I have been diagnosed with hip dysplasia as a teenager, however have I always had hip dysplasia?

In many cases adolescent hip dysplasia is a progression of paediatric hip dysplasia, and patients will have had some failure of hip formation as a younger child. In some cases patient may have had treatment as a child for hip dysplasia and may have had a relatively normal hip, however over time the hip joint formation regresses, and this can result in poor socket formation as an adolescent.

How long is recovery after hip dysplasia surgery?

This depends on the nature of the surgery which is undertaken. After a periacetabular osteotomy, most patients are back to playing sport and activities at approximately 3-4 months.

I get clicking and catching in my groin, is this a sign of hip dysplasia?

Clicking and catching in the groin can be a sign of hip dysplasia, and instability of the hips lies in and out of its socket. If you have these symptoms would highly recommend that you are evaluated by a specialist orthopaedic surgeon.

I have hip dysplasia, what is the risk of developing hip arthritis?

This is a very difficult question to answer without a thorough evaluation of your x-rays and an assessment of your condition. The risk of developing arthritis is directly related to the amount of bony coverage of the ball of the femur.

My child has hip dysplasia - will they be in pain?

Hip dysplasia in young children is typically non-painful, when children become older >6-8yrs then pain can occur.

How long will my child need their brace for?

This depends upon how they grow and how the hip dysplasia resolves. Typically the minimum time a brace is required is 3 months. However, it is not uncommon for children to require braces up to 12-18months in severe cases.

Will my child have a developmental/walking delay due to being in a brace?

Most children who have been in a brace will have a delay in their ability to walk, but they normally catch up very quickly when the brace is removed.

Can my child walk in the brace?

In a hippo or rhino brace, children can often stand or crab walk. They can also usually pull themselves up to stand.

Can my child do tummy time in the brace?

Tummy time is difficult in any brace or orthotic. When the brace is off, it is recommended to encourage this as much as possible.

What is my child's risk of arthritis in the future?

If hip dysplasia is detected early and treated successfully, there is a low risk of arthritis, however, if there is residual dysplasia, or if the condition is detected late, this increases the risk of arthritis.

How common is femoroacetabular impingement?

FAI is most common in healthy, active adults and athletes between the ages of 25-50 years. In older patients, it is also frequently accompanied with osteoarthritis.

Does stretching help hip impingement?

Addressing internal rotation to combat symptoms can sometimes provide relief, however if you're too aggressive and stretch too high up into hip flexion it can actually increase hip pain. For this reason, it is important to seek professional help when treating FAI.

Is surgery required for hip impingement?

Typically, non-surgical methods for therapeutic injections are used to treat hip impingement before surgery. If pain persists, we may recommend surgery to reshape the bones in the hip joints.

What happens if a labral tear goes untreated?

If left untreated, a labral tear can become an irritant to the hip joint which can increase friction and speed the presence of osteoarthritis in your hip. If the tear gets worse, it can become a tissue flap that can cause severe pain when moving your hip. Treatment may be recommended and can help minimise pain.

What aggravates a hip labral tear?

Labral tears are most commonly caused by structural abnormalities in the hip, and they can additionally be caused by repetitive injuries from lunging, squats, kicking, sports and extremes of range of motion. Cycling can bean aggravatingactivity as hip flexion combined with other movements can aggravate your pain. You may also wishto avoidactivities such as football, soccer, gym, basketball and ballet as they can irritate the tear and cause sharp pain in the groin or hip. Treatment of labral tears may provide relief allowing you to return to some activities you enjoyed.

What does a labral tear feel like?

For many patients, a torn labrum may show no symptoms, making diagnosis difficult. For others, pain in the hip joint, groin or buttocks can be a sign of a torn labrum, sometimes experienced alongside an audible clicking sound in the joint when engaging in high-intensity activity. Pain levels usually correlate with activity, subsiding with rest.

Do I need surgery for a torn labrum?

Surgery may be required to correct a hip labral tear, as often a torn labrum is a symptom of a deeper structural issue with the hip. In this case, simply correcting the tear may not provide effective relief to the patient. In cases where the labral tear has no underlying cause, some conservative treatment methods such as NSAID drugs and targeted physical therapy can provide relief. Surgical treatment often takes the form of minimally-invasive hip arthroscopy.

How is a hip labral tear diagnosed?

Labral tears are normally diagnosed by a combination of physical examination and assessment of the hip joint, and confirmed by an MRI.

What is the difference between hip dysplasia and hip arthritis?

While symptoms may be similar, Hip dysplasia is a developmental disorder largely influenced by genetics. Hip arthritis on the other hand can be caused by a range of factors including weight, joint injury or increasing age.

What is the difference between hip arthritis and a labral tear?

Labral tears are typically caused by trauma, arthritis, femoroacetabular impingement or acetabular dysplasia, while the most common cause of hip arthritis is old age. Labral tears are also more common in athletes, however people with labral tears in their hip are also more likely to develop hip arthritis.

Avascular Necrosis

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Avascular Necrosis (osteonecrosis) of the hip is a condition that occurs when the blood supply to the hip bone is disrupted. As bone cells die without a blood supply, this can lead to collapse of the hip joint and arthritis. Osteonecrosis is also called avascular necrosis or aseptic necrosis. It can occur secondary to steroid use, alcohol, medications, and other medical conditions. If you have hip symptoms and have any of these conditions, please call us to arrange a consultation as you may be suffering from avascular necrosis.

Symptoms of Avascular Necrosis

Avascular Necrosis (AVN) develops in stages. Hip pain is typically the first symptom. This may be a dull ache or throbbing pain in the groin or buttock area. As the disease progresses, it slowly worsens and over time putting weight on the affected hip, and moving the hip joint will be painful.

How long it takes for the disease to progress through these stages varies from several months to many years. It is important to diagnose AVN early, because some studies show that early treatment is associated with better outcomes.

Treatments for Avascular Necrosis

Although nonsurgical treatment options like medications or using crutches can relieve pain and slow the progression of the disease, generally treatment is surgical.

Patients with osteonecrosis that is diagnosed in the very early stages (prior to femoral head collapse) are good candidates for hip preserving procedures.

Core Decompression

This procedure involves drilling holes into the femoral head to relieve pressure in the bone and create channels for new blood vessels to the hip.

Vascularized fibula graft

A segment of bone is taken from a bone in your leg (fibula) along with its blood supply (an artery and vein). This graft is transplanted into a hole created in the femoral neck and head.

Total hip replacement

If AVN has advanced to femoral head collapse, the most successful treatment is total hip replacement. This involves replacing the damaged cartilage and bone with implants.

FAQ

What happens if avascular necrosis is left untreated?

When avascular necrosis is left untreated, the disease will progress. The bone may develop a crack, in which the bone collapses. Should this occur at the end of the bone, the surface of the joint will be irregular, which can cause arthritic pain and loss of function to the affected joint.

Does exercise help avascular necrosis?

There is no evidence exercise helps avascular necrosis, and weight bearing on a hip with avascular necrosis can contribute to collapse of the joint and the development of arthritis. It is essential that your hip is evaluated by a hip specialist to determine the correct physical regime for you.

Will avascular necrosis spread to other bones in the body?

No, avascular necrosis cannot spread to other bones in the body. In the absence of other conditions, AVN will stay in the same body part. However, avascular necrosis can occur in other parts of the body, for example if it affects one hip, there is between 10-40% chance it can affect the other hip.