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AIMS: The aim of this study was to establish the incidence of developmental dysplasia of the hip (DDH) diagnosed after one-year of age in England, stratified by age, gender, year, and region of diagnosis. PATIENTS AND METHODS: A descriptive observational study was performed by linking primary and secondary care information from two independent national databases of routinely collected data: the United Kingdom Clinical Practice Research Datalink and Hospital Episode Statistics. The study examined all children from 1 January 1990 to 1 January 2016 who had a new first diagnostic code for DDH aged between one and eight years old. RESULTS: The incidence of late-diagnosed DDH was 1.28 per 1000 live births. Within the study population, 754 children were identified with a diagnosis of DDH after one-year of age. Of all late diagnoses, 536 (71.1%) were detected between one to two years of age. There were 608 female patients (80.6%) and 146 male patients (19.4%), giving a female-to-male ratio of 4.2:1. Distribution was evenly spread throughout England. CONCLUSION: The incidence of late-diagnosed DDH has not been reduced from that reported 35 years ago, prior to the introduction of the national selective screening programme for DDH. Cite this article: Bone Joint J 2019;101-B:281-287.

Original publication




Journal article


Bone joint j

Publication Date





281 - 287


DDH screening, Developmental dysplasia of the hip, Late-diagnosed DDH, Selective screening programme, Child, Child, Preschool, Cost of Illness, Databases, Factual, Delayed Diagnosis, England, Female, Hip Dislocation, Congenital, Humans, Incidence, Infant, Infant, Newborn, Male, Neonatal Screening