Hip Dysplasia Overview

 

The Basics

 

What is hip dysplasia?

Hip dysplasia, also known as developmental dysplasia of the hip (DDH) or click hips, is the most common musculoskeletal birth anomaly in the world; however it does not only present at birth, hence the inclusion of 'developmental' in the formal name.

The hip joint is made up of a ball and socket; the femoral head of the thigh bone (femur) is the ball and the acetabulum of the pelvis is the socket. Loose ligaments around the joint can allow for misalignment of varying degrees to occur. The hip joint is classified as displaced when the ball and socket do not fit together in their 'normal' position. Sometimes this is due to abnormal development and/or lack of growth.

Left undiagnosed it’s one of the leading causes of early-onset arthritis of the hip and possibly, the need for a hip replacement; it is a significant public health issue. Treatment is optimised when diagnosis occurs within the first 3 months of life.

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Left undiagnosed it’s one of the leading causes of early-onset arthritis of the hip and possibly, the need for a hip replacement; it is a significant public health issue. Treatment is optimised when diagnosis occurs within the first 3 months of life.

All parents, and parents- to-be, are urged to educate themselves 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.

Who Hip Dysplasia Affects

 

Free Parent Resources

 

Routine hip checks are not a mandatory standard in Australia, but are recommended in the surveillance for hip dysplasia. We've developed these resources in a bid to stop hips going unchecked, and help stop children presenting with late diagnosed hip dysplasia.

Request your Parent Resource today which includes:

 

What are the statistics?

8 infants a day are diagnosed with hip dysplasia in Australia. Despite this, the likelihood of a parent being aware of the condition, prior to a diagnosis of it for their child, is only 57%. This limited awareness is contributing to the rising number of those diagnosed late with this potentially life changing condition.

The reported incidence of developmental dysplasia of the hip varies widely. This is due to the difference in average rate of diagnosis using clinical examination (manual checks) alone or using ultrasonography as well. One in 6 babies born full-term have some hip instability at birth. This increases to one in 10 when a family history of the condition is present.

Per 1000 births, the incidence of treatment required for DDH using the Barlow clinical test is 1.5. Using ultrasonography, the overall incidence increases to three to four per 1000 births.

Depending on the skill level of the assessor, clinical examination alone can lead to under diagnosis of  DDH. However, for the same reason, ultrasonography can lead to over diagnosis of DDH due to subjectivity in the classification system.

 

'Having no risk factors is the biggest risk for late diagnosed hip dysplasia. DDH is everybody's business.'

 

 

Preventative Strategies

 

For newborns and babies;

Allow:

  • Natural leg position. Legs bent at knee and turned out at hip (froggie position).
  • Wide based carriers that support the legs, out to behind the knee, in the 'M' position are recommended.

Avoid:

  • Tight swaddling. Legs should be free to move.
  • Baby seats, car seats, carriers, and slings that bring legs together at the knees, allow the legs to hang, or position the legs stretched out straight and together.
  • Baby walkers and jumpers that have narrow based seats, suspended off the ground as babies feet aren't taking their weight the whole time in this supported standing position and there are increased forces through the hip joint from 'hanging' in the seat without the legs supported adequately.

For adults:

Hip dysplasia can cause osteoarthritis. Hip-preservation surgery [pelvic osteotomy] can be considered for candidates with hip dysplasia from their early teens to help potentially delay, reduce or prevent the onset of osteoarthritis.

 

Healthy Hips Australia requests your contribution to put these resources in the hands of every parent in Australia. In addition to raising awareness, we offer support to people impacted by hip dysplasia.

Improve hip dysplasia support & awareness today. Donations over $2 are tax deductible.

 

Further Information

Hip Dysplasia in Teenagers & Adults

Signs & Symptoms

Diagnosis

Treatment

Guidelines

 

Page Reviewed:  31 March 2019. Information sources available here.

Disclaimer

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. Every effort is made to ensure this information is up to date, accurate and easy to understand. Healthy Hips Australia accepts no responsibility for any inaccuracies, information perceived as misleading. This can be reproduce with acknowledgement to Healthy Hips Australia. Handouts are available to download free of charge at www.healthyhipsaustralia.org.au