Dr. Josué Calderón Gamba

Hip dysplasia

It is a spectrum of pathophysiological and anatomical abnormalities in which the acetabulum has a superior posterior and anterior deficiency, and does not fully and correctly cover the head of the femur, leading to chronic subluxation or dislocation (loss of joint contact) of the femoral head of the acetabulum. This pathology is a congenital disorder (that is, it is present from birth), and of development in the first years of life. Women, breech births, and people with a first-degree relative with hip dysplasia are at higher risk of developing it.

In children, when early detection is carried out at ages when they are not yet walking, non-surgical management can be carried out by means of continuous immobilization in the hip flexion position, with the aim of achieving adequate concave development of the acetabulum. If it is not diagnosed in time, the child will necessarily require surgical management that should ideally be at an early age. In symptomatic adolescents or young adults, without having developed osteoarthritis, a Periacetabular Osteotomy is usually necessary.

Symptoms

In babies, the only thing subtly detectable by their parents is usually a limitation to separate the lower limbs (hip abduction), otherwise it is undetectable. In children there will be no pain, if not more frequently a slight limp. Generally, in adolescents or young adults, symptoms such as mild lameness can occur with simple activities, associated with pain in the lateral aspect of the hip. Groin pain will appear, which will not be sudden, but progressive and will increase over time as the injury worsens, generally related to damage to the labral and the anterior acetabular rim. If treatment is not provided in time, it is proven that a pathological process will be generated that will lead to damage to the articular cartilage also called wear (Osteoarthritis).

What should I do?

In adulthood, the first thing to do when severe groin pain occurs is to make an appointment with a specialist doctor. This will probably assess gait, measure lower limb length, determine muscle power and range of motion. He will order certain diagnostic images of the pelvis and hips to determine the condition of the joint. After this you can determine the treatment to follow. But the ideal time for comprehensive treatment and to prevent the devastating consequences of dysplasia is in the first 4 to 8 months of life, which is why screening for hip dysplasia is so important at these ages.

Handling:

As I said before, in the case of symptomatic young adults with a very mild degree of Osteoarthritis, an option to reduce the consequences of hip dysplasia is Periacetabular Osteotomy, in which the Acetabulum is reoriented, thereby The coverage of the Femoral Head is improved and the overload in the Acetabular Labrum, the capsule, and the ligaments of the hip is reduced.

A good diet, weight care and low-impact exercise are key in accompanying driving.

If not treated in time, hip dysplasia can cause great severe damage to the joint, with sequelae of the disease that will frequently appear at an early adulthood, and Total Hip Replacement should be considered, so that the patient can stop your pain and achieve a better quality of life.

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