)
Huang et al. [72]	1988	Taiwan	Chinese	9884	10	1.01
Chang et al. [73]	2007	Taiwan	Chinese	*	*	2.9
Hoaglund et al. [74]	1981	Hong Kong	Chinese	557683	38	0.07
Boo and Rajaram [54]	1984	Kuala Lumpur	Chinese	12115	4	0.33
Limpaphayom [75, 76]	1975	Thailand	Thai	33433	17	0.5
Ang et al. [56]	1997	Singapore	Malay	7439	40	5.4
Boo and Rajaram [54]	1984	Kuala Lumpur	Malay	29695	21	0.71
Japanese—before Educational/ Prevention Campaigns
Naito [77]	1958	Japan	Japanese	*	*	56.0
Akabayashi [78]	1958	Miyagi, Japan	Japanese			33.0
Tsuji [79]	1964	Tokyo, Japan	Japanese			11.9
Kashiwagi and Kagawa [80]	1965	Kobe, Japan	Japanese	929	41	44.1
Haginomori [81]	1966	Kochi, Japan	Japanese	3323	106	31.9
Tanabe et al. [82]	1972	Okayama, Japan	Japanese
			All	2756	73	26.5
			Dislocation		32	11.6
			Subluxation		41	14.9
Wada et al. [83]	1993	Tokushima Prefecture,	Japanese			22*
Ishida [84]	1993	Aichi	Japanese			11.2*
Ishida [84]	1993	Fukushima	Japanese			18*
Ishida [84]	1993	Osaka	Japanese			8*
Ishida [85]	1993	Kyoto	Japanese			28*
Kikuike et al. [86]	1993	Takayama/Gifu	Japanese	2289	25	10.9
Gotoh et al. [87]	1993	Asahikawa	Japanese	15944	95	6
Saito [88]	1993	Sapporo	Japanese			12*
Shinohara [89]	1993	Matsudo	Japanese			5.1*
Iwasaki and Takahashi [90]	1993	Nagasaki	Japanese			6.3*
Japanese—Seminal Study on Effects of Extension Diapering/Swaddling
			Japanese
Ishida [85]	1977	Kyoto, Japan	Swaddled	3778	200	52.9
			Not swaddled	3047	17	5.6
Japanese— after Educational/Prevention Campaigns
Higuchi [91]	1984	Tokyo and Ibaragi Prefecture	Japanese	13379	45	3.4
Wada et al. [83]	1993	Tokushima Prefecture,	Japanese	17224	20	1.2
Ishida [84]	1993	Aichi	Japanese			1.1*
Ishida [84]	1993	Fukushima	Japanese			5*
Ishida [84]	1993	Osaka	Japanese			3*
Ishida [85]	1993	Kyoto	Japanese			3*
Kikuike et al. [86]	1993	Takayama/Gifu	Japanese	1749	10	5.7
Gotoh et al. [87]	1993	Asahikawa	Japanese	9471	17	1.8
Saito [88]	1993	Sapporo	Japanese			5.0*
Shinohara [89]	1993	Matsudo	Japanese			1.8*
Iwasaki and Takahashi [90]	1993	Nagasaki	Japanese			2.0*
			All	714254	769	1.08
			Chinese	57962	52	0.1
Weighted avg.			Malay	37134	61	1.6
			Japanese
			Before	25241	340	13.5
			After	41823	92	2.2

∧Incidence from [82].
∗Only the incidence was given and could not be included in the weighted averages.

