Hip Dysplasia
Everything about the causes, symptoms, and most effective treatments to correct improper femoral insertion in the hip.
Symptoms and Causes
Hip dysplasia is a malformation in which the femoral head does not properly fit into the bony socket (acetabulum), resulting in a joint that is either partially or fully dislocated.
Depending on the degree of involvement, hip dysplasia is classified into four types:
- Acetabular dysplasia: the acetabulum is inadequately formed, causing improper femoral head insertion.
- Hip subluxation: the femoral head is displaced or partially outside the bony socket.
- Hip dislocation: the femoral head is completely outside the acetabulum.
- Lax hip: although the femoral head is within the joint, it easily dislocates, leading to instability.
In most cases, hip dysplasia is a congenital condition present at birth. If detected early, prompt treatment can correct it relatively easily. When the condition is less apparent and detection is delayed (adult hip dysplasia), management is more complex and often requires surgical intervention.
Symptoms
Symptoms of hip dysplasia vary depending on the patient’s age:
In infants:
- One leg longer than the other.
- Reduced flexibility on one side of the hip compared to the other, usually noticeable during diaper changes.
- Asymmetry of the groin or buttocks.
- Limping when beginning to walk.
In adults:
- Pain when walking, exercising, or sitting for prolonged periods.
- Frequent muscle contractures.
- Feeling of hip instability.
- Loss of strength.
Causes
Hip dysplasia may result from several factors:
- Limited space in the final weeks of pregnancy.
- Fetal "breech" or "frog-leg" position, with legs spread and extended upwards.
- Low amniotic fluid levels.
- Excessive pressure during delivery.
- Physical inactivity.
- Obesity.
Risk Factors
The risk of hip dysplasia is higher in the following situations:
- First pregnancy.
- Large infant.
- Breech presentation.
- Genetic predisposition.
- Poor positioning in the crib.
- Excessive use of car seats or baby carriers.
Complications
The most common complications of hip dysplasia include:
- Chronic pain.
- Hip instability: excessive movement of the femoral head within the acetabulum.
- Acetabular labrum tear: damage to the cartilage surrounding the acetabulum, causing pain, stiffness, or joint locking.
- Hip osteoarthritis: friction between the femoral head and acetabular cavity wears down the cartilage, limiting movement and causing pain.
Prevention
Hip dysplasia cannot always be prevented, as most cases are present at birth. However, following certain recommendations can reduce the risk in children and adults:
- Maintain proper infant positioning: legs should not be too close together or excessively spread.
- Limit the use of car seats or baby carriers.
- Choose baby transport devices that support the natural hip position.
- Maintain appropriate body weight.
- Attend neonatal check-ups to detect early signs as soon as possible.
Which Specialist Treats Hip Dysplasia?
Hip dysplasia is managed by specialists in traumatology and orthopedic surgery.
Diagnosis
Typically, hip dysplasia in infants is diagnosed during pediatric check-ups through a physical examination. The specialist moves the infant’s legs in various directions to assess joint function.
In more subtle cases and in adults, in addition to gait evaluation, ultrasound or X-ray imaging is used to detect structural abnormalities or bone malformations.
Treatment
Various treatments are available for hip dysplasia, depending on the type of pathology and the patient’s age:
- Newborns: an orthopedic device (Pavlik harness) is applied to maintain the femoral head in the correct position. This usually yields good results after wearing it for several weeks (6–12 weeks).
- Infants older than six months: if the harness is insufficient, a closed reduction is performed, manually positioning the bone in its proper place under general anesthesia. Once the hip is correctly positioned, a cast is applied for 2–4 months to restrict movement.
- Children older than 18 months: an open reduction is performed, a surgical procedure in which the bone is placed in the correct position. A cast is also applied postoperatively to ensure joint stability.
Physical therapy is effective for newborns and during recovery following orthopedic devices or as part of postoperative care. It strengthens muscles, improves mobility, and promotes proper joint development.
