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What is hip dysplasia?

Hip dysplasia, also known as developmental dysplasia of the hip (DDH) and acetabular dysplasia, is a condition where the hip socket doesn’t fully cover the ball of the femur, causing the hip to partially or completely dislocate. This poor fit (or incongruency) can also lead to premature damage to the cartilage, pain, instability and stiffness.

Hip dysplasia can be present at birth or develop throughout childhood and adolescence. Hip dysplasia is a relatively common condition, affecting about 1 in every 1,000 infants born in the US each year, and is more common in girls. The good news is most babies have no long-term complications if their hip dysplasia is treated when they’re younger than 6 months. Sometimes, older children and adults can develop hip dysplasia, with symptoms such as pain or instability occurring later in life.

Hip dysplasia symptoms

Symptoms of hip dysplasia differ by age. In infants, one leg may appear longer than the other, or a limp may develop once the child starts walking. One hip may also feel less flexible during diaper changes. In teenagers and young adults, hip dysplasia can lead to pain, limping, giving way or clicking. Further development of arthritis or a labral tear can cause groin pain during activity and a feeling of hip instability.

When to see a doctor

All infants are screened for DDH, but parents should discuss symptoms with their baby’s pediatrician at a well-baby checkup.

You should also visit a doctor promptly if symptoms of hip dysplasia cause:

  • Limited ability to move a joint or bear weight on a leg
  • Severe hip pain that doesn’t improve after a few days
  • Visible changes or deformity to the structure of the hip joint
  • Any new onset of a limp, hip pain, or feelings of instability in a child or adolescent
Hip dysplasia illustration

What causes hip dysplasia?

The exact causes of hip dysplasia aren’t clear. There are genetic factors, environmental factors, and developmental reasons that can increase the risk.

If the ball of the developing femur isn’t positioned firmly into the hip socket, the socket will not completely form around it. Instead, the socket will become too shallow to fully support the femoral head. As the fetus grows larger and more tightly positioned in the uterus before birth, the shallow hip socket can force the femoral head out of position.

Hip dysplasia risk factors

Hip dysplasia tends to run in families, but any baby can be born with the condition, and anyone can develop it. Though hip dysplasia can affect either hip, it is more common to have it bilaterally with differing severity.

Risk factors for hip dysplasia include:

  • First-born babies
  • Larger infants: Babies who are larger and more crowded in the uterus may be at higher risk.
  • Sex: Girls are two to four times more likely to have hip dysplasia than boys.
  • Birth position: Babies born breech (feet first) are more likely to develop hip dysplasia.
  • Family history: Having a parent or sibling with hip dysplasia increases the risk of a child developing it.
  • Swaddling: Improper swaddling that keeps the hips extended and together can increase the risk of hip dysplasia.

Complications of hip dysplasia

People with hip dysplasia, both adults and infants, are at a higher risk of hip dislocation and early joint degeneration. While dislocations usually happen due to serious trauma, hip dysplasia weakens the hip joint, increasing the risk of partial dislocation that develops over time, known as gradual subluxation. It can also cause looser muscles and ligaments around the hip.

Other hip dysplasia complications can include:

  • Hip labral tears: As you age, hip dysplasia can damage the labrum, the soft cartilage that forms a rim protecting the hip socket.
  • Osteoarthritis: Concentrated pressure and friction on the hip socket may damage or wear down the cartilage in the hip joint.
  • Recurring hip pain: The poor fit of your hip joint can lead to pain and instability.

How is hip dysplasia diagnosed?

In addition to a check right after birth, infants are often screened for hip dysplasia at all their well-child visits. For higher-risk infants, an ultrasound is often performed. Diagnosing hip dysplasia in adolescents and adults requires a combination of a physical exam and imaging tests. Tell your doctor when you first noticed the hip pain and if any activity makes it worse.

  • Medical history and exam

    Your doctor will take your medical history and whether you had hip dysplasia during childhood. They may also ask if you’ve had any accidents that affected your hip and whether you currently experience pain or functional problems with your hip.

    As part of the physical exam, your provider will ask you to move your hip through a range of motion and examine you for a leg-length discrepancy or a tilted pelvis. They’ll ask you to walk so they can observe your gait and check for limping.

  • Imaging tests

    Diagnostic imaging tests can help confirm hip dysplasia. Tests and scans help your doctor locate abnormalities and signs of damage in the hip joint and identify the source of your pain.

    • Ultrasound: Ultrasounds are used on infants suspected of having hip dysplasia. They use sound waves to produce images of the hip at certain angles.
    • X-rays: X-rays taken from a specific angle can reveal a shallow hip joint, and they are often used for teens and adults.
    • CT and MRI scan: A CT and MRI can show further detailed anatomy and soft tissues in the hip joint and may be used in adults suspected of having hip dysplasia.

Hip dysplasia treatment

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Several treatments for hip dysplasia can relieve discomfort and protect the hip joint. Early diagnosis and treatment can lead to options that preserve hip function so you can lead an active life. Your doctors will recommend a treatment depending on your age and the extent of your hip damage.

Infants are usually treated for a few months with a soft brace, such as a Pavlik harness, to help keep their joints aligned as they grow. If your child starts treatment when they are younger than 6 months old, this may be all they need to correct hip dysplasia.

Lifestyle changes

For adults with hip dysplasia that hasn’t damaged bone or cartilage, lifestyle changes may help protect your hip joint.

  • Choose low-impact sports, such as cycling or swimming.
  • Lose weight to relieve pressure on the joint.
  • Consider physical therapy, which may help protect joint function and increase range of motion.

Medication

Your doctor may recommend medications to help you find relief from the pain of hip dysplasia and delay or avoid surgery. Although these medications can’t fix hip dysplasia or address the cause of your condition, they can relieve your pain, allowing you to continue a more active lifestyle.

  • Corticosteroids: These injected medications may reduce inflammation around the hip joint.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): These over-the-counter medications can reduce pain and inflammation.

Surgery

When nonsurgical treatments are no longer effective, or your hip dysplasia is severe, surgery might be the best treatment option. The type of surgery will depend on your age, activity level and severity of hip damage.

Hip dysplasia surgeries include:

  • Periacetabular Osteotomy: A surgeon realigns and reshapes the existing bones in your joint.

In some instances, it may be necessary to replace the hip joint. If your hip joint has become severely damaged, a doctor may recommend hip replacement surgery, in which a surgeon replaces your natural ball and socket with a metal and plastic artificial joint.

Locations

We offer several locations for your care, including orthopedic specialty centers in North and Central Texas.

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Frequently asked questions

  • Is hip dysplasia genetic?

    Yes, hip dysplasia can be passed from parents to children. But genetics isn’t the only risk factor. Girls, babies born in the breech position and babies swaddled tightly are at higher risk.

  • How can you prevent hip dysplasia?

    Because most people with hip dysplasia are born with it, it usually can’t be prevented. Speak with your OBGYN about ways to protect your child’s hips or treat hip dysplasia once your baby is born.

  • How do you treat hip dysplasia?

    Treatment for hip dysplasia depends on the age and the severity of the condition. Babies are usually treated with a soft brace for a few months. In adults, lifestyle changes, medication or in some instances, surgery may be utilized to treat hip dysplasia.

  • Is hip dysplasia painful?

    Yes, hip dysplasia can be painful, especially during physical activity.

  • How common is hip dysplasia in babies?

    Hip dysplasia is a common condition that affects about 1 in 1,000 newborns in the US.