Hip

Dysplasia

What Is Hip Dysplasia?

Hip dysplasia is a condition in which the hip joint does not develop properly, making the hip malaligned and leading to abnormal structure and function of the joint. There are two main forms of hip dysplasia, infantile and adolescent, which occur at different stages of life.

Infantile hip dysplasia, also known as developmental dysplasia of the hip (DDH), occurs in newborns and infants. It is caused by a variety of factors, including genetic predisposition, abnormal positioning of the baby in the womb, and other environmental factors. In DDH, the ball and socket of the hip joint may be misaligned or poorly formed, leading to instability, dislocation, or subluxation (partial dislocation) of the joint. Symptoms may include a limp or uneven leg length, limited range of motion, and clicking or popping sounds when moving the hip.

Adolescent hip dysplasia typically develops during adolescence, although it may not be diagnosed until adulthood. This form of hip dysplasia may be caused by genetics, abnormal hip mechanics, or other factors. In adolescent hip dysplasia, the hip joint may be shallow or poorly formed, leading to increased wear and tear on the joint over time. Symptoms may include pain or stiffness in the hip, limited range of motion, and an increased risk of hip arthritis in later life.

There are several differences between infantile and adolescent hip dysplasia. Infantile hip dysplasia is typically diagnosed in infancy or early childhood, while adolescent hip dysplasia may not be diagnosed until later in life. In DDH, the hip joint is often unstable and may require a special harness or brace to keep the joint in the correct position. In contrast, adolescent hip dysplasia often leads to increased wear and tear on the joint, which can eventually lead to hip arthritis.

Treatment for hip dysplasia depends on the severity of the condition and the age of the patient. In infantile hip dysplasia, early diagnosis and treatment are critical to prevent long-term complications. Treatment may include a harness or brace to keep the joint in the correct position, or surgery to realign the joint. In adolescent hip dysplasia, treatment may include physical therapy, pain management, or surgery to repair or replace the joint.

How is Hip Dysplasia treated during adolescents and adults?

The treatment options for adolescent and adult hip dysplasia depend on the severity of the condition, the age of the patient, their level of function and the presence of symptoms. Common treatment options for hip dysplasia in adolescents and adults include:

  1. Non-surgical options: Non-surgical treatments for hip dysplasia may include physical therapy, activity modification, and pain management. Physical therapy can help improve pelvic posture and thus hip stability, improve hip joint mobility, strengthen the surrounding muscles, and relieve pain. Activity modification involves avoiding activities that may aggravate hip dysplasia symptoms, such as high-impact exercises or sports. Pain management may include over-the-counter or prescription pain medication, as well as corticosteroid injections to reduce inflammation.
  2. Surgical options: Surgery may be necessary for severe cases of hip dysplasia that do not respond to non-surgical treatments. The specific type of surgery will depend on the severity of the condition and the age of the patient. Some surgical options include:
    • Periacetabular osteotomy (PAO), also called Bernese Osteotomy: This surgery involves cutting and repositioning the hip socket to improve its alignment with the femoral head.
    • Femoral osteotomy: This surgery involves cutting and repositioning the femur to improve its alignment with the hip socket.
    • Hip arthroscopy: This is a minimally invasive surgery that involves inserting a small camera into the hip joint to remove damaged tissue or repair torn cartilage. It can be a helpful adjunct to osteotomies for patients with hip dysplasia.
    • Total hip replacement: This surgery involves removing the damaged hip joint and replacing it with an artificial joint made of metal, plastic, or ceramic materials.

Always remember the choice of treatment option depends on the patient’s age, the severity of the hip dysplasia, the presence of arthritis, the level of function and the patient’s own goals.