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Dr. James Walentynowicz, St. Luke's Hospital

Hip dysplasia more common in women, early diagnosis and treatment important

Hip dysplasia, a disorder commonly referred to as developmental dysplasia of the hip (DDH), is a condition where the hip socket may be misshapen or does not cover and support the femoral head, or "ball" of the femur (thigh) bone. When this misalignment occurs, it may cause the femoral head to slide in and out of the socket or, in some cases, move completely out of it causing increased wear and tear on the cartilage and labrum, which is the cartilage attached to the rim of the hip socket bone. At this point, the joint's surface wears down at an accelerated pace.

The condition is present at birth, occurring in about one in every 1,000 births, and it is more common in women. The signs and symptoms of hip dysplasia during childhood, adolescence and early adulthood are frequently quite mild and not recognizable to the average person. It is not until someone reaches their late 30s or early 40s that the symptoms typically manifest themselves.

When hip dysplasia is not diagnosed or treated early in life, women will experience differences in leg length, abnormal gait, decreased agility, mild hip instability, abnormal hip movement or even the inability to walk. Other conditions may develop later on in life including pain, deformity of the hip or osteoarthritis. At this point, there are various non-surgical and surgical treatments to try.

Non-surgical options are preferred before any surgical approaches are considered. They include rest, physical therapy, over-the-counter anti-inflammatory medications like ibuprofen or acetaminophen, weight loss or avoidance of activities that encourage discomfort. Although effective, non-surgical options only treat the symptoms, not the underlying problem.

If non-surgical treatments fail or if the pain worsens, surgical procedures can be considered. This may include a pelvic osteotomy in which the surgeon can restore the hip joint by improving the contact or coverage between the femoral head and the hip socket. Other options include hip arthroscopy, a minimally-invasive technique where small instruments are used to shave tissue, cauterize structures or remove misshapen bone. In more advanced cases where there is severe degeneration, patients are normally advised to undergo total hip replacement in which the damaged bone and cartilage is removed and replaced with prosthetics.

Dr. James Walentynowicz specializes in orthopedic surgery at St. Luke's Hospital. For more information, call 314-205-6060 or visit St. Luke's Physician Referral Service page.

This article was published in the St. Louis Post-Dispatch on May 31, 2012.

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