17903 Hip Dysplasia

Overview

Hip dysplasia is a condition where the hip joint does not develop properly. The ball at the top of the thigh bone does not sit snugly in the cup-shaped socket of the pelvis, which can make the joint unstable, loose, or even slip out of place (dislocate).

Yes, it is one of the most common hip problems in newborns. About 1 to 2 babies in every 100 are born with some form of hip instability or dysplasia. Many mild cases get better on their own, but others need treatment. It can also come to light later in life, especially in active adults.

Hip dysplasia can affect anyone, but it is much more common in females, first-born children, babies born in the breech position (feet or bottom first), and children with a family history of the condition. Adults can also be diagnosed for the first time, often in their 30s to 50s.

Symptoms

Common symptoms

• A limping walk
• A feeling that the hip is loose or 'giving way'
• Clicking or popping sensation in the hip
• Reduced movement or stiffness in the hip
• Pain in the hip, groin, or buttock, especially during activity

Symptoms in children

• In babies: legs that appear different in length, extra skin folds on one thigh, or one leg turning outward more than the other
• In toddlers: a delay in starting to walk, a waddling walk, or a persistent limp
• Older children may complain of hip or knee pain and may have trouble running or jumping

Symptoms in older adults

• Dull, aching pain in the hip or groin that gets worse with walking or standing
• Stiffness in the hip, especially after sitting for a long time
• A noticeable limp or feeling that the hip is not stable
• Difficulty putting on shoes or socks because of reduced hip movement

Causes

Main causes

• The hip joint being loose or shallow as a baby develops in the womb
• Loose ligaments that do not tighten up after birth, allowing the ball to slip in and out of the socket
• Genetic factors that affect how the hip joint forms
• Breech position in the womb, which puts stress on the hip joint

Risk factors

• Being female
• Being a first-born child
• Breech birth (feet or bottom first)
• Family history of hip dysplasia or a family member who had surgery for hip problems at a young age
• Being wrapped too tightly with hips straight and legs together (improper swaddling)

When to see a doctor

See a doctor urgently if:

• If your child is limping or refuses to walk, especially if this started suddenly
• If your baby has a noticeable leg length difference or signs of discomfort in the hip
• If you have severe hip pain or the hip feels like it is coming out of joint

Book a routine appointment if:

• If you notice any signs of hip instability in your baby, such as clicking hips or unequal leg lengths
• If you have hip pain or stiffness that isn't getting better after a few weeks
• If you were born with risk factors for hip dysplasia and are considering a check-up

Diagnosis

A doctor will start by asking about symptoms and checking your or your child's medical history. They will then do a gentle physical examination to check how the hip moves and whether it can be moved in or out of the socket.

Tests that may be done

• Physical exam of the hips in babies (using movements like gently spreading the legs and checking for a 'clunk' or 'click')
• Ultrasound scan for babies under 6 months of age, which can create images of the soft joint
• X-ray for older children and adults to look at the shape and position of the hip bones
• CT or MRI scans are sometimes used if more detail is needed, especially in complex adult cases

What to expect at your appointment

The doctor will move your or your child's legs gently and carefully. The exam is not painful, though it might feel unusual. If problems are found, you will likely be referred to a specialist doctor who treats bone and joint conditions (an orthopaedic specialist).

Treatment

Treatment depends on age, the severity of the dysplasia, and whether the hip is unstable. The goal is to get the ball to sit correctly in the socket so the joint can grow and develop in the proper shape. In babies, this often involves wearing a soft brace or harness. In older children and adults, treatments may include physiotherapy, activity changes, and occasionally surgery.

Self-care at home

• Work with a physiotherapist to strengthen your hip muscles, which can help hold the joint in place
• Choose low-impact exercises, such as swimming, cycling, or walking, that do not jar the hip
• Avoid high-impact sports like running or jumping if they cause pain
• Maintain a healthy body weight to reduce pressure on the hip joint
• Use a pillow between your knees when sleeping on your side to help align the hips

Medical treatments

Doctors may recommend non-drug treatments like physiotherapy to improve muscle support around the hip. Pain relief is sometimes used, but all medications should be discussed with a qualified healthcare provider. In some cases, they may recommend a walking aid or a special brace. Surgery is considered when the joint remains unstable or when arthritis has already developed.

When is surgery considered?

Surgery may be needed if the hip is severely unstable, if it dislocates, or if arthritis is causing serious pain and disability. In younger people, surgery to reposition the bones (called a pelvic osteotomy) can help the joint function better. In older adults with severe arthritis, a hip replacement may be the best option.

Living with this condition

Living with hip dysplasia means being gentle with your hips while staying active. Listen to your body, stop activities that cause sharp pain, and make small changes to protect the joint. Following your treatment plan and going to regular check-ups can help you stay on track.

Lifestyle tips

• Stay physically active with low-impact exercises to keep your hip joint mobile
• Learn proper posture and body mechanics for sitting, bending, and lifting
• Wear supportive, comfortable shoes with good grip
• Avoid heavy lifting or sudden twisting movements that stress the hip
• Ask your healthcare team about a personalized exercise plan

Diet and exercise

A balanced diet rich in calcium and vitamin D supports strong bones and joints. It is also important to keep your weight healthy, as extra weight puts added strain on the hips. Gentle exercises like swimming, stationary cycling, and yoga can improve flexibility without overloading the joint.

Mental health and emotional wellbeing

Living with a long-term hip problem can sometimes lead to frustration or low mood, especially when pain limits your activities. It is normal to feel this way. Talking about your feelings with loved ones, a counselor, or a support group can help. Remember that treatment can improve your symptoms and quality of life.

Prevention

Hip dysplasia cannot always be prevented, especially when there is a genetic cause. But in babies, proper swaddling techniques can help. When wrapping a baby, make sure the hips have room to bend and move outward. Avoid tightly straightening the baby's legs.

Screening programmes

Many countries screen newborns for hip dysplasia as part of routine checks. If your baby has risk factors such as breech birth or a family history, an ultrasound scan may be offered to check the hips carefully. Early screening means early treatment, which usually gives the best outcomes.

Complications

If left untreated

• The hip joint may become dislocated, making walking difficult
• Early wear and tear of the joint (osteoarthritis) can develop, causing pain and stiffness
• One leg may end up shorter than the other
• Chronic pain and reduced mobility can affect daily life and quality of life

Long-term outlook

The outlook for hip dysplasia is generally very good when it is found early. Most babies treated with a harness or brace go on to develop normally and lead active lives. For older children and adults, treatments like physiotherapy, lifestyle changes, and joint-preserving surgery can greatly reduce pain and improve function. Even if arthritis develops, modern hip replacement surgery has excellent results, allowing most people to return to everyday activities without pain.

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