More Worry for Childhood Hip Dysplasia

There’s new information that children who had a totally normal hip may deteriorate if they also had a dislocated hip on the opposite side.

Fotosearch_i1118

http://www.ncbi.nlm.nih.gov/pubmed/25183584

A report from Oslo, Norway followed 48 patients for fifty years after closed reduction and cast immobilization for a dislocated hip when only one side was affected. The other side was perfectly normal by all available x-ray measurements at the time of initial treatment. In these patients, the previously normal hip became dysplastic in 17% of patients, or approximately one out of six. That’s a pretty high number when the hips were normal as infants. The ages at time of initial treatment was from 4 months to 5 years.

There are probably a lot of lessons in this long-term study. It’s unlikely that the treatment caused the other hip to become dysplastic. This means that there are underlying conditions that may cause hip dysplasia to develop after birth. Another lesson is that not all dislocated hips occur at birth. It’s long been known that late dislocations can occur. Some have occurred after normal ultrasound studies at six weeks and this is another reason why dislocations may be found at walking age instead of at birth. Another lesson is that parents and doctors can never stop worrying about the opposite hip even when it looks normal. There is a tendency to stop seeing the doctor after things have been going well for a few years. Now, it seems that follow-up x-rays are needed until skeletal maturity if there was a complete dislocation on one side or even on both sides. This also explains why some hips that were successfully treated may worsen with age even though there doesn’t seem to be any reason for that to happen.

Fortunately, most children with mild hip dysplasia improve naturally or respond to non-surgical treatment. Also, the large majority of children who are treated for hip dislocation never have any more problems with that hip or the other hip. We recommend that parents remain optimistic because most of the time things go well. However, parents of children with complete hip dislocations should also remain vigilant for any signs of deterioration of the treated hip, or signs of problems with the opposite hip until maturity.

 

Terjesen T. Dysplasia of the contralateral hip in patients with unilateral late-detected congenital dislocation of the hip: 50 years’ follow-up of 48 patients. Bone Joint J. 2014 Sep;96-B(9):1161-6.

« Back
  • Call to Action Buttons

  • Email Sign Up

    Email Sign Up
  • Social Media Links

  • Translate Link

    Para ver en Español Click Aquí

  • SubNav Menu

  • Hippo CTA

  • Child CTA

  • Latest News

    Latest News

    view all

    NYU Langone Health - Hip Symposium

    Jun 06

    This symposium will highlight the major challenges facing providers wh...

    PAO vs THR - What to do and when to do it?

    Apr 09

    A staggering number of adults are suffering with chronic hip pain due ...

    Can I play sports after my PAO?

    Feb 21

    Hip dysplasia in young adults is becoming increasingly recognized. Man...

  • Latest Stories

    Latest Stories

    view all

    Phil

    Jun 29

    Hello my name is Phil, I am a 32 year old male who lives in Oregon, US...

    Kiley

    Jun 25

    As a parent the last thing you want to hear after your child is born i...

    Malia

    Jun 14

    Malia was diagnosed with hip dysplasia and placed in a Pavlic harness ...