Hip Dysplasia

Evidence 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686436/  

Pavel Kotlarsky, Reuben Haber, Victor Bialik, and Mark Eidelman 

Developmental dysplasia of the hip (DDH) describes the spectrum of structural abnormalities that involve the growing hip. Early diagnosis and treatment is critical to provide the best possible functional outcome. Persistence of hip dysplasia into adolescence and adulthood may result in abnormal gait, decreased strength and increased rate of degenerative hip and knee joint disease. Despite efforts to recognize and treat all cases of DDH soon after birth, diagnosis is delayed in some children, and outcomes deteriorate with increasing delay of presentation. 

Education 

Hip dysplasia occurs when the hip joint doesn’t develop normally. It is commonly diagnosed during infancy or early childhood and at this early age is referred to as ‘Developmental Dysplasia of the Hip’ (DDH).  

Usually, the ball at the top of your baby’s thighbone (the femoral head) is held in a cup-shaped socket in the pelvis. The ball is held in the socket by ligaments and muscles. 

In hip dysplasia, the femoral head is not in the right place and your baby’s hip will not develop correctly. 

Some of the signs and symptoms of hip dysplasia are: 

• uneven skin creases near the buttocks or at the front of the upper leg in the groin 

• legs are a different length 

• doesn’t move their legs normally 

• has a turned-out foot 

Your doctor, midwife or early childhood nurse can check your baby’s hips at any time, but often will check them during baby checks done: 

• at birth 

• one week after birth 

• 6 weeks after birth 

• 6 months after birth 

• when they begin to walk 

Your doctor, midwife or early childhood nurse might also arrange an ultrasound or refer you to a paediatrician (children’s doctor). 

What treatment will my child need? 

Treatment varies depending on your baby’s age and how severe the condition is. 

If hip dysplasia is picked up at birth, your baby could wear a soft brace (a Pavlik harness) or a plaster cast for up to several months. This helps the hip develop normally. Babies with braces usually have regular ultrasounds to check their progress. 

Some babies will need an operation to put the femoral head back into the socket. This is more common if babies are diagnosed after 6 months of age. Sometimes further surgery may be needed. 

Your baby’s hips should develop normally after treatment. Your doctor will monitor your child for rare problems such as arthritis. 

Empowerment 

Most cases of DDH are found early and improve with simple treatment. 

Most children have no major problems after they finish treatment. 

Your baby should have regular hip checks by your GP or healthcare worker in the first year of life. 

Useful links 

The Sydney Children’s Hospital Network 

https://www.schn.health.nsw.gov.au/fact-sheets/developmental-dysplasia-of-the-hip-ddh 

Pregnancy, Birth and Beyond  

https://www.pregnancybirthbaby.org.au/hip-dysplasia-in-babies 

Miracle Babies Foundation 

https://www.miraclebabies.org.au/content/hip-dysplasia/gkj8so 

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