What are Developmental Problems?
Developmental problems of the hip include a range of problems relating to the early growth and subsequent development of the hip. These issues, if left untreated, can lead to early onset of arthritis.
The most common developmental problem in the hip is developmental dysplasia, where the hip socket is shallow. Screening is now done on new-born babies to diagnose hip dysplasia early as the treatment is often quite simple in infancy and early childhood. Treatment options include double nappies or a period of time in a pavlik harness, to encourage the hip to develop properly. It is not uncommon, however, to find developmental dysplasia presenting in early adulthood, with increasing groin pain. This pain is caused by early damage to the joint as a consequence of the abnormally high pressures transmitted through the abnormal hip joint anatomy.
What are the symptoms of Developmental Problems?
Symptoms of developmental hip dysplasia are very variable. It is quite common for patients to develop a progressive limp as they walk some distance. Patients may complain of pain related to muscle imbalance around the hip which can be felt in both buttocks or laterally in the hip and groin pain, often radiating into the thigh. Developmental dysplasia of the hip often goes hand in hand with hypermobility, so it is not uncommon for hip movements to remain good in the presence of developmental dysplasia.
What are the treatment options for Developmental Problems?
The most important factor in determining treatment options for developmental hip dysplasia is to define the underlying anatomy (how the bone is formed). In some patients there may also be changes of arthritis in the joint. The investigations often include plain x-rays, MR scanning and also CT scanning with 3D reconstructions.
Treatment options include keyhole surgery, injection therapy and in selected cases onward referral to a specialist young adult hip surgeon for consideration of surgery. Periacetabular osteotomy is a specialist procedure that involves changing the orientation of the hip socket or acetabulum to improve cup and ball coverage in the joint and decrease long-term risk of arthritis.
In some cases where degenerative change has progressed too far, in particularly in patients over the age of 40 or 45, joint replacement surgery may be considered.
When should I see my doctor?
If groin pain is present and has been persisting despite physiotherapy and simple pain relief, you should attend your GP for further investigation and potential ongoing referral.