Detecting and Treating Symptoms of Hip Dysplasia
Hip dysplasia, a condition in which the two parts of the hip joint are poorly connected, is a common cause of severe osteoarthritis – especially among females. It often occurs at birth, but can develop later in life too, sometimes without warning. Read on to learn the causes and symptoms of hip dysplasia and learn the best treatments...
The thigh bone’s connected to the hip bone – that’s what the song says.
But sometimes that connection doesn’t work so well, resulting in a hip joint that’s dislocated, partially dislocated or loose.
These conditions, known as hip dysplasia, are the most common cause of hip arthritis in women under age 50.
They account for as many as 10% of hip replacements in the U.S., says Charles T. Price, M.D., director of the International Hip Dysplasia Institute at the Arnold Palmer Hospital for Children in Orlando, Fla.
Doctors screen every baby for symptoms of hip dysplasia.
When it’s caught early, it can be treated with braces, casts and sometimes surgery.
But some forms of the condition can develop later in life.
They may cause little or no pain for years, but – if untreated – eventually lead to osteoarthritis, deterioration of the joint, and the eventual need for total hip replacement surgery.
If you are concerned about your own hip health, here are answers to the most important questions about this often silent condition.
What exactly is hip dysplasia? It’s a catch-all term that describes a variety of malformations of the hip joint.
Picture a cup-shaped socket (called acetabula), which holds the ball-shaped top (femoral head) of the thigh bone (femur).
When the tight fit between these two pieces is lost, the top of the femur is able to move within or outside the hip.
It can be loosened within the joint, able to move to easily in and out of the joint (subluxated) or totally out of the joint (dislocated).
“Hip dysplasia describes any abnormal relationship between the ball and the socket,” says Michael J. Goldberg, M.D., director of the Skeletal Health Program at Seattle Children’s Hospital.
When do symptoms of hip dysplasia occur? About 10 out of every 1,000 babies are born with loose hips, says Dr. Goldberg.
For many of these infants, the problem will resolve within several months. But about 1 in 1,000 babies will either be born with hip dysplasia or develop it in the first years of life.
“In a newborn, the socket isn’t in a cup shape yet,” Dr. Goldberg says. “It’s actually more of a flat plate. It begins to round up and turn into the shape of a bowl, then a cup, and eventually it wraps around the ball-shaped top of the femur. This process continues until we stop growing.”
It can also show up later in life, in the teen years or even adulthood.
As bones keep forming, sometimes the cup-shaped cavity doesn’t grow deep enough to hold the femoral head.
“The forms of hip dysplasia that involve the growth of the socket are often quite subtle,” says Arabella I. Leet, M.D., associate professor in the Division of Pediatric Orthopedics at Johns Hopkins Hospital in Baltimore.
Although the hip may not sit well in the socket, she says, it’s not likely to move in and out noticeably either.
As a result, it can be years before an adult discovers any symptoms of hip dysplasia.
“It’s sometimes diagnosed incidentally, when a woman has pain playing sports or when it shows up on an X-ray,” Dr. Leet says. “Sometimes we don’t know until the woman develops arthritis.”
What are the risk factors? There’s a strong genetic link, according to the American Academy of Pediatrics. Children whose parents had healthy hips have a 6% risk.
But when one parent has had hip dysplasia, the risk increases to 12%. And for children who have both a parent and a sibling with the condition, the risk increases to 36%.
It’s also more common in girls than boys, due to a hormone called relaxin that’s released by women during the birth process.
Relaxin loosens the mother’s hips to make childbirth easier, but it also affects the babies – especially girls – causing hip instability that can lead to dysplasia, according to the American Academy of Pediatrics (AAP).
Either hip (or both hips) can be affected, but dysplasia is three times as common on the left side – possibly due to the positioning of most babies in the womb, the AAP says.
It’s also more common in breech babies (those delivered feet- or buttocks-first), because their position limits movement of the legs and hips during fetal development.
What are symptoms of hip dysplasia in adults? If you have ongoing hip pain, are walking with a limp, or hear a clicking or popping noise in your hip, it’s a good idea to get an X-ray, says Dr. Leet.
Other conditions can also cause these symptoms – including uneven hip height or leg length.
So try to find a doctor who specialises in hip treatment, is aware of subtle joint abnormalities and has a lot of experience reading the X-rays.
“Hip dysplasia causes a deep ache on the front surface of the hip joint,” Dr. Price says. “If you’re having pain in the groin or the front of the hip that persists or gets worse, you should have it checked out.”
Or, Dr. Price says, “pain in the side of the hip is more likely to be caused by trochanteric bursitis” (inflammation of the bursa, a fluid-filled sac in the hip).
If I do have symptoms of hip dysplasia, what’s the treatment? If you’re under 50, your doctor will probably recommend you have hip-preservation surgery.
Known as an osteotomy, it reshapes the hip socket so that it covers the ball of the joint.
For young adults, the most common surgery is periacetabular osteotomy.
It reshapes and deepens the socket, which is then held in place with screws (which are sometimes removed later).
“This is a well-studied procedure with good outcomes,” Dr. Price says. “Once you’re fully recovered, you can return to activities, including sports.”
It also stops the deterioration of the joint, so you’re less likely to need total hip replacement surgery later in life.
The downside is the recovery period: six weeks on crutches and up to three months before you can start intensive rehabilitation, Dr. Price says.
“If you truly have dysplasia, it’s best to have the surgery early,” Dr. Price says. “Because it’s a mechanical disorder, postponing it can cause more damage. The quicker it’s diagnosed and treated surgically, the better the long-term outcome.”
Sometimes the cartilage is already so damaged this surgery isn’t an option. If that’s the case – or if you’re over 50 – your doctor may suggest total hip replacement surgery, known as arthroplasty. The damaged cartilage and bone are removed and replaced with artificial parts.
Expect to spend 3-5 days in the hospital; full recovery can take anywhere from 3-6 months.
What about other treatments – such as exercise and physical therapy – to relieve symptoms of hip dysplasia?
There are ways to relieve pain – but “they won’t prevent the need for surgery,” Dr. Price says.
The strain on the joint will continue, and it will eventually deteriorate further.
In the meantime, any of these techniques may relieve your arthritis pain, suggests Dr. Leet.
While the debilitating pain may discourage hip dysplasia patients from exercising with an exercise specialist trained to help increase mobility to the affected joints; ignoring the issue will exacerbate and worsen the deterioration of the joints & rehabilitation from eventual surgery will be compromised.
If you suffer from any form of arthritis and wish to undergo exercise therapy, please contact us via the contact form at the top of this page. Thank You.
(acknowledgements for source material -http://everydayhealth.com)