A condition of the hip where the socket (acetabulum) and hip ball (femoral head) is misaligned in adults is known as adult hip dysplasia.1 Adults who have no history of the problem are affected too despite the fact that children are commonly affected with Hip Dysplasia. The problem is often fixed through surgery but other options like physical therapy (PT) and/or temporizing medication can help.
Incorrect or underdevelopment of the acetabulum or the femoral head in adults, gives rise adult hip dysplasia or hip dysplasia in adults. A shallow acetubulum or rotated femoral head in the hip makes it difficult for the proper positioning of the femoral head within the acetebelum. Osteoarthritis will result due to prolong friction that result when the cartilage wear out (labral). The reason for this situation is prolonged or severe misalignment of the hip socket and ball.
Causes of Adult Hip Dysplasia
It is unknown as to what causes adult hip dysplasia or hip dysplasia in adults despite the awareness that it is due to the abnormality of hip development within the growing years.
Arthritis in adults is detectable in infancy screening up to only 10% according to medical experts. Instability of hips in toddlers can be detected. Failure of the socket development in due to the fact that babies’ sockets are shallow and elevates the probability of instability during old age. Current methods cannot detect this situation. Babies with shallow sockets are now being treated and the interest is rising as to those considered at below the normal condition. Treatment of babies is always mandatory to those that fall below the 1% hip development, but consideration can be attributed to those who fall below 5% also. It will require deep research to ascertain that treating this condition at an early stage may hinder the development of adult arthritis.
It is around the time of birth that causes hip dysplasia can be known. This is usually a loose hip. Normal hormone that relaxes ligament to ease childbirth is often the known cause. Left hip is normally affected than to the right. The left hip is stretched more than normally in the left because the normal position that the baby takes in the womb, the left hip is stretched more than the right hip.
Up to 15% of every newborn have instability. Firstborn babies are some of the contributing factors of Dysplasia due to insufficiency of room in the womb. Other factors are breech position stretching the hips, helpful family history and girls because their ligaments are more lax.
1-2 in every 20 member of a family member with hip dysplasia has the chance of needing treatment of hip dysplasia (5-10%).
How Frequent is the Adult Hip Dysplasia?
Hip arthritis in women who are young is commonly caused by adult hip dysplasia. One in every five reported cases of hip dysplasia is in men. The chances of hip dysplasia causing hip arthritis amounts to 5-44%. Hip dysplasia is the cause of 10% replacements of hips in the USA. Hip dysplasia covers about 35,000 of hip replacement cases per year in the United States. Hip preservation surgery in modern day technology that prevent total hip replacement if it is detected early.
Newborn infants are commonly affected. Factors that may vary the frequency required for the treatment of babies depend on sex, race nationality among other factors. An estimated number of two to three children in every one thousand need treatment for hip dysplasia. Studies have indicated that 1 in every 6 has mild instability. Renewed interest has emanated regarding the “resolve” as to the probability of being the cause of adult hip dysplasia.
Why Was I not Diagnosed Having Hip Dysplasia When I Was a Baby by My Doctor?
The ways of discovering the hip dysplasia that are currently available are inadequate. The doctors are not to be blamed but rather the methods. More methods that are able to prevent dysplasia from developing at infancy needs to be developed. These are yet to be answered by International Hip Dysplasia Institute.
Signs and Symptoms of Adult Hip Dysplasia
Both hips can be affected by either severe or mild adult hip dysplasia. The pain usually starts at adolescent owing to hip socket with dysplasia and becomes worse with time. It may not be easy to discern early mild dysplasia until puberty and no pain may be experienced until late teen years.
The signs and symptoms that is common for adult hip dysplasia or hip dysplasia in adults includes:
- Turning or positioning of legs abnormally
- Immobility in the fully dislocated or partially (subluxed) hip.2
- In the partially or fully dislocated hip the leg will look shorter on that side.
- You will waddle if both hips are affected but you will limb if one is affected. Abnormally is not easily detectable if both hips have been dislocated.
