What is hip dysplasia, and how can it be managed?

In this article below, highly regarded consultant orthopaedic surgeon, Professor Richard Field, discusses hip dysplasia in expert detail, outlining the associated causes, symptoms, and treatment options. 

What is hip dysplasia?

Hip dysplasia, also known as developmental dysplasia of the hip (DDH), is a medical condition where the hip joint does not develop properly. This can affect individuals of all ages, from infants to adults. In hip dysplasia, the socket (acetabulum) is too shallow, causing the femoral head (the ball) to be inadequately secured in the joint, which can lead to partial or complete dislocation of the hip.

Causes and risk factors

The exact cause of hip dysplasia is not fully understood, but several factors contribute to its development. Genetics plays a significant role, as a family history of hip dysplasia increases the risk. The positioning of the baby in the womb, particularly breech presentation during the last trimester, can affect hip development.

Certain swaddling practices that keep the legs straight and tightly wrapped can also contribute to the condition. Additionally, females are more likely to develop hip dysplasia than males. Firstborn children are at a higher risk due to the limited space in the uterus, which can restrict proper hip development.

Symptoms and diagnosis

Symptoms of hip dysplasia vary depending on the age of the patient. In infants, signs include uneven leg lengths, asymmetrical thigh folds, and limited range of motion in one leg. Older children and adults may experience hip pain, a limp, and a clicking or popping sensation in the hip joint.

Diagnosis typically involves a physical examination and imaging tests. For infants, an ultrasound is commonly used, while older children and adults may require X-rays or MRI scans to assess the hip joint structure.

Treatment options

Treatment for hip dysplasia depends on the patient's age and the severity of the condition. For infants, a Pavlik harness, a soft brace that holds the baby's hips in a stable position, is often effective. In some cases, a closed reduction procedure may be necessary, where the hip is manually placed back into the socket under anaesthesia.

If detected later in children, treatment may involve a hip spica cast or surgical interventions like an osteotomy, which reshapes the hip socket. Adults with hip dysplasia may need physical therapy, pain management, or surgical procedures such as periacetabular osteotomy (PAO) or total hip replacement in severe cases.

Living with hip dysplasia

With early diagnosis and appropriate treatment, many individuals with hip dysplasia can lead normal, active lives. Regular follow-ups with healthcare professionals are essential to monitor the condition and prevent complications. Advances in medical technology and surgical techniques continue to improve outcomes for those affected by this condition.