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Overview

Dysplastic hips is a term used to describe a broad spectrum of abnormalities of the hip joint that can develop soon after birth or over time during childhood. It is difficult to detect dysplastic hips because there is no pain associated with the condition and it does not prevent a child from learning to walk. The condition can be congenital, meaning a child is born with it, or it can develop over time.

In a healthy hip joint, the femur and the curved portion of the pelvis fit together like a ball and socket, in which the ball rotates freely protected by a smooth layer of tissue. When a person has dysplastic hips, something goes wrong within this process. Some conditions included in the diagnosis of dysplastic hips include:

  • Dislocated hip – when the cartilage on the ball and the cartilage on the socket do not meet
  • Dislocatable hip – when the ball easily pops out of the socket
  • Subluxatable hip – when the ball is not properly seated in the socket
  • Dysplastic hip – where the ball, socket, or both are malformed

Causes & risk factors

The exact causes of dysplastic hips are not clear. It is, however, widely believed that this is a developmental condition, as it is known to occur around the time of birth, after birth, or during childhood.

Babies are at increased risk for dysplastic hips when:

  • They are a twin or multiple, or he/she was in a  breech position
  • There is a family history of the condition

Symptoms

Symptoms of dysplastic hips include:

  • The folds in the skin of the thigh or buttocks may appear uneven, one leg may appear shorter, or one hip may turn outward
  • The space between the legs may look wider than normal
  • A click or snapping sound may be heard when hip is moved
  • Limited range of motion
  • Pain does not usually occur in infacts or young children, but older children and adolescents may feel pain

Diagnosis & testing

Diagnosing dysplastic hips can be difficult if both hips are affected because the hips will appear symmetrical. It is most commonly discovered during the newborn examination done by your child’s pediatrician but can also develop over time.

Ultrasounds and X-rays are commonly used for definitive diagnosis of dysplastic hips.

Treatment

Depending on the severity and type of condition, as well as the age of the patient, there are several options for the treatment of dysplastic hips.

Nonsurgical treatments for dysplastic hips are most common for children under 6 months of age:

  • Pavlik harness – a specially designed, flexible harness that gently aligns the position of your baby’s hips so that, over time, they will grow properly
  • Hip abduction brace – a hard brace for infants to hold their hips in a properly aligned position. The brace will allow for normal hip development

Surgical treatments for dysplastic hips include:

  • Closed reduction – the most common surgical treatment, this minimally invasive procedure allows your child’s physician to manipulate the ball of the hip back into the socket.
  • Open reduction – when tissue is blocking the top of the thigh bone from resting comfortably in the socket, this procedure allows your child’s surgeon to clear out the joint so that it can rest normally.
  • Osteotomy – is the strengthening of the hip joint so that the strongest cartilage does most of the weight-bearing activities.
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