Hip Dysplasia Treatment

Hip dysplasia treatment in Israel is carried out by experts in the Orthopedic Department Herzliya Medical Center’s private hospital. The orthopedic department at HMC practices a wide variety of surgical and conservative treatments of congenital and acquired abnormalities, aimed at restoring the physiological functions of the hip joint.

A normal hip joint, a “ball-and-socket” joint consists of the femoral head (of the top of the femur) – the ball, and the acetabulum (hip socket), the joints fit together in such a way allowing free rotation of the ball in the socket, articular cartilage provides a smooth surface area for the joints to move. Labrum lines the acetabulum, stabilizing the hip joint and maintains synovial fluid inside the hip joint, with no friction or tear when in motion.

What is hip dysplasia?

Hip dysplasia is formerly known as congenital dislocation of the hip, (CDH), or developmental dysplasia of the hip (DDH). There is a loose fit of the femoral head to the articular surface of the acetabulum. Also, there is abnormal joint mobility and dislocation. There are several degrees of severity from mild dysplasia underdevelopment which increases the risk of dislocation to heavy displacement and deformation of the joint. Depending on the type of anatomical abnormality, dysplasia is classified as:

• Acetabular dysplasia – shallow acetabulum
• Dysplasia of the femoral head
• Rotational hip dysplasia

Causes of hip dysplasia

There are multiple causes of hip dysplasia. It includes underdevelopment of one or both hip joints during fetal development may be due to toxemia of pregnancy, premature birth, a small amount of amniotic fluid, a diabetic mother and/or abnormal placental blood circulation. Often the disease is observed in large birth weight and breech births. Dysplasia is frequently seen in the immediate family, which makes it very possibly a hereditary disease. Girls, as well as the first children in the family,  have a higher risk of DDH. The disease can also develop during the first year of life under the influence of external factors that disrupt the normal development of the hip joint (tight swaddling to bringing the hips).

Symptoms of hip dysplasia

In some cases, hip dysplasia can be diagnosed at birth, but usually mild and severe disorders are defined within the first year of life. It is necessary to consult a specialist if any of the following symptoms are present:

• Different lengths of legs
• Abnormal movement of one leg (limitation of hip abduction)
• Uneven skin folds in the thigh or a noticeable strain in the hip (usually determined at 2-3 months)

A lack of a timely diagnosis results in serious changes starting the moment a child begins to walk. Often there is a characteristic of hip dysplasia known as the waddling gait (duck-like). Abnormality of posture and the normal physiology of the joint includes further distortion of the pelvis, hip, and spine, which may cause severe disability as well as inhibit the physical development of the child.

Hip dysplasia diagnosis at HMC

Podiatrists at Herzliya Medical Center in Israel can detect the presence of dysplasia in an objective examination of a patient. Ultrasound confirms the diagnosis of hip dysplasia. The simplicity and safety of this method of assessment allow for an ultrasound to act as a screening test for all newborns, which is practiced in many countries, including Israel. If necessary, experts may recommend an X-ray study of the pelvis; however, this is used more often in patients older than a year.

Conservative treatment of hip dysplasia

In milder forms of hip dysplasia, treatment will be conservative when there is no indication of the dislocation of the femoral head. The goal of a conservative approach is to fix the hip joints and place them back in their physiological position, in order to prevent hip dislocation. The main methods of conservative treatment are:

• Wide swaddling: a method used in children with minimal changes. Using two diapers can preserve the correct angle of the hip joint over a long period. In addition, ultrasonic follow-up of the joint determines the effectiveness of the treatment and the necessary duration to continue treatment
• Fixation with Pavlik stirrups – a technique that is more effective for fixing the hips than broad swaddling and can be applied when there are more noticeable changes
• Closed reduction of dislocation and external fixation (with contraindications to surgery)

The conservative treatment of hip dysplasia is combined with therapeutic massage and physiotherapy procedures to strengthen the muscles and ligamentous apparatus.

Hip dysplasia procedure at HMC

Hip dysplasia procedures are done due to the lack of effectiveness of conservative treatment, as well as in the late diagnosis (defined by repeated ultrasound or radiographic studies). The orthopedic department at Herzliya Medical Center’s private hospital conducts a wide variety of surgeries for hip dysplasia. Among the major surgical procedures:

• Surgical (open) reduction of the dislocation of the hip
• Osteotomy of the proximal femur to correct the deformation
• Osteotomy structures of the acetabulum and pelvis

At Herzliya Medical Center, young patients and their parents are provided with excellent conditions for hospitalization. The multidisciplinary team’s caring nature and individual approach to each patient guarantee the successful treatment and rapid recovery for hip joint function.