Hip Dysplasia

Hip dysplasia, also known as developmental dysplasia of the hip (DDH), is a condition where your hip joint doesn't fit together as it should. This condition may affect one or both hips and is often present at birth.

Our team of orthopedic specialists are here for you to help get you relief from your hip pain caused by hip dysplasia. We're experts on leading-edge technology and techniques, giving patients a full range of advanced treatment options to consider based on their specific goals and needs.

Symptoms of hip dysplasia in adults

Sometimes, hip dysplasia is diagnosed when you first experience hip pain, instability or early-onset arthritis. Symptoms of hip dysplasia in adults can vary in severity and may include:

• Persistent pain in your groin or the side or back of your hip.
• A feeling of instability in the hip, particularly during physical activities.
• Limping or a change in your walking pattern.
• Difficulty with activities that require hip movement, such as running or even prolonged sitting.
• Clicking or popping sounds in the hip joint.

Hip dysplasia in babies

Hip dysplasia might develop in the womb or during the first few months of life. The exact timing can vary, but the earlier it’s detected, the better the chances of successful treatment.

It can occur due to several factors, including the position of the baby in the womb and genetic factors. Hip dysplasia can sometimes develop as the baby grows, especially if risk factors are present.

Symptoms of hip dysplasia in babies

Recognizing the symptoms of hip dysplasia early is key to effective treatment. Here are some signs you might notice in your baby:

• Uneven leg lengths: One leg may appear shorter than the other.
• Asymmetrical skin folds: Extra skin folds on the thigh or buttocks that are not symmetrical.
• Limited range of motion: Difficulty moving one leg outwards as easily as the other.
• Clicking or popping sounds: You might hear or feel a clicking or popping sound when moving the baby’s hip.
• Hip instability: The hip may feel unstable or like it’s slipping in and out of place.

Recognizing the symptoms of hip dysplasia early is crucial for effective treatment. If untreated, hip dysplasia can lead to early arthritis.

Causes of hip dysplasia

Hip dysplasia is influenced by several factors, including genetics and your environment. Some common causes may include:

• Family history: If you have a family member with hip dysplasia, your chances of developing it are higher.
• Position in the womb: Breech babies, or those positioned with their feet down in the womb, are at higher risk.
• Swaddling practices: Swaddling babies tightly with their legs straight can increase the risk, as it restricts normal hip movement.

Women, or those assigned female at birth, are more likely to have hip dysplasia than men. Hormonal differences between males and females play a significant role in the likelihood of developing hip dysplasia.

During pregnancy, the hormone relaxin is produced to loosen the ligaments in the pelvis to help with childbirth. This hormone can also affect infants, making their hip joints more susceptible to instability and dysplasia.

Diagnosing hip dysplasia

Diagnosing hip dysplasia typically involves a physical exam and imaging tests, such as an ultrasound, X-ray or MRI.

For infants, your doctor will perform specific maneuvers like the Ortolani and Barlow tests to check for hip instability.

What are the Ortolani and Barlow tests?

With the Ortolani test, your doctor will place their hands over your child’s knees with their thumbs on the thighs. The doctor slowly and gently moves the baby’s legs apart, spreading them outward. This movement is called abduction.

As the doctor moves the legs, they feel any clicking or popping sensations in the hip joints. A positive Ortolani sign is when the doctor feels a “clunk” or a movement that indicates the hip is sliding back into the socket. This clunk means the hip was out of place and has been moved back in during the test.

The Barlow Maneuver is done when the doctor holds the baby’s thighs with thumbs on the inside of the knees and their fingers on the outside of the thighs. They gently push the baby’s knees together, moving their legs inward towards the middle of the body. This movement is called adduction.

A positive Barlow sign is when the doctor feels a “clunk” or a shift, which means the hip can be dislocated with this maneuver.

Can hip dysplasia be cured?

Hip dysplasia is very treatable, especially when caught early. While there’s no single cure that works for everyone, a range of treatments can significantly improve hip function and reduce pain.

Early intervention is key, particularly in infants, as their bones are still developing and can be guided into the correct position more easily. In older children and adults, treatment might be more complex but is still very effective.

Treatment for hip dysplasia

Treatment for hip dysplasia depends on your age and the severity of the condition. Here are some common treatment options:

• Pavlik harness: For infants, this soft brace holds the baby's hips in the correct position, allowing normal development. It’s typically worn full-time for several weeks or months.
• Closed reduction and cast: If the Pavlik harness is not effective, a procedure called closed reduction might be used. The doctor will gently place the hip into the correct position and then apply a body cast to hold it in place.
• Surgery: For older children and adults, surgery might be necessary. Procedures can range from minimally invasive arthroscopy to realign the hip, to more extensive operations like osteotomy, where the hip bones are cut and realigned. While not a common treatment, hip replacement surgery may be recommended in some severe cases.
• Physical therapy: After surgery or casting, physical therapy is crucial for regaining strength and mobility in the hip joint.

Hip pain management is also a big part of treatment. This might include over-the-counter or prescription pain medications. Lifestyle changes such as maintaining a healthy weight and avoiding high-impact activities can also help manage symptoms.