Hip Dysplasia by definition refers to a developmental abnormality of a joint and in particular hip dysplasia is characterized by an improperly formed hip joint leading to instability, pain and occasional arthritic changes. It commonly affects the joint where the ball (femoral head) nested in the socket (acetabulum) but is not smoothly and firmly inserted into the cup – like structure.
Hip dysplasia is of two broad categories:
Developmental Dysplasia of the Hip (DDH): This is one of the congenital diseases that affect the incidence of the hip joint. More so, it is often presents in the children below the age of five years.
Acquired Hip Dysplasia: This type occurs progressively due to factors such as injury, overuse, or in some instances due to aging thus affecting the adults.
Hip Dysplasia Symptoms
Hip pain, especially in the groin or outer thigh
Limited range of motion
Instability in the hip or a sensation of the hip collapsing.
Some of the symptoms include; difficulty in walking or limping.
A sound that can be described as a click or a pop in the hip area is abnormal and should be addressed.
Hip Dysplasia Causes
There are several ways by which hip dysplasia can be triggered hence it may be genetic, environmental or both. Here it is some cases and factors, they are as follows:
Genetic Factors
Risk Factor 1: Hip dysplasia also has a genetic predispose as it is known to run in the families; thus if one is a victim, the chances are high that generations in their family also experienced the same.
Genetic Factors: Some hip malformations can be hereditary and therefore contributes to the formation of dysplasia.
Developmental Factors (DDH)
Jerks while Pregnant: The posture of the baby in the womb seems to have some role in the development of the hip joint of a new-born baby. Lack of room in the uterus, particularly when the baby presents in the breech position, which is when the baby’s feet or bottom is facing down in the womb, increases the risk of baby having hip dysplasia.
It is characterized as low amniotic fluid levels in pregnant women that limit fetal motion and impede the growth of joints.
Swaddling: The tight bundling of a baby or keeping baby’s legs straight might hinder natural crossing of the legs and can lead to DDH.
Trauma or Injury
Damage to the Joint: Any kind of direct injury to the hip joint such as fracture-dislocation will adversely affect the hip joint and may lead to dysplasia or exacerbation of dysplasia.
Stress or Trauma: Repeated stress or trauma, such as the one experienced by athletes or those people who perform high impact activities regularly can also be a cause of acquired hip dysplasia particularly in the adulthood.
Environmental Factors
Gender: Hip dysplasia is common in females than males; this may be cause by differences in structure of the pelvic region.
Firstborn children: Firstborn children are also more vulnerable; this could be attributed to the following reasons; that the pelvic space of the mother is narrow during childbirth.
Birth Weight: Hip dysplasia is also common among babies with low birth weight or those born preterm.
Other Medical Conditions
Some diseases, for example, Ehlers-Danlos syndrome or Down syndrome that involve connective tissues pose the chances of joint instability including the hip dysplasia.
Some of the conditions that are associated with hip dysplasia include cerebral palsy, spina bifida or any other diseases that affect muscles as well as bone growth.
Acquired Hip Dysplasia in Adults
Wear and Tear (Osteoarthritis): With age, the cartilage in Hip joint may steadily wear out thus developing or worsening of Hip Dysplasia results into pain and limited movements.
Obesity: Too much weight also creates on the hip joint brings possibility of development of dysplasia or increases the instability of the joint in case it already been affected.
Pre-existing Injuries: Any past hip injuries or hip replacement surgeries may have shifted the position/shape or form of the hip joint and may well lead to dysplasia.
Hip Dysplasia Treatment
The treatment of hip dysplasia depends with the degree of developing hip dysplasia, age, whether the hip dysplasia is congenital or not. Thus, some of the treatment methods include non-surgical ones and various surgical ones as well.
Non-Surgical Treatment
These are initial treatments that are usually given to patients who have trivial or first attack episodes or relatively young patients.
Physical Therapy
Medications
Bracing or Splinting
Lifestyle Modifications
Weight Management
Surgical Treatment
Surgery might be advisable in extreme cases or where other treatments cannot help to treat the situation effectively.
Osteotomy
Hip Arthroscopy
Total Hip Replacement
Periacetabular Osteotomy
Post-Surgical Rehabilitation
Rehabilitation is vital in the later stages to help the individual achieve functional recovery of the hip joint. This typically includes:
Physical Therapy
Gradual Weight-Bearing
Pain Management
Long-Term Management
Lifestyle Adjustments
Monitoring
Hip Dysplasia in Adults
Adult hip dysplasia usually develops from hip dysplasia, which is more common in infancy or childhood, but left untreated or undiagnosed. In the long-run it would result in difficulties within the hip joint, problems like pain, instability, and even chances of developing osteoarthritis of the joint. Although hip dysplasia affects children more often, the disease may not manifest or progress in the adult population for many years.
Causes of Hip Dysplasia in Adults
The causes of hip dysplasia in adults are as follows:
Health consequences of untreated developmental dysplasia in childhood: It is possible to have mild developmental dysplasia in childhood and never realize that you have it until you start feeling pain or experiencing some other problems in adulthood.
Acquired hip dysplasia: This occurs where an injury takes place, or constant stressing of the hip joint alters the constitution of the joint and instability arises.
Arthritis: The condition can progress to affect degenerative arthritis and afterward may just be painful and worsens joint degeneration.
Genetics and Family History: There are certain hereditary factors which become influential in causing the problem of hip dysplasia in adults.
Hip Dysplasia in Infants
Developmental dysplasia of hip or DDH refers to a condition in which the hip joint is not developed as it should in infants. The head of the thighbone is not firmly in place in the socket of the pelvis known as acetabulum. It can be partially or fully displaced or even totally displaced.
Hip Dysplasia Diagnosis
Newborn Physical Examination
Barlow Test: Examiner is performed to know whether the hip joint can be dislocated or not.
Ortolani Test: It is used to see whether a dislocated hip can be relocated or moved back into their proper position or not.
Given within 72hr of birth and then at every subsequent visit.
Ultrasound Imaging
Sought for babies less than six months of age before the hip bones begin to calcify.
Enables assessment and portrayal of cartilage and joint on real-time movements.
X-ray
A different type is applied after six months of age when the child’s bones can be detected on x-rays.
Shows the position of the femoral head and development of the socket.
Risk-Based Screening
Some of the patients might undergo imaging early even though the physical examination is normal due to certain risk factors that they might possess such as breech birth or family history.
Hip Dysplasia Surgery
Periacetabular Osteotomy (PAO)
Who it’s for: Young people that are most of the time still in their 30s and have not had surgeries, arthroscopy, or have severe osteoarthritis with bad cartilage.
What it does: Shifts the acetabulum away from the femoral head to be more adequately positioned to cover it.
Improve general health and quality of life and, in the process, prevent joint replacement surgery for as long as possible.
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