Ultrasonography and the Reorientation of Developmental Hip Dysplasia Research: An NLP-NMF Trend Analysis (1980-2024)
Background: Graf's introduction of hip ultrasonography (US) in the 1980s coincided with a major change in developmental hip dysplasia (DDH) screening and diagnostic practice, with a gradual reduction in reliance on examination-and radiograph-only strategies. Methods: A natural language processing pipeline and non-negative matrix factorization (NLP-NMF) were applied to Scopus-indexed DDH publications, extracting topics and weights across 4 epochs (pre-1980, 1980-1984, 1985-1989, 1980-2024) anchored to the 1980 US milestone. Topic co-occurrence networks, weight distributions, and segmented regression summarized thematic shifts and tested for a 1980 breakpoint. Results: In the post-1980 corpus, a distinct diagnostic imaging theme emerged and strengthened, while surgery declined and anatomy remained influential. In 1985-1989, joint anatomy dominated (39.1%), followed by diagnosis (18.6%), pediatric orthopedics (15.3%), surgery (13.7%), and conservative treatment (13.4%). Across 1980-2024, clinical evaluation accounted for 31.5% of publications, followed by anatomy (19.6%), genetic anomaly (16.7%), diagnostic imaging (16.6%), and surgery (15.6%). Within diagnostic imaging, US carried a high weight (0.948), underscoring its central role. Segmented regression identified a structural breakpoint around 1980, temporally coincident with the period in which hip US entered clinical practice and diffused across the field. Conclusion: The NLP-NMF analysis of 4 decades of DDH literature shows a sustained pivot toward imaging-supported, clinically anchored evaluation and growing attention to etiologic and syndromic/anomaly contexts alongside anatomical determinants, with potential implications for earlier detection, risk-aligned follow-up, and more targeted use of operative management.
- Journal
- EURASIAN JOURNAL OF MEDICINE
- Year
- 2026
- Volume
- 58
- Issue
- 2
- eISSN
- 1308-8742
- DOI
- 10.5152/eurasianjmed.2026.251249
- WoS UID
- WOS:001737361000001