Hip Dysplasia Diagnosis in Infants and Adults

Hip Dysplasia is condition whereby the hip socket does not fully cover the “ball portion” of the upper thighbone. As a result of this, the hip joint can easily become partially, or in some cases, completely dislocated. Those who suffer from hip dysplasia are often born with the condition.

The main causes of hip dysplasia are as follows;

• At birth, the hip joint is made up of soft cartilage that gradually develops into bone. If the ball joint isn’t seated firmly into the socket at this point of development, the socket fails to fully mould around the ball joint. As a result of this, the socket is oftentimes too shallow, which increases the risk of dislocation.
• During the final month of pregnancy, womb space can become crowded resulting in the hip joint moving out of position, in turn resulting in the formation of a shallow socket.

Signs and symptoms of hip dysplasia differ amongst age groups. In infants, a disparity in leg length may be evident when they begin to mobilize independently. Young children may walk with a limp, or one hip may be significantly less flexible than the other.

In adolescents and young adults, hip dysplasia may result in osteoarthritis or a hip labral tear. This occurs when the cartilage lining the hip joint is damaged, or where the soft cartilage (labrum) that rims the socket portion of the hip joint, is damaged. Adolescents and young adults are likely to experience activity-related groin pain or sensations of instability in the hip.

Hip dysplasia is often diagnosed or ruled out shortly after birth following a physical examination by way of ultrasound or x-ray. It has become common practice in recent times to carry out hip examinations soon after birth, particularly in cases of twins or multiple births, a breeched birth position, a family history of hip dysplasia, or where concerns arise from a physical examination.

However, hip dysplasia can be difficult to diagnose, particularly where both hips are affected (bilateral) due to the appearance of the hips being symmetrical. The hips may appear loose, but otherwise fine, and can then progressively worsen as the infant develops. As a result of this possibility, the American Academy of Paediatrics recommend that an ultrasound is carried out at six weeks of age in cases of children who were in a breeched position at birth. It is also recommended that infants undergo x-rays at four months of age in such cases to monitor any potential progression in this regard.

If hip dysplasia is diagnosed shortly after birth, it can be corrected with the use of a soft brace known as a Pavlik harness. This brace secures the ball portion of the joint firmly in its socket for several months. This helps the socket mould to the shape of the ball.

If detected in early childhood, the condition can be treated with surgery that often results in a complete repair and return to normality post surgery. There are several types of surgery available where a diagnosis has been made early.;

• Closed Reduction- This is the most common treatment between the ages of 6 and 24 months of age. This is a minimally invasive procedure involving physical manipulation of the ball back into the socket.
• Pelvic Osteotomy- This is carried out in cases where the hip socket requires repair.
• Femoral Osteotomy- This procedure involves the tipping of the thigh bone so that the ball points deeper into the socket. This is also known as a Varus De-rotational Osteotomy (VDO or VDRO).
• Periacetabular osteotomy- The socket is cut free from the pelvis and then repositioned for better joint movement.

Where hip dysplasia is diagnosed and treated at an early age, symptoms can be fully corrected and/or reversed.

Hip dysplasia in adults is usually treated by way of Hip Preserving Surgery or Joint Replacement Surgery, although milder cases of dysplasia can benefit from non-surgical treatment. Such non-operative treatments include weight loss, joint injections and specialization physical therapy.

Unfortunately, non-surgical methods rarely provide a lasting solution for hip dysplasia because the joint itself is not properly formed, and has not been corrected during early development.

If you or your child suffer form hip dysplasia and have concerns surrounding the diagnosis and or treatment of same, please do not hesitate to contact us to explore whether you may have a right to compensation.