While DDH is most often present at birth, it may also develop during a child’s first year of life. Adolescent hip dysplasia is usually the end result of developmental dysplasia of the hip. These patients may not show symptoms of hip dysplasia until reaching adolescence. In patients with hip dysplasia, the acetabulum is shallow, meaning that the ball, or femoral head, cannot firmly fit into the socket and may be easy to dislocate.
Treatment for adolescent hip dysplasia focuses on relieving pain while preserving the patient’s natural hip joint for as long as possible. In many cases, this is achieved through surgery to restore the normal anatomy of the joint and delay or prevent the onset of painful osteoarthritis.
The doctor may recommend nonsurgical treatment depending upon certain clinical factors and many more, and for patients who have such extensive joint damage that the only surgical option would be a hip replacement.
A surgical treatment is recommended if the patient is experiencing pain and has limited damage to his or her articular cartilage. The surgical procedure most commonly used to treat hip dysplasia is an osteotomy. “Osteotomy” literally means “cutting of the bone.” In an osteotomy, the doctor reshapes and reorients the acetabulum and/or femur so that the two joint surfaces are in a more normal anatomic position.
There are different types of osteotomies that can be performed to treat hip dysplasia. The specific procedure your doctor recommends will depend on a number of factors, including:
- Your child’s age
- The severity of the dysplasia or extent of the damage
- Whether osteoarthritis is present
- The number of remaining growing years
Dr. Manjunatha GS, Specialist Orthopedic Surgeon at Dr. Joseph’s Polyclinic in Karama, cited: “Dysplastic hip is the most common congenital hip disorder in children and generally leads to secondary osteoarthritis of the hip joint at a very young age.”.
Dr. Manjunatha diagnosed a 58-year old British female patient with Developmental Dysplasia (dislocation) of the hip, or dysplastic hip, on the right side. Further complicating her case, the friction caused by the abnormal and continuous gritting of the joint, caused the patient’s right hip centre to be 1.6cms above her left hip and also lead to the development of severe secondary osteoarthritis. Dr. Manjunatha commented on the case: “Though it is uncommon for the condition to go undetected for so many years, by performing the total hip replacement surgery and limb correction, we successfully managed to alleviate the patient’s pain and enabled her to regain the ability to perform daily tasks and functions”.
The surgery involved minimally invasive incisions and the patient was able to walk in less than 24 hours without experiencing any pain. The patient also required mild sessions of physiotherapy and was able to walk without any support or walking aids by the third week post-surgery. Dysplastic hip occurs in two forms, namely partial subluxation and complete dislocation. It is more likely for the condition to be diagnosed when it occurs in a single joint, however in the patient’s case; it remained undiagnosed until the age of 58.
Throughout her life, the patient struggled with mobility and found it difficult to execute certain movements such as going up the stairs, sitting cross-legged or even stretching her legs. She underwent surgery done by Dr. Manjunatha to correct a birth defect and regained her ability to perform normal daily activities.