- Osteoarthritis can occur if hip dysplasia is not diagnosed.
Tests to Diagnose Adult Hip Dysplasia
Screening of hip dysplasia shall begin postnatal and throughout the early years of the baby. This is because early detection has proven to be the vital factor in treating hip dysplasia. Any persistent pain in adulthood and during adolescent and the evaluation of the care to be administered will be determined. Thus it is necessary to detect.
The range of motion of the hip should be examined on the onset of discomfort or pain in an adolescent or an adult. Normal motion range will be seen during the early stages of a mild adult hip dysplasia or hip dysplasia in adults. If you try to bend your knee on 90 degree to a position that is straight or attempting to move your leg from your body (abduction), it may result in stiffness or discomfort in the hip. The length of the hips may vary, or limping may result owing to the worsening condition of the patient’s hip condition. Rotating the thigh away or towards the body may start becoming difficult.
Physical exams that entail MRI and X-rays will be conducted to ascertaining the condition.3 The alignment of the femoral head and the acetabulum will be assessed through an X-ray scan and the cartilage (labrum) and the soft tissues of the hip will assessed through an MRI scan.
Treatment for Adult Hip Dysplasia
Keeping the acetabulum and the femoral head in good contact is the main aim of treatment for adult hip dysplasia. Consideration should be taken with regard to the patient’s age and the severity of the hip dysplasia. Thus the treatment of patients will vary.
Non-Surgical Treatment for Adult Hip Dysplasia
The patients of adult hip dysplasia can be monitoring their conditions if they have mild dysplasia of the hip that is treated at an early stage. Inflation and pain in the hip can be relieved by steroids injections. The flexibility and the strength of the joint can be increased together with the muscle strength by decreasing force by using a cane while undergoing physical therapy.
Surgical Treatment for Adult Hip Dysplasia
Hip Arthroscopy for Treating Adult Hip Dysplasia
Hip arthroscopy can be helpful in treating hip dysplasia in adults. Before deepening the socket, in cases of adult dysplasia, addressing the case of a torn cartilage is mandatory. Arthroscopy (insertion of a small camera to the body) is the first step in minimal invasive procedure. Minor repairs will be made after viewing the hip socket. Repeated labrum tearing will result if this procedure is used alone. Another valuable procedure known as osteotomy will be required for arthroscopy to be effective as stipulated below:
Periacetabular Osteotomy of Ganz
Ganz (Periacetabular) osteotomies are the effective and commonly used procedure of repositioning and deepening the socket of the hip even after the skeletal age maturity has been achieved. Free the hip socket in order to reset is what is usually involved in the procedure of periacetabular osteotomy. Proper alignment and positioning of the socket will be ensured through the use of screws. The correct position of the hip socket head is restored by complete surgical separation of the acetubulum. Adults and teenagers with acetabular hip dysplasia can be well again.
It is less common to find adult hip dysplasia requiring femoral realignment. The bone is cut so as to change its angulations or rotation and screws and plates are put in place for holding the bone until is healed.
Hip Replacement Treatment for Adult Hip Dysplasia
This condition will be determined by the severity of both hips which renders other viable procedures of preservation of hips insufficient. Thus this procedure is the last resort.
What Happens as a Result of Untreated Hip Dysplasia in Adults?
Total joint replacement will be needed for hip dysplasia in adults which has been ignored. Temporary relief can be attained through anti-inflammatory medicine and exercise. The joint surface’s pressure has to be advanced over a broad area and it can only be achieved by realigning the hip-joint. Surgery is necessary and it must be prior to wearing out of the surface of the joint which may be hard to heal. It is unwise to put up with the pain, which may be the advice of some doctors, because the reason of the pain is the dysplasia.
People who are below 50 years can avoid surgery for artificial joint replacement if hip preservation surgery is done early. Hip replacement is successful in people older than fifty years but complete hip replacement is less successful in young adults. Therefore, it is wise to avoid it when it is possible.