Hip dysplasia

Hip is the largest “ball and socket” joint in the body and is held together by ligaments, tendons, and a joint capsule. The femoral head (ball) of the joint should fit into the socket (acetabulum) so that ball can rotate freely. But if the hip joint is in the wrong shape, and the socket is not in the correct position, there will be increased force and abnormal wear on the cartilage. This condition is called as hip dysplasia.

Most of the people with hip dysplasia are born with the condition. If the condition is diagnosed in the early infancy stage, a soft brace can usually correct it, but if it is diagnosed after two years of age, surgery is performed.

Causes

The exact cause of hip dysplasia is not known, but it is believed to be developmental i.e., it develops during the time of birth, after birth, or during birth. Genetics also pay a role, but it is not a direct cause. If you have a family history of hip dysplasia, then you are 12 times more likely to develop the same.

Signs and symptoms

Symptoms are not seen until you grow old if you have mild dysplasia. The signs and symptoms vary by age group; you may notice that one leg is longer than the other. Pain is normally not observed in infants, but it is the most common symptom in young adults and adolescents. When you change the diaper, one hip may be less flexible than the other. Once your child begins walking, a limp may develop. Few people may also experience instability in the hip.

Risk factors

It is commonly seen in girls. The risk is higher in babies born in the breach position or with foot deformities.

Surgery

Surgery is the only possible treatment option for older children and adults. If the condition is mild, it is treated arthroscopically in which long-handles tools and tiny cameras inserted through small incisions.

In severe cases, the position of the hip socket is also corrected. Periacetabular osteotomy is performed in which the socket is cut free from the pelvis and then repositioned to match up better with the ball.

Hip replacement surgery is also recommended if the dysplasia has severely damaged your hips.

Self-Management

To reduce pain and to manage the symptoms quickly, you have to make certain lifestyle modifications apart from undergoing treatment through surgery or medications.

  • Try to reduce weight, if you are obese

  • Eat calcium-rich food

Complications

Hip dysplasia can damage the soft cartilage that rims the socket portion of the hip joint; this condition is called a hip labral tear.

Osteoarthritis is the common complication developed by the people with hip dysplasia. There may be a risk of developing a difference in leg length, limitation in function and decreased agility, if left untreated.

Diagnosis

Hip dysplasia is difficult to diagnose if it is bilateral because both the legs would be symmetrical. Doctors often use a combination of physical exams and ultrasound or X-rays to diagnose hip dysplasia. The doctor would move your baby’s leg to different positions to check if the hip joint fits together well.

If your doctor suspects that you have hip dysplasia, he or she would recommend going for imaging tests such as CT scan and MRI scan.

Treatment

The hip dysplasia treatment depends on the age and extent of the hip damage. For infants, the doctor would suggest soft braces such as Pavlik harness that hold the ball of the joint firmly into the socket for several months.

For infants older than six months, the doctor would move the bones into the proper position and then hold them for several months with a full-body cast.