Hip Dysplasia

Hip Dysplasia is an abnormality of the hip, occurring when the ball and socket of the hip do not fit together in their 'normal' position. Hip dysplasia, also commonly referred to as ‘clicky hips’, is also known as development dysplasia of the hip (DDH). It is a very common hip abnormality worldwide, and 8 to 10 Australian children per day are diagnosed with hip dysplasia. Hip dysplasia affects more girls than boys.

The hip joint is made up of a ball and socket; the head of the thigh bone (femur) is the ball and the socket (acetabulum) is part of the pelvis. When the ligaments around this ball and socket joint are loose, it can cause the hip joint to become misaligned. The hip joint is considered to be ‘dislocated’ or ‘subluxated’ when the ball and socket do not fit together in their 'normal' position. The hip can also be ‘dysplastic’ which means the shape is not normal.

What are the signs and symptoms of Hip Dysplasia?

Infant hip dysplasia

The ideal time for treatment is in the first 3 months of life. If infant hip dysplasia is left undiagnosed, it is one of the leading causes of early-onset arthritis of the hip, which could lead to the need for a hip replacement later in life.

All parents are strongly encouraged to learn about the risk factors for and potential signs of hip dysplasia, and to ensure their children’s hips are routinely checked from birth right through until 3.5 years of age.

Signs to look out for in infants and young children:

· A ‘Clunk’ when moving the hip

· Uneven thigh creases or crooked buttock creases

· Leg(s) are difficult to spread apart

· Different leg lengths

· Limping when walking

· Child walks on tippy toes on one side

The presence of these symptoms does not necessarily mean your child has hip dysplasia. If you have any concerns, please speak with your GP, Paediatrician or Child Health Nurse.

Teen and adult hip dysplasia

Hip dysplasia might not be present at birth but can develop at some stage later in childhood; this can occur when the growth of the hip joint does not match the growth of the rest of the body. Some babies have shallow hip sockets that do not develop completely or become unstable at an older age.

Hip dysplasia in adults is the most common cause of hip arthritis in young women. During the teenage years and into adulthood, the most common first sign of hip dysplasia is pain in the hip. The hip joint is located in the middle of the crease where the thigh joins the body, where the hip bends and straightens.

What are the causes of Hip Dysplasia?

Hip dysplasia can be caused by a development abnormality or lack of growth. Contributing factors for hip dysplasia are first born babies (as there is not as much room in-utero), baby girls and breech babies. Breech birth babies can have hip dysplasia because they are born in a position that stretches the hips. Hip dysplasia is almost 10 times more likely where there is a family history. Wrapping or swaddling a baby’s lower limbs with the knees pushed together also predisposes to hip dysplasia, and should be avoided.

How is Hip Dysplasia diagnosed?

Early diagnosis of hip dysplasia ensures the best possible outcomes. If you have any concerns with your child’s hips, please speak with your GP, Paediatrician or CaFHS nurse. Some will be detected by examining your child, some children will need an ultrasound or x-ray to confirm the diagnosis.

What are the treatment options for Hip Dysplasia?

Most mild hip instability improves spontaneously. Infant hip dysplasia needing treatment occurs in approximately 2-3 children per thousand. The aim of treatment is to make the ball sit properly in the socket, become stable in the socket and help the shape of the ball and socket to develop more normally. Treatment in younger children usually involves bracing. In older children or if bracing fails, surgery may be required.