Hip Dysplasia

Hip Dislocation

Hip dysplasia refers to a hip socket that doesn’t fully cover the ball portion of the thighbone, which can lead to partial or complete dislocation of the hip joint. The majority of individuals with hip dysplasia are born with the condition. Doctors typically screen for hip dysplasia shortly after birth and during regular check-ups. In cases where hip dysplasia is detected in infancy, a soft brace can often correct the issue. Mild cases of hip dysplasia may not cause symptoms until a person reaches their teenage or young adult years. The condition can cause damage to the joint’s cartilage lining and the labrum, a soft cartilage that encircles the socket part of the hip joint, leading to a hip labral tear. Surgery may be required in older children and young adults to realign the bones for optimal joint function.

Types of Hip Dysplasia

There are several types of hip dysplasia, including:

  • Developmental dysplasia of the hip (DDH): This is the most common type of hip dysplasia and occurs when the hip joint doesn’t develop normally during the fetal stage or early childhood.
  • Adolescent hip dysplasia is usually the end result of developmental dysplasia of the hip (DDH), a condition that occurs at birth or in early childhood. Although infants are routinely screened for DDH, some cases remain undetected or are mild enough that they are left untreated. These patients may not show symptoms of hip dysplasia until reaching adolescence.
  • Acetabular dysplasia: This occurs when the socket of the hip joint is too shallow or poorly formed, which can cause the hip joint to dislocate easily.
  • Congenital hip dysplasia: This is a form of DDH that is present at birth.
  • Secondary hip dysplasia: This can occur as a result of other conditions or injuries, such as Legg-Calvé-Perthes disease, slipped capital femoral epiphysis, or a hip dislocation.

Regardless of the type, the condition can cause pain and discomfort in the hip and surrounding area, as well as limited mobility and a limp.

Symptoms of Hip Dysplasia

In infants, symptoms of hip dysplasia may include one leg appearing shorter than the other, limited mobility or range of motion in the hip, and a clicking or popping sound when the baby’s hip is moved. In adults, symptoms can include hip pain, stiffness, or a sensation of “catching” or “locking” in the hip joint. Some people may also experience groin pain, difficulty walking or standing, or a limp. However, some people with hip dysplasia may not experience any symptoms at all.

Causes of Hip Dysplasia

Hip dysplasia is a congenital condition, which means it is present at birth. It occurs when the hip joint doesn’t develop properly, which can be due to a combination of genetic and environmental factors. Some factors that can contribute to hip dysplasia include:

  • Family history: Hip dysplasia can be inherited and tends to run in families.
  • Positioning in the womb: When a baby is in the womb, if their legs are extended and in a straight position for an extended period, it can increase the risk of hip dysplasia.
  • Breech position: Babies who are in the breech position during pregnancy have an increased risk of hip dysplasia.
  • Firstborn children: Firstborn children have a higher risk of hip dysplasia.
  • Female gender: Females have a higher risk of developing hip dysplasia than males.
  • Hormones: Hormonal changes during pregnancy can affect the development of the hip joint.
  • Environmental factors: Swaddling a baby’s legs tightly or carrying a baby in a carrier that doesn’t support the hips can increase the risk of hip dysplasia.

Diagnostics of Hip Dysplasia

Hip dysplasia can be diagnosed through a physical examination, medical history, and imaging tests such as an ultrasound, X-ray, or MRI. During the physical exam, a doctor will assess the range of motion in the hip joint, check for any clicking or clunking sounds, and look for any signs of pain or discomfort. Imaging tests such as an ultrasound, X-ray, or MRI can show the shape and position of the hip joint and can help identify any abnormalities. X-rays are typically used to diagnose hip dysplasia in older children and adults, while an ultrasound is more commonly used to diagnose hip dysplasia in infants and young children. In some cases, a doctor may also perform an arthroscopy, which involves inserting a small camera into the hip joint to examine the joint and surrounding tissues more closely. This can help diagnose a hip labral tear, which can be a complication of hip dysplasia.

Complications of Hip Dysplasia

If left untreated, hip dysplasia can lead to several complications, including:

  • Osteoarthritis: The abnormal hip joint can wear out faster than normal, leading to osteoarthritis.
  • Labral Tears: The labrum is a ring of cartilage that lines the hip socket. In hip dysplasia, the labrum can become damaged or torn, causing pain and stiffness.
  • Hip Instability: The hip joint can become unstable and prone to dislocation, which can cause significant pain and disability.
  • Early Hip Replacement: Severe cases of hip dysplasia may require early hip replacement surgery, which can have risks and complications.
  • Impaired Function: Hip dysplasia can impair mobility, range of motion, and overall function, leading to a decreased quality of life.

Treatment of Hip Dysplasia

The treatment for hip dysplasia depends on the severity of the condition and the age of the patient. Here are some possible nonsurgical and surgical treatments.

Nonsurgical treatments: 

  • Observation: In some cases, mild hip dysplasia may not require any treatment other than regular observation.
  • Pavlik harness: This is a type of brace that is used for infants under six months old. It holds the hip joint in place and helps it develop properly.
  • Closed reduction: This is a procedure where the doctor manually moves the hip back into its socket while the patient is under anesthesia.
  • Physical therapy: Certain exercises can help strengthen the muscles around the hip joint, improving stability and reducing pain.

Surgical treatments:

  • Open reduction: In some cases, the hip joint cannot be put back into its socket without surgery. This procedure involves making an incision and manually repositioning the joint.
  • Osteotomy: This is a surgery that involves cutting and repositioning the hip socket to provide better coverage of the ball portion of the upper thighbone.
  • Total hip replacement: If the hip joint is severely damaged, a total hip replacement may be necessary. This involves removing the damaged joint and replacing it with an artificial joint.