At C.S. Mott Children’s Hospital, we specialize in treating all types of hip dysplasia from newborn infants to adolescents and young adults. Our hip team includes multiple experts with advanced training treating complex hip problems. We specialize in both non-surgical and surgical treatments, including a range of procedures from therapy, bracing and casting to arthroscopic and open hip preservation procedures such as periacetabular osteotomies and surgical hip dislocations. 

Our team has helped pioneer many of these advanced techniques, and we are continually at the forefront of international hip dysplasia treatment and research. Our goal is to help kids and young adults get back to doing the things that they love to do, and to be there with them and their families every step of the journey.

To make an appointment, please reach out to our team to schedule with one of our two hip experts. At your first appointment we will start with a comprehensive history and physical exam as well as screening diagnostic imaging (either ultrasound for infants, or radiographs for children and adults).

Hip dysplasia is most often painless during infancy and early childhood. Common symptoms during infancy may include

• One leg shorter than the other

• Limited hip motion

• Clicks or clunks when the hip is repositioned

Although children with a dislocated hip can learn to walk at a normal age, they may walk with a limp or waddle. Oftentimes one of their legs will also appear short.

As children progress into adolescence and adulthood, hip dysplasia most often presents with pain and fatigue in the hip, particularly during walking, running or sports-related activities. Although some types of dysplasia may lead to rapid joint degeneration, most types of instability produce pain but the joint degeneration is very slow. Left untreated for a long time, hip dysplasia may lead to progressive joint degeneration and arthritis likely leading to an eventual total hip arthroplasty.

Hip dysplasia is most common in first-born females with a family history of hip dysplasia and/or a history of breech position in utero. Early in life it can frequently be caught via screening ultrasounds or screening hip exams at routine well-child checks. Later in life it most often presents with hip pain during activities and/or feelings of instability in the hip.

Diagnosis typically starts with a detailed history and physical examination. After 6 months of age, radiographs are the standard means for initial diagnosis. Additional advanced imaging such as a CT scan or MRI may be ordered if symptoms persist or surgery is being considered. Finally, diagnostic and/or therapeutic intra-articular corticosteroid injections may be considered in adults with persistent hip pain of unclear etiology.

Overall, there are multiple anatomic factors that may contribute to the development of hip instability. These can include dysplasia of the socket (acetabulum), varying degrees and types of femoral deformity, ligamentous laxity and muscular imbalances and weaknesses. The goal of a detailed history, physical examination and advanced diagnostic information is to try to accurately pinpoint the most likely source of the pain such that we can offer more targeted treatment options.

At C.S. Mott Children’s Hospital, we also have a special hip ultrasound clinic once per month for adolescents and adults with persistent hip pain that is jointly staffed by musculoskeletal radiologists and orthopaedic experts with expertise treating hip dysplasia. This unique clinic is a valuable resource for dynamic evaluation and diagnosis of complex hip pathology potentially requiring surgical management.

Specific treatment will be recommended based upon the patient’s age and dysplasia severity.

In infants, first-line treatment up to 6 months of age is typically a Pavlik harness and/or abduction brace to help guide the hip back into the socket and promote proper growth and remodeling of the joint. Most infants with hip dysplasia can be treated without surgery. For those infants with persistently unstable and/or dislocated hips, they may require a procedure in the operating room to place their hip back into the socket and hold it in place with a body cast (spica cast). This may include either gentle repositioning alone (closed reduction) or an incision over the hip to directly put it back into the socket (open reduction).

As children get older, bracing and harness use become less effective, and they may need surgery to replace the hip in the socket. Older children may also need additional procedures performed at the same time to reshape the bones around the hip to better contain and stabilize the ball (called osteotomies).

In adolescents and young adults with painful hip dysplasia, more advanced reconstructive options may be needed to stabilize the hip. These may include arthroscopic procedures or open hip preservation procedures such as periacetabular osteotomy, femoral osteotomy or surgical hip dislocations. Although these procedures are larger and more invasive with a longer recovery, excellent long-term outcomes can be achieved.

Our team has cared for thousands of children and young adults with hip dysplasia. We have specialized expertise in both the non-surgical and surgical management of a variety of complex hip disorders. Our providers are national and international experts in caring for pediatric hip conditions, and we actively participate in many of the leading research meetings and international research groups focused on various hip conditions. In particular, our experts have helped to pioneer many of the arthroscopic and open hip procedures used to treat patients of all ages across the world, and we are actively involved in research looking to understand and improve the diagnosis and treatment of hip dysplasia.

• International Hip Dysplasia Institute

• OrthoKids