EXPLORING VARIABILITY IN WEANING PRACTICES FOR BRACE TREATMENT OF DEVELOPMENTAL DYSPLASIA OF THE HIP

IntroductionWeaning infants from brace treatment for developmental dysplasia of the hip (DDH) is a practice employed by many, but there is variability in how it is defined and implemented. Previous surveys demonstrated weaning is performed by 66% of POSNA members, 50% of EPOS members and 33% of BSCOS members. However, little is known about when weaning starts, what “weaning” entails, and how protocols differ.This study aims to explore these practices and help define the weaning process to inform a future randomised controlled trial (RCT) comparing weaning versus no weaning.MethodA survey generated using Googleforms was distributed to clinicians specialising in DDH. The survey asked respondents to define weaning, whether they follow a specific protocol, when they begin the weaning process, and how long it lasts. Additional questions explored what informs the decision to wean, when clinicians believe the brace can be fully removed, and the specifics of their weaning regimen.ResultsClinicians from around the globe participated. They commonly defined weaning as a gradual reduction in brace usage. Most clinicians followed departmental protocols that varied based on severity or classification. Opinions differed on when to initiate the brace removal process. Practices and weaning regimens demonstrated considerable variability. There was broad consensus supporting an RCT comparing weaning to non-weaning.ConclusionsThis survey underscores the discrepancies in practises related to the weaning of brace treatment. A well-designed RCT comparing weaning to non-weaning is essential to establish gold standard practices.