What is hip dysplasia?

The hip joint consists of the top end of the thighbone (femur) which fits into a curved part of the pelvis (the acetabulum) like a ball and socket. In hip dysplasia, the acetabulum is too shallow so the hip becomes dislocated or unstable. The condition is also called ‘developmental dysplasia of the hip (DDH)’ or ‘clicky hips’.

Hip dysplasia in babies is more common if the baby had a breech birth or if there is a family history of the condition. It is more common in girls and firstborn children.

Hip dysplasia diagnosed early in life can be corrected and usually fixed completely. But if not treated in childhood, hip dysplasia can damage the joint over the years and is a leading cause of hip pain and arthritis in older people. People with hip dysplasia may eventually need a hip replacement.

Symptoms of hip dysplasia

Hip dysplasia in babies is not painful. Symptoms include:

• a hip joint that clicks when it’s rotated
• uneven legs or skin creases near the buttocks
• late sitting or walking
• uneven walking

In adolescents and adults, the main symptom of hip dysplasia is sharp pain, especially in the groin area. It’s common after sport and can be worse when you’re standing up from a seated position, climbing in and out of a car, going downstairs, or if you suddenly rotate your hip.

Diagnosis of hip dysplasia

All newborn babies are examined for hip dysplasia in their first few days of life. These tests are repeated again at 6 weeks and at every appointment with the doctor or child and family health nurse. If they detect a problem or if your baby is at high risk of hip dysplasia, they may order an ultrasound.

In older children and adults, a physical examination and an ultrasound are used to diagnose the condition. An MRI or CT scan may be necessary to have a closer look at the acetabulum and assess any damage.

Treatment of hip dysplasia

Treatment depends on your age, how severe the condition is, and whether you have developed arthritis.

In babies, the wearing of a soft brace (known as a Pavlik harness) for 6 to 10 weeks may help the hip develop normally. A small number of babies may need to have surgery or spend time in a plaster cast.

In adolescents and adults, the aim of treatment is to preserve the hip for as long as possible. You may receive anti-inflammatory medicines, steroid injections and physiotherapy to help manage the condition.

Surgery can sometimes be used to reposition the acetabulum or repair the cartilage. But in some cases, the person may need a hip replacement.

Living with hip dysplasia

Gently moving and stretching the hip will help to keep it lubricated and moving well. A physiotherapist can give you an exercise plan. Physical activity and strengthening exercises will help you stay healthy, but avoid running and impact sports as they put too much pressure on the hip joint.

Walking with a cane may help in the later stages of hip dysplasia. One to 2 of every 5 adults with hip dysplasia develop osteoarthritis, a leading cause of disability. Find out more about living with osteoarthritis here.

Where to seek help

• your GP
• your physiotherapist
• a maternal child health nurse at Pregnancy, Birth and Baby on 1800 882 436.
• International Hip Dysplasia Institute
• Arthritis Australia