Hip Dysplasia in Adults
Hip dysplasia, or developmental dislocation of the hip (DDH), is an abnormal formation of the hip joint. In hip dysplasia, the femoral head (the ball) fits too loosely into the acetabulum (the socket), causing instability. The disorder typically develops during gestation or shortly after birth, but may develop later in childhood. In the past, this condition was referred to as congenital dysplasia of the hip (CDH).
Since the condition can present without pain and may not even interfere with the baby's ability to learn to walk, it can go undetected. For this reason, testing for DDH is a normal part of the newborn physical examination. Nonetheless, some cases of hip dysplasia are not diagnosed until adolescence or adulthood, by which time the condition is more complicated and often impossible to correct without surgical intervention.
Hip dysplasia can affect one or both hips, and may be mild or severe. Mild cases result in a hip that is unstable and partially dislocated (a subluxation), while severe cases involve a hip joint that is permanently dislocated, either partially or fully. When an adult is diagnosed with hip dysplasia, it is usually because osteoarthritis has developed and the patient is experiencing pain. While it is unclear why hip dysplasia, left untreated, results in osteoarthritis, it is suspected that part of the femur (thigh bone ) damages tissue as it presses against the pelvic wall. Eventually, not only arthritis, but bone deformity, may occur.
Risk Factors for Hip Dysplasia in Adults
DDH predominantly affects females, first-born children and children born in the breech position. It is also more common in the left hip. Individuals with a a family history of the condition are at greater risk. Because hip dysplasia can develop in a child's early years, it is important that children be checked regularly for the condition to avoid the pitfalls of letting the disorder go untreated until adulthood.
Symptoms of Hip Dysplasia in Adults
Usually, hip dysplasia presents in adolescents or adults with pain and possibly a limp. Most often, deep pain is experienced in the groin or the side or back of the hip. In some rare instances, a clicking sound or sensation may occur as well. As time passes, the intensity and frequency of the pain generally increases.
Diagnosis of Hip Dysplasia in Adults
Definitive diagnosis of hip dysplasia requires X-rays and sometimes an MRI. The condition is identified by a shallow hip socket. On some occasions, hip dysplasia is diagnosed accidentally during an imaging examination administered for another reason.
Treatment of Hip Dysplasia in Adults
Depending on the severity of the dysplasia and the seriousness of the symptoms, the treatment may vary. Weight loss and other lifestyle changes can improve the condition. For mild cases, physical therapy may be sufficient to lubricate the joint, lessen pain, and ease mobility. Physical therapy includes leg stretching, particularly hip abductions, during which the leg is moved out from the body. When engaging in physical therapy exercises, it is usual for patients to be provided with applied heat before the exercise regimen and ice packs afterwards.
When the arthritis in the hip is more advanced and the pain more intrusive, hip arthroplasty, commonly known as hip replacement surgery, is necessary. In some cases, the surgery may be performed prophylactically, but this is rare, since it is impossible to predict when the hip will become seriously arthritic.