ReviewFrontiers in pediatrics2022
Four decades of developmental dysplastic hip screening according to Graf: What have we learned?
Review in Frontiers in pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk Factors for Developmental Dysplasia of the Hip Before 3 Months of Age: A Meta-Analysis.JAMA network open · 2025Pooled it
- A stabilization device significantly improves measurement reliability and efficiency of Graf ultrasonography for developmental dysplasia of the hip: a retrospective cohort study.Frontiers in pediatrics · 2026Article
- Early Screening for Developmental Dysplasia of the Hip: Sonographic Reference Values, Risk Factors, and Treatment Considerations.International journal of neonatal screening · 2025Article
- Ultrasound-based statistical shape modeling for prognosis in unstable hip dysplasia.The ultrasound journal · 2025Article
- Artificial Intelligence in Pediatric Orthopedics: A Comprehensive Review.Medicina (Kaunas, Lithuania) · 2025Review
- Impact of probe tilt on Graf ultrasonography accuracy for neonatal hip dysplasia screening.SICOT-J · 2025Article
- "ICODE Hip US Calculator": a mobile phone aid for screening with Graf's sonographic technique.Journal of ultrasonography · 2024Article
- Universal ultrasound screening and early treatment of developmental dysplasia of the hip: a critical review.Journal of medicine and life · 2024Review
- Treatment of developmental hip dysplasia with manual therapy following Pavlik harness failure: a case report with long-term follow-up.The Journal of manual & manipulative therapy · 2024Article
- Hipology 2023: Science, Philosophy, and Craft.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2023Review
- Assessment for late developmental hip dysplasia in a cohort of infants with risk factors and normal hip ultrasound.Frontiers in pediatrics · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Sonographic hip examination according to Graf is widely accepted standard for diagnosing developmental dysplastic hips (DDH) but it is criticized for alleged intra- and interobserver variations. This review was conducted to evaluate whether objective quality criteria according to the Graf method are fulfilled within scientific literature. Methods: A systematic literature search on Pubmed was performed using the search string: [(DDH) OR (Hip dysplasia)] AND (Graf). Studies suitable by title, abstract, manuscript, containing an image of sonographic hip examination and online accessibility were included into analysis. Results: 131 studies were included into final analysis. Only 68 (51.9%) presented correct sonographic images according Graf's criteria. 98 (74.8%) studies plotted alpha-angles (angle between bony roof line and base line) but only 85 (64.8%) studies beta-angles (angle between cartilage roof line and base line). Studies were contributed from 25 countries. Conclusion: Assumingly, skepticism regarding the Graf method is based on user errors and insufficient application of the Graf quality assessment algorithm resulting in high intra- and interobserver variations. When performed correctly, the Graf method is of high diagnostic value.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.