Hip dysplasia is a hereditary condition where the hip socket doesn’t completely cover the upper thighbone. It can occur in the womb if the ball and socket do not fit well together while the joint is developing, resulting in a socket that is too shallow.
With hip dysplasia the hip joint can easily become dislocated, either partially or totally. The condition may damage the cartilage that lines the joint and can cause labral tears (damage to the ring of cartilage surrounding the socket which is called the labrum).
Symptoms that might indicate hip dysplasia include:
One leg being noticeably shorter than the other, causing a limp.
Less flexibility in one hip and a feeling of instability.
It may not be possible to prevent hip dysplasia which occurs more commonly in girls and babies born in the breech position. However, midwives and paediatricians check for the condition early on and steps can be taken to reduce its impact.
Babies are checked for signs of hip dysplasia shortly after birth and during routine health appointments. If the condition is diagnosed, treatment may begin immediately. However, milder cases may not cause symptoms until the person is a teenager or young adult. At this stage, surgery may be necessary. In addition to a physical examination, ultrasound scans or X-rays may be used to confirm the diagnosis.
Treatment will depend on the age at which the condition is diagnosed and the extent of the problem. It may include:
For babies up to six months old – a soft brace to hold the ball part of the joint in its socket for several months, helping the socket to mould to the shape of the ball.
For older babies – after moving the bones into the correct position, a full-body cast may be used to keep them in place.
A surgical procedure called a periacetabular osteotomy may be used for more severe cases. This involves cutting the socket free from the pelvis and repositioning it so there is a better match with the ball on the thighbone.
Hip replacement surgery may be needed for the most severe cases, where the condition has caused osteoarthritis.
Hip avascular necrosis occurs when there is a lack of blood supply to the hip bone tissue, causing it to die. When there is an interruption to the blood supply to the bone, it results in tiny breaks which can ultimately cause the bone to collapse. Blood supply to sections of bone can be interrupted as the result of:
A fracture or dislocation which can damage blood vessels
Excessive alcohol or high doses of steroids.
Fatty deposits that can block blood vessels and reduce blood flow to bones.
Cancer treatments involving radiation that can harm blood vessels.
Diseases that reduce blood flow to the bone, including sickle cell anaemia.
In around a quarter of cases, however, the cause is unknown. The condition is most common in people aged between 30 and 50.
In the early stages, there may be no symptoms but as the condition develops it causes a gradual increase in pain levels. The condition can develop in one or both sides of the hip.
To prevent avascular necrosis of the hip, it is advisable to reduce levels of cholesterol in the blood, limit alcohol use and avoid smoking. If you are taking high dose steroids it is important to monitor your health as it increases the risk of bone damage.
Femoro acetabular impingement – or hip impingement – can develop when a problem with the ball or socket rim interferes with the smooth motion of the hip, resulting in cartilage damage. It is a significant cause of hip osteoarthritis in people under 40.
Initially it may be asymptomatic (without any symptoms) but as the condition progresses it can cause pain when walking or bending the hip and a decreased range of motion. If the cartilage has begun to wear away, you may experience pain even when resting.
Hip impingement is normally due to either:
Pincer impingement, which is a deformity of the hip socket that can cause the neck of the thighbone to bump against the rim of the socket.
Cam impingement which is a deformity of the ball at the top of the thighbone. This can cause part of the ball to jam in the socket when the hip is bent.
Initial treatments include rest, anti-inflammatories and exercises to strengthen the hip muscles. If this fails to provide adequate pain relief, a range of surgical options exist, including:
Hip arthroscopy – this is a minimally invasive procedure that involves making a small incision in the skin and inserting an instrument called an arthroscope which has a camera at one end. Tiny surgical instruments can be used to repair the damaged cartilage or clean out any damage to the labrum.
Hip replacement surgeryHip replacement surgery – this may be required if osteoarthritis is advanced and pain is severe.
Whatever your age, our expertise can help you feel healthy, active and pain-free again.
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