Developmental dysplasia of hip – An overview

Abstract

Developmental dysplasia of the hip refers to a spectrum of severity ranging from mild acetabular dysplasia with a stable hip, to more severe forms of dysplasia with hip instability, to established hip dysplasia with or without subluxation or dislocation. DDH affects 1-3% of newborns and is responsible for 29% of primary hip replacements in people up to the age of 60 years. Ligamentous laxity is also believed to be associated with hip dysplasia, though this association is less clear. The treatment of DDH is age-related and the goal is to achieve and maintain concentric reduction of the femoral head into the acetabulum. A dislocated hip which can be reduced and a reduced hip that can be subluxated should be treated with the orthosis. All such hips should be treated in orthosis or harness beginning at the time of diagnosis. This results from excessive pressure on the femoral head after reduction in extreme abduction and internal rotation leading to vascular occlusion. Avascular necrosis results from excessive pressure on the femoral head after reduction in extreme abduction and internal rotation leading to vascular occlusion. Developmental dysplasia of the hip is a challenging condition. Formal training in the treatment of various age groups with DDH is mandatory. Successful treatment with Orthoses requires careful counselling of parents. Surgical management requires careful pre-operative planning and adequate follow up to ensure the best clinical outcomes.