Early Signs of Hip Dysplasia: When to Seek Treatment
To understand exactly what hip dysplasia is, you need to know a little about our bones and anatomy, and how the human body works and moves. Bones come together at certain points in our body to create a joint and depending on the number of bones that meet and the type of joint that is formed, will determine the type of movement and flexibility that part of the body is able to perform. Different types of joints allow different types of movement - think about how you can move your neck in all sorts of different positions, yet you can only bend and straighten your elbow in one direction. The hip joint is one of the biggest joints in the body and is known as a ball and socket joint. It is exactly as described, where the ball on the upper part of the thigh bone, or femur, fits snugly into the socket - the curved part of the pelvis known as the acetabulum. This joint provides a wide range of motion and provides support for your legs to hold your body.
Hip dysplasia happens when a person's hip joint doesn't develop properly, and this usually occurs at birth. Signs of hip dysplasia in babies include having one leg that turns out more than the other, moving one leg less than the other, or having wrinkled or uneven skin around the thigh and buttock. The hip joint is made of soft cartilage at birth, which gradually hardens into bone, but if the ball isn't firmly seated into the socket, then the socket will not fully form around the ball. The socket will develop too shallow for the ball to have a snug fit and hip dysplasia will occur.
It is standard practice for a doctor or midwife to assess the newborn baby's hip joints for proper positioning and mobility before they are discharged from the hospital, and this is usually done with a physical examination to assess their range of motion. An ultrasound may be used to confirm a diagnosis if there are any concerns. Whilst hip dysplasia can develop in any baby because the foetus's position in the womb can put pressure on the hips, breech babies are more at risk. Hip dysplasia is usually more prevalent in first-borns and girls and is usually more common on the left side. It can also be a genetic condition that is passed on from the parents.
Treatment for hip dysplasia in babies usually involves wearing a soft brace or harness that will help the hips develop and grow normally, and early detection and treatment of hip dysplasia, or DDH (developmental dysplasia of the hips, as it is also known) is very successful.
When Should Hip Dysplasia Be Treated?
The sooner hip dysplasia is diagnosed the simpler the treatment and the better the outcome. However, it can be tricky to diagnose it in newborns as it doesn't cause them any pain, so it is important to be aware of abnormalities as they grow. Signs of hip dysplasia in 1-year-olds include uneven lengths of the legs - especially when lying down, the skin folds around the hips and buttocks may not line up, you may notice a clicking or popping sound when the hip is moved and when changing nappies one hip may be less flexible than the other. As your baby learns to walk the symptoms to look out for may become a little more obvious, and signs of hip dysplasia in 2-year-olds include a waddling gait or a limp while walking, the child may lean to the affected side when standing, the affected leg may turn outwards, and the hip joint may feel stiff.
As your child develops and gets older other indications will become more obvious too, the waddling and limping may become more pronounced, and in 4-year-olds signs of hip dysplasia can also now include pain, especially in the groin area, and the child may feel an instability in their hips. Treatment will depend on the severity of the condition and the child's age, and hip dysplasia treatment can still include braces or splints, but more severe cases may need a closed reduction procedure. This is a surgical procedure performed under general anaesthetic to manually move the hip joint back into place and a brace may be worn for some weeks after to make sure the hip joint stays in place.
What Are the Red Flags of Hip Dysplasia?
The main signs to look for if you are worried about developing hip dysplasia are having pain in the front of your hip or groin (sometimes the pain can be more on the outside), occasional or mild pain that can increase in frequency or intensity over time, pain that worsens with activity or towards the end of the day, and noticing a feeling of locking, clicking or popping within your groin. For other people, the first sign can be knee pain. Sometimes teenagers or young adults may have been born with mild DDH, but the symptoms only develop as they grow, but as the hip joint continues to develop throughout the teen years sometimes youngsters that were not born with DDH may develop it if the hip doesn't grow properly.
What Happens if Mild Hip Dysplasia is Left Untreated?
Whilst problems in infants can go unnoticed if the symptoms are mild, if hip dysplasia is left untreated it can cause irreversible damage to the hip joint, and this includes causing pain, loss of function and arthritis as the person gets older. When the ball of the femur (femoral head), doesn't fit smoothly into the socket (acetabulum) the force that is produced on the hip joint isn't distributed evenly, and this increased stress on a smaller area can lead to pain and degeneration of the hip. Over time the smooth cartilage becomes frayed and wears away, and untreated hip dysplasia in adults can lead to osteoarthritis and the eventual need for a hip replacement.
The key thing to remember with hip dysplasia is that is it a treatable condition, and the earlier it is diagnosed the better the outcome. As hip dysplasia progresses so will the pain that accompanies it, there will be a progressive loss of range of motion of the hip, difficulty and discomfort sleeping on the hip and a limp may develop which can cause other imbalances in the body.
Hip Hip Hooray for Adult Treatment...
There is treatment for hip dysplasia in adults, and by visiting orthopaedic experts like VBJS Specialists, the damage to your hips can be analysed by using imaging like X-rays, CT and MRI scans to assess the right treatment for you.
In less severe cases, non-surgical treatments may work best, and these can include lifestyle changes and physiotherapy, NSAIDs such as ibuprofen and naproxen to help reduce pain and inflammation, or by injecting cortisone (an anti-inflammatory agent) directly into the joint. If you don't respond to this treatment, you may be recommended hip dysplasia surgery. The most common procedure is called an osteotomy, where the surgeon reshapes the socket, and/or ball of your hip so they fit more smoothly together. This type of surgery has a high success rate and can relieve symptoms and treat the issue. Sometimes, if the arthritis in the hip and the wear and tear on the cartilage is so great the only option is for a total hip replacement.
If you are experiencing hip discomfort visit your doctor early for the best outcome.