Adolescent Hip Dysplasia: Causes, Symptoms, and Treatment

Adolescent hip dysplasia is a condition characterized by abnormal development or alignment of the hip joint in young individuals during their teenage years. It can lead to hip instability and potentially result in long-term hip problems if left untreated. This blog aims to provide valuable information about adolescent hip dysplasia, including its causes, symptoms, and available treatment options.

What Is Adolescent Hip Dysplasia:

Adolescent hip dysplasia refers to a condition where the hip joint does not develop normally, leading to an unstable or improperly aligned hip joint. It can occur due to various factors, including genetics, abnormal bone growth, or environmental factors during hip joint development.

Causes of Adolescent Hip Dysplasia:

Several factors contribute to the development of adolescent hip dysplasia, including

Genetic predisposition: Certain genetic factors can increase the risk of hip dysplasia in adolescents.
Hormonal influences: Hormonal changes during growth spurts can affect the development of the hip joint.
Mechanical factors: Abnormal forces or stress on the hip joint during growth can impact its development.
Environmental factors: Swaddling techniques, baby carriers, or tight clothing that restrict hip movement during infancy can contribute to hip dysplasia.

Symptoms of Adolescent Hip Dysplasia:

The symptoms of adolescent hip dysplasia can vary, but common signs include:

Pain or discomfort in the hip, groin, or thigh region.
Clicking or popping sensations in the hip joint during movement.
Difficulty with activities that involve hip movement, such as walking, running, or climbing stairs.
Limited range of motion in the hip joint.
Uneven leg length or an abnormal gait.

Diagnosis and Evaluation for Hip Dysplasia in Teenagers:

A healthcare professional will conduct a thorough evaluation to diagnose adolescent hip dysplasia. This may include:

Physical examination: Assessing the hip range of motion, stability, and overall hip joint function.
Imaging tests: X-rays, ultrasounds, or magnetic resonance imaging (MRI) scans to evaluate the hip joint’s structure and alignment.
Assessment of symptoms and medical history: Discuss the onset, duration, and severity of symptoms, as well as any relevant family history.

Treatment Options for Adolescent Hip Dysplasia :

The treatment for adolescent hip dysplasia depends on the severity of the condition and the age of the individual. Treatment options may include:

Observation and monitoring: In mild cases, observation may be recommended to assess the hip joint’s natural development.
Physical therapy: Specific exercises can help strengthen the hip muscles, improve stability, and promote optimal hip joint alignment.
Orthotic devices: Braces, splints, or harnesses may be used to help maintain proper hip alignment during growth.
Surgical intervention: In more severe cases or when conservative treatments are not effective, surgical procedures, such as hip reconstruction or realignment, may be necessary.

Long-Term Outlook and Follow-up Care for Hip Dysplasia in Teens:

With early diagnosis and appropriate treatment, the prognosis for adolescent hip dysplasia is generally positive. Regular follow-up visits with healthcare professionals, including orthopaedic specialists, are essential to monitor hip joint development and ensure optimal outcomes.

Understanding Adolescent Hip Dysplasia

For proper hip function, the socket should fully cover the femur’s ball part. Hip dysplasia occurs when this joint doesn’t develop correctly. In such cases, the socket doesn’t entirely encase the femur’s ball, resulting in instability and pain. Although doctors often address hip dysplasia in infants, symptoms might not arise until adolescence.

What Triggers Hip Dysplasia in Youth?

The exact cause of hip dysplasia remains unclear, although it has a familial tendency. Despite lacking a precise genetic marker, it’s observed more in girls and first-born children. Symptoms can emerge during adolescence or early adulthood due to substantial changes in the ball-and-socket shape during the growth’s final stages.

What are th Potential Long-Term Effects of Hip Dysplasia

Over time, hip dysplasia can lead to:

Gradual cartilage erosion due to restricted joint movement.
Labrum, the stabilizing soft tissue around the socket, can suffer damage.
Hip osteoarthritis, especially in older adults, with hip dysplasia being a primary cause.
This emphasizes the importance of early identification and treatment for hip dysplasia.

Why Opt for the SGH Hip Preservation Program for Hip Dysplasia Care?

At Saudi German Hospital, We have skilled orthopaedic surgeons that stand out as a leading surgeons in UAE for advanced hip preservation surgeries. Our skilled team, including radiologists and physical therapists, collaborates to diagnose and address hip dysplasia in young individuals. We provide opportunities for involvement in clinical trials and research, enhancing our approach to hip disorder treatment. This ensures early access to pioneering treatments for hip dysplasia.

What are the Common Symptoms of Adolescent Hip Dysplasia

Hip pain is prevalent among teenagers and young adults with dysplasia, particularly worsening during activities like walking and running. Active participation in sports can exacerbate the strain on the hip joint, which is already affected by dysplasia. Symptoms of hip dysplasia in teens and young adults encompass:

Groin pain, especially in the front hip region.
Sensations of popping, locking, or snapping within the hip joint.
Increased pain when standing.
Muscle fatigue or tiredness sensations around the hip area.

