November 17, 2021

Pediatric and young-adult hip dysplasia: Types, causes and treatment options

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Also: How hip preservation procedures can give patients an active life.

Hip dysplasia occurs when a hip socket doesn’t completely cover the ball, also known as the femoral head. This imprecise fit means the hip joint can become partially or fully dislocated. The shallow hip socket can also increase wear and tear on the joint’s protective cartilage, leading to pain. Doctors check newborns for hip dysplasia, but the condition can occur later during development with symptoms starting in early teenage years to young adult-life as well.

Hearing that your child has received a hip dysplasia diagnosis can be overwhelming. But Jonathan Schoenecker, M.D., at Vanderbilt Children’s Orthopaedics, reassures families about a relatively new area of orthopedics called “hip preservation.” Hip preservation surgeries can help increase mobility and ease pain from birth until the time when a patient may need a total hip replacement later in life.

“We explain to families that even if their baby’s hip is dislocated, or found to be dysplastic as a teenager or young-adult we’re still going to give them a normal life,” Schoenecker said. “ As a physician — helping patients remain mobile and limiting their pain is what gets me up in the morning.”

Types of pediatric hip dysplasia

Hip dysplasia can occur because the hip didn’t form correctly in the womb, but it may also crop up during adolescence if hip dysplasia went undiagnosed in infancy or if a healthy hip doesn’t develop properly during bone growth, Schoenecker explained. Sometimes hip dysplasia goes unnoticed until stress on the hip increases through athletics, a minor accident or pregnancy.

Hip dysplasia treatments

Hip preservation may involve a complex reconstructive surgery, which Schoenecker specializes in. Or it may involve a procedure called arthroscopy, performed with a small camera, a specialty of Jaron Sullivan, M.D. Some patients will require both.

“Hip preservation was something that was a void 20 years ago, and there are few people in the area who specialize in it — especially the two together,” Schoenecker added. “Having two experts in the same surgery, doing what they do best, is such a benefit.”

Two decades ago, doctors sent younger patients with hip dysplasia to physical therapy if they had pain because not much could be done except to wait for a total hip replacement, he explained. But hip replacements were typically reserved for people over 50.

“There’s a big decision in hip preservation as to whether you should try to preserve the hip or replace it,” he added. For these complex decisions, Schoenecker and Sullivan put their heads together with Vanderbilt’s joint replacement experts. “The comprehensive care that we give the hip is literally from the birth of the hip to the time that you need the hip replaced,” Schoenecker said.

The impact of hip pain

Hip pain can have an extreme impact on quality of life. “Hip pain and problems with the hip are arguably one of the worst things that can happen to a musculoskeletal system,” Schoenecker said, “because if you can’t sit, you can’t walk, you can’t sleep, what can you do?” That’s why hip preservation as well as hip replacement can be life-changing. “It really puts into context how disabling hip pain can be,” Schoenecker explained. “If you’re experiencing hip pain, it’s a good idea to get checked out. And know that there are good surgical procedures to preserve your hip.”

Vanderbilt Orthopaedics is Tennessee’s leading provider of orthopaedic care.

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