The effect of the Coronavirus Disease-19 pandemic on delaying the diagnosis of developmental dysplasia of the hip: A systematic review

Abstract

Early intervention is always considered the best management of any health condition. This includes developmental dysplasia of the hip (DDH). DDH can be treated conservatively with early and precocious intervention to prevent any future surgical interventions. The impact of the coronavirus disease-19 (COVID-19) pandemic on these cases remains controversial. This paper aims to review and summarize the published evidence of the pandemic's impact on delaying the diagnosis and management of DDH. This systematic review protocol included searching PubMed, MEDLINE, Google Scholar, EMBASE, ScienceDirect, Directory of Open Access Journals, Web of Science, and Cochrane Library databases for English language studies published during the COVID-19 pandemic from 2019 to 2021. Six studies were included that met the criteria of inclusion. Two of these studies were retrospective studies, two were letters to the editor, one was a case report, and finally, one descriptive review. The first retrospective study was conducted in Turkey with a total sample size of 935, and the second study was conducted in Italy in two centers with a total sample size of 294. The Turkish study had 13 patients diagnosed with DDH, six of them had pathological hips when compared to the two patients diagnosed in the year before the pandemic. Similarly in Italy, 28 patients in the pandemic period were diagnosed when compared to eight only in the year before the pandemic. The case report that was conducted in Italy concluded that treatment is more complicated in a delayed diagnosis of DDH. Although screening programs can be considered a mode for transmitting infection of COVID-19, the risk of delaying diagnosis and management of DDH might become a heavier burden than treating the infection itself.