Approaches to Diagnosis of Hip Dysplasia in Teens and Young Adults

Our process commences with a medical history review and a thorough physical examination. For confirming hip dysplasia, we might request noninvasive imaging, including:

X-rays: Providing an overall assessment of the ball-and-socket joint.
CT scan: Offering a 3D perspective of the hip joint.
MRI: Revealing soft tissue details and potential cartilage issues.

At the Saudi German Orthopedic and trauma hospital, our expertise in interpreting these scans ensures accurate diagnosis and timely treatment for your hip ailment.

Non-Surgical Solutions for Hip Dysplasia in Adolescents

Our initial approach centers on non-surgical remedies for hip dysplasia, including:

Physical therapy: Enhancing the strength of hip muscles aids in stabilization and pain reduction.
Anti-inflammatory medication: Diminishing swelling can enhance well-being and facilitate a more active lifestyle for certain hip dysplasia patients.

Surgical Treatments for Adolescent Hip Dysplasia

Should your child endure pain and possess limited articular cartilage damage in their hip, the physician might suggest surgery. The prevailing surgical method for treating hip dysplasia is an osteotomy, involving bone reshaping and reorientation of the acetabulum and/or femur. This aligns the joint surfaces more naturally.

Diverse osteotomy types address hip dysplasia, selected based on factors such as your child’s age, dysplasia severity, labrum damage, presence of osteoarthritis, and remaining growth years.

Periacetabular osteotomy (PAO)

Periacetabular osteotomy (PAO) currently stands as the primary choice for adolescent hip dysplasia. This procedure involves adjusting the acetabulum area. Periacetabular osteotomy involves creating four cuts in the pelvic bone. (B) Using specialized tools, the surgeon manipulates bone fragments to access the acetabulum. PAO typically takes 2 to 3 hours. During the procedure:

The surgeon makes four pelvic bone cuts around the hip joint to free the acetabulum.
They reposition the acetabulum over the femoral head for a more natural alignment, guided by X-rays.
Several screws are inserted to secure the repositioned bone until healing. Periacetabular osteotomy with screw fixation is depicted in this X-ray, displaying bone repositioning and screw support.

Arthroscopy

Arthroscopy might accompany PAO, utilizing a small camera (arthroscope) for labrum repair. Arthroscopic actions encompass:

Labral refixation: Trimming torn tissue, and reattaching the labrum to the acetabular rim.
Debridement: Easing pain by trimming torn/weakened labral tissue.

How do I know if I have hip dysplasia?

The initial indication of hip dysplasia in adolescents or young adults commonly manifests as hip pain and/or a limp. Typically felt in the groin or hip side, the pain intensifies during activity and eases with rest. Often, a catching, snapping, or popping sensation accompanies activity-related pain. Due to potential delays in diagnosis, individuals might consult multiple orthopedic surgeons and experience prolonged symptoms. If hip pain worsens inexplicably, seeking a second opinion is advisable.

Is there a cure for hip dysplasia?

In due course, surgery becomes necessary for most individuals with hip dysplasia to enhance hip support. In early arthritis stages stemming from hip dysplasia, partial cartilage preservation allows for hip preservation surgery, realigning the joint.

This realignment positions the remaining joint surface more favorably for bearing weight. Medical professionals often liken the joint surface to tire tread that diminishes over time due to use. Similar to tire balance affecting tread wear, realignment can extend the joint’s longevity, analogous to rotating tires before complete wear, ensuring better tread endurance.

What is Hip Dysplasia in Teenagers?

Hip dysplasia in teenagers arises from abnormal hip joint development, with potential detection shortly after birth or during later stages, categorized as adolescent hip dysplasia (AHD).

A well-functioning hip joint involves proper fitting of the femur’s ball (top) within the pelvic socket. Dysplasia emerges when this fitting goes awry, inducing discomfort and, when unaddressed, potentially culminating in early arthritis.

Why didn’t doctors diagnose me when I was a baby?

In essence, the current detection approaches prove insufficient. Norway, operating under socialized healthcare, embraced comprehensive screening four decades ago, including ultrasound screening introduced three decades ago. In 2008, Norwegian researchers examined hip replacements in young individuals, revealing that 92% of adolescent dysplasia cases went undetected during childhood.

This is disheartening for doctors, as their diligent efforts fell short in identifying childhood hip dysplasia. The issue lies in the methods, not the doctors themselves. It’s increasingly evident that dysplasia can emerge post-infancy, necessitating broader adoption of preventive measures.

Is it important to see a Hip Specialist vs a General Orthopedist if I have Hip Dysplasia?

