Hip Dysplasia

Hip dysplasia is a disease of abnormal development of the femoral head and hip socket. It can be caused by multiple underlying conditions with the common finding of abnormal positioning of the femoral head relative to the hip socket. The main risk factors are female sex, family history, certain conditions during the mother's pregnancy, and certain ethnic groups. The cause of hip dysplasia is not clearly known but is thought to be due to a predisposition of soft tissue laxity (looseness) which causes the femoral head to move away from the hip socket during childhood. Gradually the femoral head can even completely dislocate from the hip socket. During childhood, hip dysplasia can be detected as a newborn using specialized tests performed by the pediatrician. If there is any question based on the presence of a hip "click" or on the examination, an ultrasound can be performed. Standard radiographs (X-rays) can also be helpful in making the diagnosis. The treatment of hip dysplasia in childhood depends on the age of the diagnosis. In very young children, harnesses or casts can be used to maintain the hip in the socket. If this is not successful, surgery is required to place the femoral head back in the socket and possibly to cut the bones to allow the hip to become more stable. Hip dysplasia that is untreated can cause significant disability for patients including hip pain, labral tears, and progression to hip arthritis at a young age. If residual findings of hip dysplasia persists after the age of 15 to 16 years old and the hip becomes symptomatic, other surgical options may be considered. These would include further realignments of the pelvis or femur called osteotomies. An osteotomy is any operation where a bone is cut and realigned. The Bernese Periacetabular Osteotomy is our preferred technique for correction of acetabular deformities in patients who are skeletally mature. If there is also a deformity of the femur, this procedure can be combined with a realignment of the femur called a femoral osteotomy.