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Conditions

Adolescent Hip Dysplasia

 

What is Adolescent Hip Dysplasia?

The term hip dysplasia describes a situation where the ball and/or socket of your child’s hip doesn't develop as expected and therefore fit together incorrectly. While infants are routinely screened for developmental hip dysplasia, it sometimes goes undetected, which can lead to adolescent hip dysplasia. Other times, adolescent hip dysplasia can develop over time as a body grows. 

Adolescent hip dysplasia becomes more apparent as a child gets older. Your child may start to feel pain due to a rapid growth spurt, increased activity, or the natural need for the hip to bear more weight as your child grows. Adolescent hip dysplasia can be treated through conservative methods, including physical therapy, or sometimes surgery is needed.

There are several variants of hip dysplasia that can cause pain in adolescence and young adulthood: 

  • Acetabular Dysplasia: The ball remains in the socket, but the socket is too shallow to keep the ball firmly in place causing hip instability, hip muscle dysfunction, and eventual cartilage loss of the hip socket and the ball. 
  • Femoral-Acetabular Impingement (FAI) - also called Hip Impingement:  FAI results from an unusually shaped hip joint that causes two bones in the hip to rub together. The pressure causes friction between the top of the femur (thighbone) and acetabulum (socket). FAI can limit motion and cause pain.  
  • Acetabular Dysplasia and FAI can occur together: These conditions can lead to a tearing of the labrum which is cartilage on the rim of the socket. Labral tears can lead to pain and further degeneration. 
 

Expert Treatment for Adolescent Hip Dysplasia

If your adolescent or teenager has hip dysplasia, your family will want to work with a pediatric hip preservation specialist. Gillette is home to one of the country's largest groups of pediatric orthopedic surgeons, several of whom specialize in adolescent and young adult hip preservation. The experienced orthopedic team at Gillette Children’s offers effective, comprehensive treatments and procedures in the hip preservation clinic, including both surgical and nonsurgical options. 

Request an appointment today, or give us a call at 651-615-5064 for more information.

 

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Nonsurgical Treatment Options for Adolescent Hip Dysplasia

In some cases, hip surgery is not needed to treat  adolescent hip dysplasia. If dysplasia is mild, sometimes rest, activity modifications, and physical therapy can improve the symptoms of adolescent hip dysplasia. Depending on the specific cause for your child’s hip pain, occasionally crutches or braces can be used during the treatment process. 

Other nonsurgical treatment options for adolescent hip dysplasia include:  

  • Activity modifications 
  • Anti-inflammatory medications 
  • Diagnostic or therapeutic injection 
  • Virtual or in-person physical therapy 
 

Surgery for Adolescent Hip Dysplasia

In many cases, hip preservation surgery is needed to treat adolescent hip dysplasia. The aim of hip preservation procedures is to repair damage to the labrum or articular cartilage , and prevent further damage to the cartilage or labrum by  reshaping or reorienting the femur or hip socket to restore proper function of the joint. Most hip conditions are treated surgically through one of the following procedures: 

A procedure to realign the bones of the joint to bear weight on the normal joint cartilage. Osteotomies require internal fixation with a metal plate and/or screws to hold the correct position while the bone heals. This procedure allows the joint to endure less stress, which reduces symptoms and further damage. Osteotomy procedures may include: 

  • Periacetabular osteotomy (PAO) The most common surgery for adolescents and young adults with hip dysplasia is a periacetabular osteotomy (PAO). During this procedure, the acetabulum is cut free from the pelvis and then repositioned to be correctly aligned.  
  • Femoral Osteotomy A femoral osteotomy is sometimes needed in conjunction with a PAO to properly align the femur, often because of a twist in the femur. This is a procedure in which the femur bone is cut and correctly oriented. Both osteotomies require internal fixation with a metal plate and/or screws to hold the correct position while the bone heals. 

A procedure in which a small camera, called an arthroscope, is inserted through a small incision to see inside the hip joint. Using this guidance, the surgeon can clear out or repair damaged tissue, allowing the joint to heal properly. Arthroscopy can be done in conjunction with a PAO or femoral osteotomy. Arthroscopic procedures may include: 

  • Labral Re-fixation In this procedure, the doctor trims the torn and frayed tissue around the acetabular rim and reattaches the torn labrum to the bone of the acetabular rim. 
  • Laboral Reconstruction  If the labrum is damaged beyond repair, it can be removed and replaced by a piece of tendon. 
  • Debridement In rare cases, simply removing the torn or weakened labral tissue can provide pain relief. 
  • Femoral or Acetabular Osteochodroplasty In some cases, recontouring of the surface of the ball or acetabular rim can minimize hip impingement. 

A procedure in which the ball is safely dislocated from the acetabulum to address mechanical and soft tissue problems inside the joint as well as around the joint. This is often combined with other femoral or pelvic osteotomies as described above.