Hip dysplasia is a condition in which the hip socket is too shallow to support the head of the femur (thighbone). This can lead to progressive instability of the hip and possible dislocation. If left untreated, it can lead to delays in walking, development of a limp, and permanent joint derangement. Milder forms can lead to impingement and even painful arthritis.
Hip dysplasia is typically present at birth or developed in early childhood. In mild cases, the femoral head may simply be loose in the socket. In more severe cases, the hip can become unstable and may dislocate.
The primary goal of hip dysplasia treatment is to preserve the natural joint for as long as possible, while also addressing pain and other symptoms associated with the condition.
Read on to learn more about the symptoms, causes, diagnosis and treatment of hip dysplasia.
What Is Hip Dysplasia?
Hip dysplasia is a disorder that results in an incorrectly shaped hip socket. Often, the hip socket does not fully cover the head of the femur (thigh bone), creating an unstable hip. Hip dysplasia can damage the cartilage lining the joint, and it can also hurt the soft cartilage (labrum) that rims the socket portion of the hip joint. This is called a hip labral tear.
This condition is relatively common and is usually present at birth. In fact, doctors treat about 1 out of 100 infants for hip dysplasia. Doctors will check your baby for signs of hip dysplasia shortly after birth and during well-baby visits. If hip dysplasia is diagnosed in early infancy, a soft brace can usually correct the problem.
However, sometimes the symptoms do not appear until later in life, and the disease goes undiagnosed until adulthood. Left untreated, it can lead to painful hip problems in adults. It’s the leading cause of hip arthritis for people under 60.
Anatomy of the Hip Joint
The hip is a ball-and-socket joint. The ball, at the top of your femur (thighbone) is called the femoral head. The socket, called the acetabulum, is a part of your pelvis. The ball moves in the socket, allowing your leg to rotate and move forward, backward and sideways. Ligaments connect the ball to the socket and usually provide tremendous stability to the joint. The hip joint is normally very sturdy because of the fit between the femoral head and acetabulum as well as strong ligaments and muscles at the joint.
The hip joint is one of the largest joints in the body and is a major weight-bearing joint. Weight bearing stresses on the hip during walking can be 5 times a person’s body weight. A healthy hip can support your weight and allow you to move without pain. Changes in the hip from disease or injury will significantly affect your gait and place abnormal stress on joints above and below the hip.
In a healthy hip, soft tissue called cartilage covers the ball and the socket to help them glide together smoothly. If this cartilage wears down or gets damaged, the bones scrape together and become rough. This causes pain and can make it difficult to walk.
There is a wide range of severity among hip dysplasia cases. Milder cases may not be noticed until adolescence or young adulthood. More severe cases can usually be detected during the perinatal period (shortly before or after birth). There are several risk factors that increase the likelihood of hip dysplasia in a prenatal or newborn child. For children who have one or more of these risk factors, it is recommended that an ultrasound be performed at around four to six weeks of age to see whether or not the hip is developing normally.
Common Symptoms
Signs and symptoms vary by age group. In infants, you might notice that one leg is longer than the other. Once a child begins walking, a limp may develop. During diaper changes, one hip may be less flexible than the other.
In teenagers and young adults, hip dysplasia can cause painful complications such as osteoarthritis or a hip labral tear. This may cause activity-related groin pain. In some cases, you might experience a sensation of instability in the hip.
Common hip dysplasia symptoms are:
- Hip pain brought on by physical activity
- Limping (usually due to pain)
- Clicking or popping sound or sensation from the hip joint
- Unexplained and worsening hip pain
Many of these symptoms can be caused by hip disorders other than hip dysplasia, so it is essential to discuss your symptoms with a doctor specializing in hip conditions.
Causes & Risk factors
Hip dysplasia tends to be genetic, largely running in families. It is also more common in girls due to a hormone called relaxin that is released by women during the birth process. At birth, the hip joint is made of soft cartilage that gradually hardens into bone. The ball and socket need to fit together perfectly. When the ball does not rest firmly into the socket, the socket will, in turn, not form firmly around the ball and the socket will become too shallow.
The most common risk factors include first pregnancy, breech birth, large baby, gender and genetic history. It has also been shown that certain ethnicities may be more prone to acquiring the disorder.
Factors that may reduce the amount of space in the womb include:
- First pregnancy
- Large baby
- Breech presentation
Diagnosis
During well-baby visits, doctors typically check for hip dysplasia by moving an infant’s legs into a variety of positions that help indicate whether the hip joint fits together well.
Mild cases of hip dysplasia can be difficult to diagnose and might not start causing problems until you are a young adult. If your doctor suspects hip dysplasia, he or she will ask you what you are doing when you feel symptoms and where your discomfort is located. If you have pain in the groin and hip after physical activity, your healthcare provider might conduct a physical examination to check your hip joint’s motility. Your doctor might order other tests such as an X-ray or MRI to explore the severity of your condition.
Treatment
Treatment for hip dysplasia depends on the age of the patient and the severity of the condition. If the condition is diagnosed early (in the prenatal period or during infancy) it can often be treated effectively with bracing. The brace does not work as well for babies older than 6 months. Instead, the doctor may move the bones into the proper position and then hold them there for several months with a full-body cast. Sometimes surgery is needed to fit the joint together properly.
People with hip dysplasia do not always need surgery. A mild hip dysplasia may not require any treatment, but may need to be monitored as the child grows. In such cases, complications may never arise or they may arise only once the child becomes an adolescent or young adult.
For more serious cases, hip dysplasia in a skeletally immature child can be treated with a variety different surgical procedures of the pelvis and acetabulum. Arthroscopic surgery is a minimally invasive surgical option where the experienced surgeon guides tiny cameras and instruments through small incisions to examine and correct hip dysplasia. Since this type of surgery is minimally invasive, patients can usually go home the same day and recover within only a few weeks.
More severe cases may require a more invasive surgery called a periacetabular osteotomy. Your healthcare provider will work closely with you to determine the best treatment option.
Contact Ventura Orthopedic Today
For the past 40 years, millions of people have experienced relief from hip pain and dysplasia and enjoyed restored mobility through total hip replacement. Hip replacement surgeries are surprisingly more routine than you may think and are performed on millions of patients worldwide each year. To diagnose your condition, an orthopedic surgeon will perform a thorough examination of your hip, analyze X-rays, and conduct physical tests.
To learn more about the procedure or to schedule an appointment with one of our hip replacement specialists, call us at 800-698-1280
