“My child’s DDH treatment is finished – now what?”

We get variations of this question asked quite frequently. Every journey is different. Treatment type and duration vary, as do the recommendations for what is safe to do, and what not to do, once treatment is over.

Do we have one concise answer to eliminate the confusion? Sadly not; we are working on getting a consensus on the main causes for confusion however.

So what do we recommend? Once you have jumped for joy (or at least your heart has whilst you sit in from of the Doctor) ask your specialist for their advice specific to your child’s individual circumstances.

Questions to ask your specialist-

We suggest you ask your specialist about what your child can/cannot do post treatment, so that you can get on with enjoying their new found freedom without hesitation:

1. Will we have a review post treatment to check the hips are continuing to develop normally? (These typically occur at 3, 6 or 12 months post treatment depending on the severity of the dysplasia and duration of the treatment).
2. Are there any activities we should avoid? The most commonly queried activities are;
   1. Jumping on the trampoline
   2. Swimming
   3. Climbing
3. Can we use the following, and if so for how long each day;
   1. Bumbo seat
   2. Jumpers (such as the Jolly Jumper)
   3. Walkers
4. Is W-sitting to be discouraged?
5. If I hear ‘clicking’ what could it mean and what should I do?
6. If I notice further signs and symptoms of DDH emerge post treatment what should I do?

HHA Recommendations-

For newborns and babies;

Allow / Encourage:

• Natural leg position. Legs bent at knee and turned out at hip (froggie position).
• Swaddle for healthy hip development. Guidelines available here.
• Baby wearing, with the legs held in the hip healthy M position, is great for facilitating healthy hip development.

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 them stretched out straight and together.
• The International Hip Dysplasia Institute recommend, “Baby walkers or baby bouncers are not recommended for 4-6 months after finishing treatment for Hip Dysplasia as a precaution. There is concern that they may put strain on the hip joints.”

Further Information –

• The potential of further treatment due to ‘regression’ is a common fear post treatment. Regression is when the hip joint fails to continue to develop/grow at an acceptable rate, or becomes mis-aligned, again after successful initial treatment. Whilst this isn’t the norm, it does occur (specialists propose in roughly only 5% of cases),  and plays a factor in part-time treatment becoming more common, (such as night-time bracing) and repeat reviews post treatment.

• The causes of hip dysplasia aren’t fully known but genetics does play a role in the incidence. According to the International Hip Dysplasia Institute, hip dysplasia is approximately 12 times more likely when there is a family history. Discuss the need to screen siblings, future siblings and relatives (depending on the strength of the family history) with your specialist.

Final word of advice…Enjoy your child’s new found freedom!

Written: February 2016. Updated February 2019.

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