Developmental Dysplasia of the Hip in Saudi Arabia and the Gulf Countries:

Objective: To describe the available research on genetic determinants with special emphasis on the developmental dysplasia of the hip (DDH), in Saudi Arabia and Gulf nations, with reference to the genetic variants, family trend, and environmental factors. Methods: The literature search was conducted in PubMed, Embase, Scopus, Web of Science, and the Saudi Digital Library and Google Scholar through a broad literature search since the beginning of the databases until 2023. Studies that conducted in Saudi Arabia or Gulf countries which evaluated the relationships of genetic factors in DDH were included. Case reports, conference abstracts, and studies that did not evaluate genetic variables and reviews were removed. Due to differences in study design and genetic methods, the data were extracted and summarized qualitatively. Results: The total 473 articles were retrieved from the search data base in which 11 articles were selected for this study. The findings indicated correlations between DDH, and various genes participated in the formation of skeleton and cartilage. Different studies reported rare variants in HSPG2 and ATP2B4, as well as polymorphisms in growth/differentiation factor 5. Several studies also demonstrated a high degree of familial clustering, female dominance, and a potential effect of consanguinity. Genetic susceptibility appears to interact with environmental and cultural factors, such as swaddling practices and delivery-related conditions. Conclusion: The etiology of DDH in Saudi and Gulf populations seems to be multifactorial with both environmental and genetic predisposition factors. There should be bigger genomic studies to further identify population-specific risk factors and aid early detection and prevention measures in the area.