Misdiagnosis of hip dysplasia frequently occurs due to the necessity for X-rays in specific positions. The average delay in accurate diagnosis spans 3 years, as these diagnostic methods are relatively novel to many doctors. If you suspect hip dysplasia and your pain’s origin remains unclear, seeking a second opinion is prudent. We’ve also provided potential questions to ask your doctor, aiding in gauging their familiarity with hip dysplasia.

What happens if Adolescent Hip Dysplasia goes untreated?

Untreated hip dysplasia in adolescents worsens, eventually necessitating total joint replacement. While exercises and anti-inflammatory medications might offer temporary pain relief, the definitive remedy involves realigning the hip joint to distribute joint surface pressures across a broader area. This necessitates surgery before the joint surface deteriorates irreversibly.

Some doctors might suggest enduring the pain, yet this isn’t usually the optimal advice for dysplasia-induced pain. Early hip preservation surgery can delay artificial joint replacement, particularly for individuals under 50. Opting for total hip replacement should be avoided when feasible, as success rates are lower in young patients compared to those over 50.

What are the advantages of a PAO over a total hip replacement?

It’s a common query without a definitive answer, as each individual’s situation varies. Opting between preserving the natural hip or total hip replacement hinges mainly on age, dysplasia severity, and expected post-surgery activity level. Your doctor is the ideal source for personalized guidance. If your doctor specializes in total hips and lacks PAO surgery experience, seeking a second opinion from a qualified PAO surgeon is advisable. Similarly, if your doctor primarily treats children and young adolescents but rarely performs total hip replacements, consulting a total hip surgeon might be valuable.

PAO yields best outcomes for those under 35 with good ball-and-socket alignment. Total hip replacements excel for those over 45, willing to curtail activities to extend artificial hip durability. Orthopedic surgeons often aim to preserve the natural hip if the adequate joint surface remains and the person is under 40-45. Displaced hips with thin joint surfaces often lead to total hip replacement, particularly after 45. The in-between years depend on existing joint damage.

PAO surgery offers success, restoring full activities and delaying replacement over a decade for 85%, and potentially two decades for some. Though successful, total hip replacements pose challenges in younger individuals who tend to disregard post-surgery restrictions after feeling better. Increased wear and replacements stem from longer lifespans and heightened activity levels.

Subsequent replacements involve more bone removal, complicating the procedure and elevating infection risks. Total hip replacement complications rise with each subsequent surgery. However, age becomes secondary when joint surfaces are worn out, necessitating a total hip replacement. Remember, your doctor can assess your hip’s condition and recommend the optimal choice between PAO surgery and total hip replacement.

Hip Dysplasia in Adolescents and Young Adults:

Adolescent hip dysplasia is a condition that affects the proper development and alignment of the hip joint in young individuals. Understanding the causes, recognizing the symptoms, and seeking timely treatment is crucial for managing this condition effectively.

With a combination of conservative treatments and, if necessary, surgical intervention, adolescents with hip dysplasia can achieve improved hip joint stability, reduced pain, and better long-term hip function. It is important to consult with healthcare professionals for an accurate diagnosis and to develop an individualized treatment plan that addresses the specific needs of each patient.

Recovery After Surgery for Adolescent Hip Dysplasia

After surgery, your child will spend 2 to 4 days in the hospital for monitoring and pain management. Typically, full weight-bearing won’t be permitted on the operated leg for 6 to 12 weeks while the bones heal in their new alignment. During this period, crutches will be necessary.

Around 6 weeks post-surgery, your child will have a follow-up with the doctor. X-rays will gauge PAO healing progress. During the visit, the doctor will determine weight-bearing safety and when physical therapy can begin. The physical therapist will guide your child through exercises to maintain range of motion as well as enhance strength and flexibility in the hip joint.

For patients ranging from teenagers to adults, post-surgery rehabilitation typically entails six months of physical therapy; many resume their chosen activities within four to six months, with overall recovery extending up to a year. The initial three months post-surgery are the most demanding in terms of recovery.

Crutches are commonly used during the bone-healing phase, where full weight-bearing on the operated leg isn’t possible. This is always a period from the initial four to six weeks to three months. Your doctor will determine when physical therapy can commence, but typically patients can begin bearing weight and undertaking range of motion exercises as early as four to six weeks post-surgery. These exercises bolster the hip joint and prepare it for weight-bearing.

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Adolescent Hip Dysplasia: Causes, Symptoms, and Treatment

What Is Adolescent Hip Dysplasia:

Causes of Adolescent Hip Dysplasia:

Symptoms of Adolescent Hip Dysplasia:

Diagnosis and Evaluation for Hip Dysplasia in Teenagers:

Treatment Options for Adolescent Hip Dysplasia :

Long-Term Outlook and Follow-up Care for Hip Dysplasia in Teens:

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Periacetabular osteotomy (PAO)

Arthroscopy

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