What causes Hip Dysplasia?
Loose hips around the time of birth is the usual cause. This is often due to normal hormones that help relax ligaments to make childbirth easier. The left hip is more frequently involved than the right because of the normal baby position in the womb that stretches the left hip more than the right. Some instability has been identified in as many as 15% of newborn infants. Contributing factors for hip dysplasia are first born babies (not as much room), girls (more ligament laxity), positive family history, and breech position that stretches the hips. When one person in the family has hip dysplasia, the chance of hip dysplasia needing treatment is 5-10% for subsequent children (1-2 in 20).
How common is Hip Dysplasia?
Some hip instability is very common in newborn infants. The exact frequency of hip dysplasia that requires treatment is variable depending on Nationality, sex, race, and other factors. Hip dysplasia that needs treatment occurs in approximately 2-3 children per thousand. However, some studies have detected mild instability in up to one infant in six (15%). Most of this mild instability resolves spontaneously. Hip dysplasia is about four times more common in girls than boys.
Did something happen during my pregnancy or delivery of the baby to cause Hip Dysplasia?
No. There are no special precautions during the pregnancy or delivery that would have prevented hip dysplasia. This is mostly a problem with loose ligaments that develop around the time of birth in all infants.
Can hip dysplasia be diagnosed prenatally?
No. There are no diagnostic tests during pregnancy that could predict hip dysplasia in infants nor can hip dysplasia be detected on the maternal prenatal ultrasound. This isn’t a true birth defect that can be identified. Hip dysplasia is more of a birth condition, although it can develop after birth in some infants.
What are some signs I can look for if I suspect my child has hip dysplasia?
There are different signs of hip dysplasia depending on the age of the child, but even complete hip dislocation is not painful before adolescence. Uneven buttock creases or extra folds of skin at the upper thigh can be a sign that there is a leg length difference due to hip dislocation in an infant. These can also be normal findings. A decrease in flexibility may also be noted during diapering. If the hips can’t be almost fully stretched out to the side, this can be due to tight muscles or a hip dislocation. After walking age a waddling or uneven gait can be a sign of hip dislocation. When both hips are affected hip dysplasia may be harder to detect.
For more information please see our Infant Signs and Symptoms page.
Is it important to see a Pediatric Orthopedist vs a General Orthopedist if my child has Hip Dysplasia?
It’s usually better to see a pediatric orthopedist. General orthopedists are trained to treat musculoskeletal disorders involving bone, joint and muscle but they may not have a lot of experience with hip dysplasia. Pediatric orthopedists have special training for musculoskeletal disorders that are seen in children.
What happens if Hip Dysplasia goes untreated?
If treatment is delayed beyond 2 years of age, hip deformity can lead to painful hips, waddling walking and a decrease in strength. If untreated altogether, osteoarthritis (a painful hip disorder) and other hip deformities can develop in young adulthood.
Are there any tips for using the Pavlik Harness?
Please see our section in Tips for Parents – Pavlik Harness.
Are x-rays harmful for my child?
Exposure to x-rays should be kept as low as reasonably achievable, but x-rays today are safer than ever because digital imaging has reduced the amount of exposure that is needed to produce a picture. It is appropriate to always question the need for x-rays, but there is no need to worry or let fear of x-rays interfere with the care of your child. According to the FDA, a routine x-ray like those used for baby hips requires a dose of 0.001 mSv (millisievert) which is almost negligible. By comparison, normal background radiation from our natural surroundings is about 3 mSv a year. So, there is little added risk from routine x-rays even in babies. CT scans have much greater amounts of radiaiton than exposure and should be kept to a minimum. MRI studies are very low energy and have no radiation exposure. MRI studies are usually used for soft tissue imaging while CT scans are used more often to show bone anatomy.
What are some coping tips once my child has been diagnosed with hip dysplasia?
Recognize your feelings and discuss them with your child’s doctors. Do not be afraid to ask any questions you may have. Also, understand that caring for infants is difficult for new parents even when a child is born without hip dysplasia. Having a child with hip dysplasia makes the job even more difficult. Ask for help if you need it. Grandparents and other family members can help with care and should be involved with your child life. Ask your child’s doctor to connect you with an experienced parent of a child with hip dysplasia. Enjoy the growth and development of your infant. There is so much more to this special time with your child than hip dysplasia.
Can baby carriers cause hip dysplasia?
Numerous scientific studies have confirmed that the spread-squat position is optimal for hip development during infancy. The hip sockets are shallower at birth than any other time. The depth of the socket develops rapidly during the first six months of life. One in six babies is born with loose hip ligaments that also become tighter with growth. The International Hip Dysplasia Institute (IHDI) acknowledges carriers that promote the optimal hip position during the first six months of life. The IHDI also discourages the most opposite position where the hips are extended and held together with the legs straight. That position of traditional swaddling is known to cause hip dislocations. Many carriers hold the infant’s hips and legs somewhere in between the known harmful position and the optimal position for healthy hip development. The IIHDI does not have an opinion about the intermediate positions because the risk of hip dysplasia has not been identified for intermediate positions. Only one theoretical publication by Dietrich Tönnis, MD – a world authority on hip dysplasia- has suggested that a narrow groin support can leverage loose hips out of the sockets when gravity is acting on the legs.
Please note that IHDI has not indicated that baby carriers may be harmful. IHDI has acknowledged the optimum position for healthy hip development during the first six months of life, and IHDI has advocated for avoiding the known harmful position during the first six months of life.
This list is meant to answer the most common questions we receive about Hip Dysplasia. If you have questions that are not addressed by this list, please take a look at our website. There is much more information than we are able to list here in our FAQs. If our website is unable to answer your question(s), please Contact Us.