What is hip dysplasia?
Hip dysplasia is a condition of the hip joint in which the top of the thigh bone does not fit properly into the socket. This increases the risk of dislocation, that is, the bone slipping out of place. It is often referred to as developmental dysplasia of the hip (DDH) or congenital dislocation of the hip, as it is usually a problem that occurs at birth or in early childhood development.
Developmental dysplasia of the hip may also go hand in hand with a condition called congenital torticollis.
Outlook (Prognosis) for hip dysplasia
As long as the condition is diagnosed early and treated, most children with hip dysplasia will develop normally and their hip will have its full range of motion. However, if left undiagnosed and untreated, it can cause problems in the future.
Symptoms of hip dysplasia
In developmental dysplasia of the hip, the hip socket is shallow and the head of the femur (thigh bone) is not held firmly in place. This makes it susceptible to dislocation, which can be painful.
Most children with hip dysplasia will develop normally.
Doctors check infants’ hips more than once throughout their development; immediately after birth during the newborn physical examination and again after six to eight weeks. Gentle manipulation of the baby’s hip joints may reveal symptoms such as:
- Discomfort or pain
- The hip is loose
- One leg may be longer than the other.
If left undiagnosed or untreated, hip dysplasia can cause the following symptoms in adolescents and adults:
- Hip pain
- Walking with a limp
- Osteoarthritis, which causes joint stiffness and pain
Medical tests to diagnose hip dysplasia
If a doctor notices a problem during the baby’s physical exam or in other situations, such as multiple births, breech deliveries, premature deliveries, or if there is a family history of the condition, he or she may order an ultrasound.
What causes hip dysplasia?
Before birth, the hip joint is made of soft cartilage as it forms, before hardening into bone after birth. During this time, the ball and socket mechanism of the joint forms as the top of the thigh bone (the “ball”) and the ball of the hip joint mold to each other. Shortly before birth, as the baby reaches a size where there is not much room in the uterus, cramping conditions can move the ball of the hip joint out of position, resulting in a shallower socket. Factors that can increase the risk of this happening are:
- Especially large babies
- First pregnancy
- Breech births
Treatments for hip dysplasia
If diagnosed early, the usual treatment for hip dysplasia is a leg brace, such as the Pavlik harness, which is designed to hold the baby’s thighs in such a way that they press into the socket, helping it to conform to the correct shape.
If the patient is older than six months of age, surgery may be needed to reposition the ball in the patella.
What type of specialist treats hip dysplasia?
Pediatric surgeons, particularly pediatric orthopedic surgeons, treat hip dysplasia in infants and children, while those whose CDD goes undetected until adulthood may be treated by orthopedic surgeons.