(d) Caucasians

Study	Year	Location	No. Pts	No. DDH	Incidence (per 1000)
Scandinavia
Severin [92]	1956	All Sweden	566142	497	0.88
von Rosen [93]	1962	Malmö, Sweden	24000	40	1.7
von Rosen [94]	1968	Malmö, Sweden	31304	171	5.46
Fredensborg [95]	1976	Malmö, Sweden	58579	548	9.33
Danielsson [64]	2000	Malmö, Sweden	15189	115	7.57
Beckman et al. [96]	1977	Northern Sweden	40419	295	7.30
Finley et al. [51]	1984	Uppsala, Sweden	62879*	193	28.0
Bjerkeim [97–102]	1974, 1976	Southeastern Norway	*	*	10.0
Finne et al. [103]	2008	Oslo, Norway	19820	34	1.7
Melve and Skjaerven [104]	2008	All Norway	519266	2509	4.83
Heikkilä [105]	1984	Southern Finland	151924	1035	6.81
Clausen and Nielsen [106]	1988	Randers, Denmark	13589	83	6.1
Weighted avg.			1510007	5713	3.8
Western Europe
Mitchell [107]	1972	Edinburgh, Scotland	31961	100	3.1
MacKenzie and Wilson [108]	1981	Aberdeen, Scotland	53033	1606	30.3
Bertol et al. [109]	1982	Edinburgh, Scotland	44953	299	6.7
Record and Edwards [110]	1958	Birmingham, England	226038	148	0.66
Leck et al. [111]	1968	Birmingham, England	94474	86	0.91
Wilkinson [112]	1972	Southampton, England	6272	37	5.9
Jones [113]	1977	Hertfordshire, England	29366	76	2.6
Noble et al. [114]	1978	Newcastle upon Tyne, England	25921	271	10.5
Catford et al. [115]	1982	Southampton, England	76724	178	2.32
Knox et al. [116]	1987	Birmingham, England	144246	96	0.67
Williamson [117]	1972	Northern Ireland	34840	97	2.78
Patterson et al. [118]	1995	Belfast, Northern Ireland	138600	243	1.75
Reerink [119]	1993	Leiden, Netherlands	2092	32	15.3
Judet and Tanzy [120]	1966	Creuse, France (only girls)	1326	48	3.6
Valdivieso Garcia et al. [121]	1989	Córdoba, Spain	33000	323	9.79
Padilla-Esteban et al. [122]	1990	Madrid, Spain	40243
		All		1747	43.4
		Dislocation		89	2.21
		Subluxation		80	1.99
		Dysplasia		1587	39.4
Sanz et al. [123]	1991	Salamanca, Spain	6135	54	8.8
Giannakopoulou et al. [124]	2002	Crete	6140	65	10.6
Di Bella et al. [125]	1997	Sicily	2000	51	25.5
		All	996038	5509	5.5
Weighted avg.		United Kingdom	906428	3232	3.6
		Mediterranean/ Spain	87518	2240	25.5
Eastern Europe
Srakar [126]	1986	Ljubljana, Yugoslavia	5000	50^@	10.0
Kepeski et al. [127]	1969	Skoplje, Macedonia	9149	302^@	33.0
Maričević [128]	1885–1993	Lastovo Island, Croatia	3676	19	5.2
Krolo et al. [129]	1968–88	Zagreb, Croatia	7168	120	16.7
Stipanicev [130]	1985	Šibenik, Croatia	26227	2203^@	84.0
Darmonov [131]	1996	Stara Zagora, Bulgaria	20417	124	6.1
Samborska and Lembrych [132]	1973	Opole, Poland	14500	159	11.0
Polívka [133]	1973	West Bohemia, Czech Republic	28471	3223	113.2
Košek [134]	1973	Dêčín and Česká Lípa, Czech Republic	23580	1048	44.4
Poul et al. [135]	1992	Brno, Czechoslovakia	35550	656	18.5
Vencálková and Janata [136]	2009	Liberec, Czech Republic	12944	335	25.9
Drimal [137]	1959	Martin, Slovakia	9510	120	12.6
Tomáš [138]	1989	Bardejov, Slovakia	7208	323	44.8
Czéizel et al. [139]	1974	Békéscsaba, Hungary	18219	523	28.7
Csató and Benkó[140]	1963	Miskole, Hungary	5513	30	5.44
Pap [141]	1956	Debrecen, Hungary	11933	217	18.2
Czeizel et al. [142]	1972	Budapest, Hungary	108966	3000	27.5
Weighted avg.			348031	12452	35.8
Australia and New Zealand
Paterson [67]	1976	South Australia	4445	31	7.0
Yiv et al. [143]	1977	South Australia	19622	206	10.5
Bower et al. [44]	1987	Western Australia	62879^∧	415	6.6
Chan et al. [144]	1999	Adelaide, Australia	118379	916	7.74
Howie and Phillips [145]	1970	Auckland, New Zealand	16103	57	3.54
Doig and Shannon [146]	1975	Canterbury, New Zealand	23443	62	2.65
Dykes [147]	1975	Southland, New Zealand	47064	103	2.19
Hadlow [32]	1988	New Plymouth, New Zealand	20657	331	16.0
Weighted avg.			312592	2121	6.8
Americas
Lehmann and Street [148]	1981	Vancouver, British, Columbia, Canada	116808	142	1.2*
Tijmes et al. [149]	1971	Llanquihue, Chile	30000	137	4.6
Hazel and Beals [150]	1989	Portland, Oregon	39429	32	0.8
Finley et al. [51]	1994	Jefferson County, Alabama	17907	12	0.7
Weighted avg.			174144	186	1.07

*The incidence and either the numerator/denominator were given; appropriate values calculated when possible.
@calculated from the given incidence and total number of births.