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.

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.

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.

Hip Arthritis

Home > Condition & Treatment Map > Hip & Pelvis Conditions & Treatments > Hip Arthritis

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Overview

Sometimes called "wear-and-tear" arthritis, osteoarthritis is a common condition that many people develop during middle age or older. It can occur in any joint in the body, but most often develops in weight-bearing joints, such as the hip. Osteoarthritis of the hip causes pain and stiffness. It can make it hard to do everyday activities like bending over to tie a shoe, rising from a chair, or taking a short walk. Because osteoarthritis gradually worsens over time, the sooner you start treatment, the more likely it is that you can lessen its impact on your life. Although there is no cure for osteoarthritis, there are many treatment options to help you manage pain and stay active.

Anatomy

The hip is one of the body's largest joints. It is a "ball-and-socket" joint. The socket is formed by the acetabulum, which is part of the large pelvic bone. The ball is the femoral head, which is the upper end of the femur (thighbone).

The bone surfaces of the ball and socket are covered with articular cartilage, a smooth, slippery substance that protects and cushions the bones and enables them to move easily.

The surface of the joint is covered by a thin lining called the synovium. In a healthy hip, the synovium produces a small amount of fluid that lubricates the cartilage and aids in movement.

Description

Osteoarthritis is a degenerative type of arthritis that occurs most often in people 50 years of age and older, though it may occur in younger people, too.

In osteoarthritis, the cartilage in the hip joint gradually wears away over time. As the cartilage wears away it becomes rough, and the protective joint space between the bones decreases. This can result in bone rubbing on bone. To make up for the lost cartilage, the damaged bones may start to grow outward and form bone spurs (osteophytes).

Osteoarthritis develops slowly and the pain it causes worsens over time.

Causes

Osteoarthritis has many causes that may make you more likely to develop the disease, including:

Increasing age
Family history of osteoarthritis
Previous injury to the hip joint
Femoroacetabular impingement (FAI)
Improper formation of the hip joint at birth, a condition known as developmental dysplasia of the hip

Even if you do not have any of the risk factors listed above, you can still develop osteoarthritis.

Symptoms

The most common symptom of hip osteoarthritis is pain around the hip joint. Usually, the pain develops slowly and worsens over time, although sudden onset is also possible. Pain and stiffness may be worse in the morning, or after sitting or resting for a while. Over time, painful symptoms may occur more frequently, including during rest or at night. Additional symptoms may include:

Pain in your groin or thigh that radiates to your buttocks or your knee
Pain that flares up with vigorous activity
Stiffness in the hip joint that makes it difficult to walk or bend
"Locking" or "sticking" of the joint, and a grinding noise (crepitus) during movement caused by loose fragments of cartilage and other tissue interfering with the smooth motion of the hip
Decreased range of motion in the hip that affects the ability to walk and may cause a limp

Imaging Tests

X-rays

These imaging tests create detailed pictures of dense structures, like bones. X-rays of an arthritic hip may show a narrowing of the joint space, changes in the bone, and the formation of bone spurs (osteophytes).

(**Left**) In this x-ray of a normal hip, the space between the ball and socket indicates healthy cartilage. (**Right**) This x-ray of an arthritic hip shows severe loss of joint space and bone spurs.

Other imaging tests

Occasionally, a magnetic resonance imaging (MRI) scan, a computed tomography (CT) scan, or a bone scan may be needed to better determine the condition of the bone and soft tissues of your hip.

Treatment

Although there is no cure for osteoarthritis, there are several treatment options that will help relieve pain and improve mobility.

Nonsurgical Treatment

As with other arthritic conditions, early treatment of osteoarthritis of the hip is non-surgical.

Lifestyle modifications

Some changes in your daily life can protect your hip joint and slow the progress of osteoarthritis.

Minimizing activities that aggravate the condition, such as climbing stairs.
Switching from high-impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling) will put less stress on your hip.
Losing weight can reduce stress on the hip joint, resulting in less pain and increased function.

Physiotherapy

Specific exercises can help increase range of motion and flexibility, as well as strengthen the muscles in your hip and leg. Your doctor or physical therapist can help develop an individualized exercise program that meets your needs and lifestyle.

Assistive devices

Using walking supports like a cane, crutches, or a walker can improve mobility and independence. Using assistive aids like a long-handled grasper to pick up low-lying things will help you avoid movements that may cause pain.

Medications

Panadol and anti-inflammatories are commonly used in conjunction with other treatments to control the pain and inflammation of arthritis. When these are failing to control your pain adequately, it may be an indication that surgery may be required.

Injections

Various injections can be performed to reduce the inflammation in the hip and these can be discussed with you during your consultation.

Surgical Treatment

Victorian Bone and Joint surgeons may recommend surgery if your pain from arthritis causes disability and is not relieved with nonsurgical treatment.

Total hip replacement

Both the damaged acetabulum(socket) and femoral head(ball) are removed, and then position new metal, plastic or ceramic joint surfaces to restore the function of your hip. Victorian Bone and Joint surgeons only uses implants with an excellent long-term record and survivorship.

Frequently Asked Questions

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.