and Treating Developmental Dysplasia of the Hip

Treatment methods for congenital hip dysplasia?

Hello, I started noticing something unusual with my right foot when I was around 12 to 13 years old; it felt like the bones were rubbing against each other while walking.
I mentioned this to my parents, but they thought it wasn't a big deal.
As I grew older, I realized that after walking for a long time or engaging in intense exercise, I would experience pain in my right hip joint.
This pain caused me to walk with my feet turned inward, on my toes, and to shift my weight to my left foot.
I visited a large hospital where the doctor diagnosed me with ligament inflammation, and I received anti-inflammatory injections and underwent electrical therapy, but none of it was effective.
Later, I went to a clinic and found out that I have developmental dysplasia of the hip.
What treatment options should I consider?

Rong, 20~29 year old female. Ask Date: 2019/05/10

Dr. Li Yongheng reply Orthopedics

Hello, in cases of congenital hip dysplasia, if the wear is not severe, corrective osteotomy can be performed.
If the wear is severe, total hip arthroplasty may be necessary.
It is recommended that you undergo a thorough evaluation at a medical center.

Reply Date: 2019/05/10

More Info

Developmental Dysplasia of the Hip (DDH) is a condition where the hip joint does not properly form in infants and young children. It can lead to various complications, including pain, limited range of motion, and altered gait patterns, as you've described. Your experience of feeling bone friction and pain in the hip joint, especially after prolonged walking or vigorous activity, suggests that the condition may have progressed over time, leading to secondary issues such as joint inflammation or even early osteoarthritis.

Given your symptoms and the diagnosis of hip dysplasia, treatment options can vary significantly based on the severity of the condition and the extent of any associated joint damage. Here are some common approaches to managing DDH:
1. Conservative Management: In mild cases, especially if the dysplasia is detected early, conservative treatments may include physical therapy, which focuses on strengthening the muscles around the hip joint and improving flexibility. This can help alleviate pain and improve function. Additionally, activity modification to avoid excessive strain on the hip joint may be recommended.

2. Surgical Intervention: If conservative measures fail or if the dysplasia is more severe, surgical options may be necessary. The most common surgical procedure for hip dysplasia is called Periacetabular Osteotomy (PAO). This procedure involves cutting the bone around the hip socket (acetabulum) and repositioning it to better cover the femoral head (the ball part of the hip joint). This can help restore proper joint mechanics and reduce pain.

- Indications for Surgery: Surgery is typically indicated when there is significant pain, functional impairment, or if imaging studies show that the hip joint is not stable. Given your description of pain and altered gait, surgical evaluation may be warranted.

- Surgical Success Rates: The success rates for PAO are generally high, with many patients experiencing significant pain relief and improved function post-operatively. However, the exact success can depend on factors such as age, the severity of dysplasia, and the presence of any other joint issues.

- Recovery and Rehabilitation: Post-surgery, rehabilitation is crucial. Physical therapy will be an integral part of your recovery, focusing on restoring strength and range of motion. Most patients can return to normal activities, including sports, after adequate recovery, which may take several months.

3. Joint Replacement: In cases where there is severe joint damage or arthritis due to long-standing dysplasia, total hip arthroplasty (hip replacement) may be necessary. This is usually considered when conservative and reconstructive surgical options are no longer viable.

4. Follow-Up Care: Regular follow-up with an orthopedic specialist is essential to monitor the condition of your hip joint and ensure that any treatment plan is effective. Imaging studies, such as X-rays or MRIs, may be used to assess the joint's status over time.

In conclusion, it is crucial to seek a thorough evaluation from an orthopedic surgeon who specializes in hip disorders. They can provide a comprehensive assessment and tailor a treatment plan based on your specific condition and needs. Early intervention can significantly improve outcomes, so do not hesitate to pursue further medical advice.

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