Congenital Hip Dysplasia: Symptoms, Diagnosis, and Treatment Options - Orthopedics

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Congenital hip dysplasia


Since elementary school, I have been unable to squat on my left leg because after squatting for a while, my left leg would start to hurt.
However, I can run and jump normally and even participate in races.
As I grew older, I often experienced soreness in my left hip after standing or walking for extended periods, and I would walk with a slight limp.
I am 23 years old now, and in recent years, the pain has become more frequent, occurring almost daily.
I also cannot sit cross-legged, and after running a short distance, I experience pain.
Sitting with my knees hugged also leads to discomfort when I walk afterward.
If my left foot is turned outward for too long or if I sit for a while, I feel some pain as well.

Recently, I visited an orthopedic clinic and had X-rays taken, which revealed that I have congenital hip dysplasia in my left hip joint.
The doctor informed me that my acetabulum is too shallow, resulting in half of the femoral head being uncovered and positioned outside the acetabulum.
The clinic doctor suggested starting with medication, but if that proves ineffective, I may need corrective surgery.
However, since I experience pain daily, does that mean I would have to take medication every day? My mother hopes to avoid surgery and wants to see if I can manage with regular care.
However, the doctor mentioned that without correction, I would eventually need a hip replacement as I age.
I personally hope to address this issue while I am still young, rather than waiting until I am older and suffering more!

Xiao Ya, 20~29 year old female. Ask Date: 2005/10/21

Dr. Shi Guozheng reply Orthopedics


First, it is important to assess the degree of coverage of the femoral head by the hip joint.
If most of the femoral head is exposed and medication does not alleviate the symptoms, surgical intervention may be necessary.
If the condition is not severe, medication may improve the situation.
Generally, it is advisable to moderate physical activity and avoid excessive movements; proper care can help manage the condition for several decades.

Reply Date: 2005/10/21

More Info


Congenital hip dysplasia (CHD), also known as 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 symptoms and complications if not addressed early. Your experience of pain and discomfort in the left hip, especially during activities like squatting, running, or prolonged standing, aligns with common symptoms associated with CHD.

Symptoms of Congenital Hip Dysplasia
The symptoms of CHD can vary widely, but common indicators include:
- Pain in the hip or groin area: This can occur during physical activities or after prolonged periods of sitting or standing.

- Limited range of motion: Difficulty in movements such as squatting or crossing legs.

- Limping or altered gait: As you mentioned, experiencing a slight limp when walking can be a sign of hip instability.

- Clicking or popping sounds: Some individuals may experience audible sounds during hip movement.

- Muscle weakness: Over time, the muscles around the hip may weaken due to altered mechanics and compensatory movements.


Diagnosis
Diagnosis typically involves a combination of physical examinations and imaging studies. In your case, the X-ray findings indicating a shallow acetabulum (hip socket) suggest that the femoral head (the ball of the hip joint) is not adequately covered, which is characteristic of CHD.

Treatment Options
1. Conservative Management: Initially, non-surgical options may be recommended, including:
- Physical therapy: Targeted exercises can strengthen the muscles around the hip and improve range of motion.

- Pain management: Over-the-counter pain relievers can help manage discomfort, but they do not address the underlying issue.

- Activity modification: Avoiding high-impact activities that exacerbate pain can be beneficial.

2. Surgical Intervention: If conservative measures fail to provide relief or if the condition is severe, surgical options may be considered. These can include:
- Osteotomy: This procedure involves cutting and reshaping the bones to improve the alignment of the hip joint.

- Arthroscopy: Minimally invasive surgery to repair or remove damaged tissue in the hip joint.

- Hip replacement: In cases of severe degeneration, a total hip replacement may be necessary, especially if the joint has deteriorated significantly.


Considerations for Surgery
- Timing: It is often recommended to address hip dysplasia sooner rather than later to prevent further joint damage and complications, such as osteoarthritis or the need for a hip replacement in later years.

- Recovery: Post-surgery, rehabilitation is crucial. Most patients can expect a recovery period that includes physical therapy to regain strength and mobility.

- Long-term Outcomes: Early intervention generally leads to better outcomes, reducing the risk of future complications.


Conclusion
Given your symptoms and the diagnosis of congenital hip dysplasia, it is understandable that you are considering your options carefully. While your mother may prefer to avoid surgery, it is essential to weigh the potential long-term consequences of untreated dysplasia against the benefits of surgical correction. Consulting with an orthopedic specialist who has experience with hip dysplasia can provide you with a clearer understanding of your options and help you make an informed decision. Remember, addressing the issue now may prevent more significant problems in the future, allowing you to maintain an active lifestyle without the burden of chronic pain.

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