1. Developmental dislocation of the hip fundamentals
Developmental dislocation of the hip surfaces during the first year of a child's life and is characterized by loose, dislocatable or dislocated hips. The condition can occur at birth or shortly thereafter; thus it is important that your pediatrician examine your child for developmental dislocation of the hip during check-ups.
Developmental dislocation of the hip is a condition best treated early. Although the condition may not cause pain or difficulty in your infant, it can lead to long-term complications later in life, including: osteoarthritis, chronic pain, abnormal gait, unequal leg length and decreased agility.
The condition is more common among infant girls than boys and occurs as a result of laxity in the muscles surrounding the hip. It is unclear whether this results from genetic or environmental factors; however, in 33 percent of cases, there is a family history of the condition.
Medical treatment before walking age has an excellent opportunity for success. After walking age, the treatment is more likely to involve surgery and the long-term results can be more problematic.
2. What are the symptoms?
- Difficulty diapering
- Difference in leg length
- Asymmetric appearance in the two legs
- Gait abnormality
- One foot pointing in or out
In older children, symptoms include:
- Limping
- Waddling
- Toe walking
- Leg-length discrepancy
- Swayback
3. What are my child's treatment options?
The goal of treatment is to manipulate the hip into an appropriate position and hold it there while the body corrects the condition and the hip strengthens. Children six months of age or younger can use a Pavlik Harness, which holds the hip in position while still allowing some movement. Doctors who treat children older than six months may move the hip into place (under anesthesia) and use a cast for three months, followed by a brace for three months.
Children who are older than one year may require surgery to correct the placement of the hip. After surgery, the child wears a cast. Additional surgery may be necessary if the hip dislocates.
4. What are the risks of surgery? Is the surgery safe?
Risks include nerve injury, infection, bleeding, and stiffness.
5. How does my child prepare for surgery?
- Complete any pre-operative tests or lab work prescribed by your child's doctor.
- Do not allow your child to take aspirin and non-steroidal anti-inflammatory medications (NSAIDs) one week prior to surgery.
- Call the appropriate surgery center to verify your child's appointment time. If the surgery is being done at The Cleveland Clinic, call 216/444-0281.
6. What should I do the night before surgery?
Do not allow your child to eat or drink anything after midnight.
7. What does my child need to do the day of surgery?
- If your child currently takes any medications, have her or him take them the day of the surgery with just a sip of water.
- Do not allow your child to wear any jewelry, body piercing, makeup, nail polish, hairpins or contacts.
- Have your child wear loose-fitting, comfortable clothing.
8. What happens after surgery?
Ask your surgeon for complete post-operative instructions.
9. How long is the recovery period after surgery?
Your surgeon will inform you of your child's recovery period.
10. What is the rehab after surgery?
Your surgeon will inform you if any rehabilitation is necessary.
11. How will my child manage at home during recovery from the procedure?
Your surgeon will provide you with home-going instructions.
12. How frequently should I schedule follow up appointments with my child's doctor following surgery?
Your surgeon will inform you of the frequency of your child's follow-up appointments.
13. What are the CCF physician credentials?
All doctors at The Cleveland Clinic Department of Orthopaedic Surgery are board-certified or board-eligible in orthopaedic surgery. In addition, our surgeons have subspecialty training and years of experience in pediatric surgery.
All Cleveland Clinic staff radiologists are board-certified or board-eligible n radiology or have the international equivalent.
All Cleveland Clinic staff rehabilitation specialists are board-certified or board-eligible in physical medicine and rehabilitation, or have the international equivalent.
All Cleveland Clinic staff pain management specialists are board-certified or board-eligible in pain management or have the international equivalent.
14. How do I make an appointment?
Call 216/444-2606 or toll free 1/800-223-2273, ext. 42606, Monday through Friday, 8:00 a.m. to 5:00 p.m. (Eastern Standard Time).
15. What clinical trials and orthopaedic research are being conducted at CCF on the procedure?
Researchers at the Cleveland Clinic are involved in ongoing studies that investigate new drugs and treatment approaches for managing disease. Participants in these clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. There are currently more than 1,700 active clinical studies underway.
16. Are there other resources that I can go to for more information on the procedure?
Patients can go to the following resources for more information on this procedure:
Cleveland Clinic Health Information Center
American Academy of Orthopaedic Surgeons
17. Why should I seek a second opinion regarding treatment for this procedure?
As modern medical care grows more complex, patients can feel overwhelmed. The opportunity to consult a recognized authority about a particular diagnosis and treatment can bring peace of mind at an emotionally difficult time. A second opinion may be beneficial when:
- You are uncertain about having surgery.
- You still have questions or concerns about your current treatment.
- A controversial or experimental treatment is recommended.
- You have multiple medical problems.
- You have choices to make about treatment.
