# Development and implementation of an interdisciplinary one-stop clinic for infant hip dysplasia: A pilot study

## TL;DR

This pilot study describes the creation of a one-stop clinic for infant hip dysplasia, aiming to improve diagnosis and treatment through interdisciplinary collaboration.

## Contribution

The study introduces a novel grouping of Graf subtypes and structured treatment phases for DDH management.

## Key findings

- 22 out of 98 infants were treated with a Pavlik harness, showing the clinic's feasibility.
- Collaborative flowcharts helped standardize care and improve interdisciplinary coordination.
- The clinic successfully integrated pediatrics, radiology, and orthopedics for DDH management.

## Abstract

•Describes the co-design and pilot implementation of a one-stop clinic for DDH.•Introduces a novel grouping of Graf subtypes to guide a structured three-phase treatment.•Presents collaboratively designed algorithms for clinic workflow and evidence-based treatment.•In the pilot phase, 22 of 98 infants were treated with a Pavlik harness, showing feasibility.•Aims to standardize care and serve as a model for implementation in similar healthcare settings.

Describes the co-design and pilot implementation of a one-stop clinic for DDH.

Introduces a novel grouping of Graf subtypes to guide a structured three-phase treatment.

Presents collaboratively designed algorithms for clinic workflow and evidence-based treatment.

In the pilot phase, 22 of 98 infants were treated with a Pavlik harness, showing feasibility.

Aims to standardize care and serve as a model for implementation in similar healthcare settings.

The authors hypothesized that establishing a one-stop clinic for the management of Developmental Dysplasia of the Hip (DDH) at our institution would enhance screening procedures, referral processes, patient compliance, early diagnosis, and timely treatment for this condition. To inform clinical practice, the authors conducted a collaborative development of flowcharts for evidence-based patient care protocols, based on the Graf method and patient journey optimization.

A weekly DDH clinic was established in a tertiary/quaternary public teaching hospital in Brazil, integrating pediatrics, radiology, and orthopedics. Flowcharts were collaboratively designed during ten interdisciplinary meetings. As a pilot study, the authors included an initial cohort involved in an observational retrospective study during the period from October 2023 to December 2024.

A novel system of grouping Graf types and subtypes was presented, accompanied by a treatment algorithm and phased therapeutic approach, based on the underlying hip pathology and immediate therapeutic requirements to promote hip centralization and acetabular development. A total of 98 infants were examined at the clinic during the specified period, with 22 receiving non-surgical treatment utilizing the Pavlik harness.

The establishment of a one-stop DDH clinic demonstrated a successful interdisciplinary approach, contributing to early diagnosis and effective treatment of DDH. The collaborative development of flowcharts facilitated the standardization of patient management protocols. Continued refinement of screening procedures and data collection methods is necessary to optimize care and inform future research on DDH management.