Methods For Treating And Managing Hip Dysplasia

September 22, 2023

Hip dysplasia is a condition involving a malformation of the hip joint that results in a higher risk of joint dislocation. The hip is one of the ball-and-socket joints in the body, and the sockets of patients with hip dysplasia don’t completely cover the ball. This affects the rotation of the ball in the socket, and the ball isn't able to rotate freely for movement. The ball and socket in the hip joint are composed of the ball of the thigh bone and the socket of the pelvis. This abnormality can cause a multitude of issues because the hips support a lot of body weight, and they’re responsible for many everyday movements like sitting and walking. Individuals can be born with hip dysplasia, or it may be caused by swaddling, breech birth, or any condition that reduces the amount of space in the womb during gestation. The symptoms of hip dysplasia can depend on a variety of factors like age. Babies sometimes have one leg shorter than the other, and older children, teenagers, and young adults may limp or experience hip pain. Treatment for hip dysplasia focuses on preserving the hip and reducing pain, and early diagnosis of the condition provides more options for treatment. Get to know the treatment options for hip dysplasia now.

Hip Preserving Surgery

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Hip preserving surgery can be performed on patients to ease the discomfort and maintain the hip. Individuals who haven’t suffered extensive damage to the hip cartilage may be good candidates for this type of surgery. A periacetabular osteotomy is often performed to lessen pain and extend the life of the joint. This surgery changes the position of the hip socket to provide better coverage to the ball of the hip joint and restore normal alignment. Candidates for periacetabular osteotomy can range in age from eleven to about fifty years old. Adolescents typically have faster recovery times, but older patients can benefit from the surgery as well. Patients with arthritis and ongoing cartilage injury are usually not good candidates for this type of operation. The surgery involves cutting around the socket to reorient it, and it's subsequently held in its new position with screws while the bone heals. Additionally, cuts to the thigh bone may be necessary for some patients to further improve hip alignment.

Joint Replacement Surgery

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Joint replacement surgery replaces the damaged joint with artificial parts made of tough plastic, ceramic, or specialized metals. This type of surgery is also known as total hip replacement or total hip arthroplasty. Total hip replacement and hip resurfacing are the two major types of hip replacement techniques. Age, distorted anatomies, leg lengths, or previous surgeries can increase the complexity of this kind of surgery. The thigh bone or pelvis of dysplasia patients are frequently misshapen and may require special methods to correct them, such as implants or bone grafts to provide support to the socket. Younger patients need a more durable and long-lasting artificial hip because of their age at the time of surgery and their higher level of activity. Short-term results of this type of surgery are similar to those of total hip replacements, but long-term results are worse for individuals with hip dysplasia. Patients with more severe hip dysplasia may need revision surgery, and they should make sure they choose an experienced surgeon to perform their joint replacement surgery for the best possible results.

Pelvic Or Femoral Osteotomy

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A pelvic or femoral osteotomy is performed to correct misalignment of the hip joint. They can be done by themselves or in conjunction with other surgeries. Pelvic and femoral osteotomies are used to fix hip dysplasia by correcting the deformity in the hip joint. A pelvic osteotomy corrects the dysplasia by cutting away bone and repositioning the hip socket in the pelvis. The surgeon places a piece of bone into the top of the socket to increase its size so it covers the ball area better. This piece of bone is held in position by screws. A femoral osteotomy corrects deformities of the femur and the hip joint and reshapes the femur so it fits better in the pelvic area. It realigns the bone and brings it closer to normal anatomy. Risk factors of pelvic and femoral osteotomies include bleeding, infection, or injury to nearby organs and tissues. More severe cases of dysplasia may need replacement surgery or another kind of osteotomy that can reposition the socket to fit better with the ball.

Hip Abduction Braces

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Age is one of the many factors that determine treatment for hip dysplasia. Many individuals are born with the condition, so babies diagnosed early can start treatment with hip abduction braces, which is one of the least aggressive treatments for hip dysplasia. It can be used to treat newborn babies because they’re very flexible and their hips can be realigned with little effort. A newborn’s dysplastic hip will move into the socket very easily, so a brace can be used to hold the ball of the joint in the socket and prevent extra movement. The braces will help the various parts of the hip joint to develop normally and become stable. Hip abduction braces are frequently used after treatments with a hip spica, which is a rigid cast. This allows for more range of motion while the hip is growing. Most braces are worn full-time for six to twelve weeks and then part-time for another four to six weeks after the hips become stable. The brace can be removed for diaper changes and bathing, but the legs must remain apart to maintain alignment of the ball and socket.

Special Hip Harness

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A special hip harness can be used to treat hip dysplasia in infants. The Pavlik harness is the most common method of treatment used for infants. It works to keep the hip joint stable and restore normal alignment within the first year of life and effectively treats the condition so development can continue normally. The harness is fit to flex the legs and position the knees to fall outwards. The proper fit of the harness is crucial to the outcome of the treatment. A loose fit may not hold the hips in place, and an extra tight fit may actually cause damage to the baby's hips. The fit should be checked regularly for this reason and also to ensure proper position of the hips. The hips should move to the proper position within a few weeks or a month after wearing the harness. Alternative methods like the hip spica can be used if the harness proves to be ineffective. Although a generally safe and effective treatment, the Pavlik harness does have potential side effects, such as nerve damage caused by improper adjustments of the harness.

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