Developmental Dysplasia of the Hip

What is Developmental Dysplasia of the Hip (DDH)?

Developmental dysplasia of the hip (DDH), sometimes referred to as congenital dislocation of the hip, describes a spectrum of conditions present from birth or early infancy in which the hip joint has not formed normally. The hip is a ball-and-socket joint, and in DDH the relationship between the femoral head (the ball) and the acetabulum (the socket) is abnormal — ranging from a socket that is shallow or unstable, through to a hip that is partially or completely dislocated.

DDH exists on a spectrum, and its impact depends on the severity and on when it is identified and treated. If not addressed, it can lead to pain, abnormal walking, instability, and early osteoarthritis of the hip.

Causes and Risk Factors

DDH reflects abnormal development of the hip joint around the time of birth. Recognised risk factors include:

• A family history of DDH
• Breech position in late pregnancy
• Being a first-born child
• Female sex
• Conditions associated with reduced space or movement in the womb

How it Presents

DDH may be identified at different stages of life:

• In infancy: through newborn screening and examination, sometimes prompted by risk factors, with ultrasound used in young infants.
• In childhood: through signs such as a limp, differences in leg length, or abnormal walking.
• In adolescence or adulthood: as hip pain, instability, or early arthritis, where milder dysplasia was not detected earlier.

Diagnosis

Diagnosis depends on age. In infants, ultrasound is commonly used because the hip is largely cartilage and not yet fully visible on X-ray. In older children and adults, X-rays are used to assess the shape, coverage, and position of the joint, and MRI may be used to evaluate the cartilage and labrum. Accurate assessment of the anatomy guides treatment.

Treatment Options

Treatment depends heavily on the age at diagnosis and the severity of the dysplasia.

• In infancy: treatment often involves bracing to hold the hip in a position that encourages normal development.
• In children: depending on severity, treatment may involve procedures to reposition and stabilise the hip.
• In adolescents and adults: where dysplasia persists and the joint is still well preserved, joint-preserving surgery such as periacetabular osteotomy (PAO) may be considered to improve coverage. Where the joint is significantly worn, hip replacement may be appropriate.

The most appropriate treatment depends on the individual situation and will be discussed with you at your consultation.

Outlook

The outlook for DDH is closely linked to early detection and treatment. Identified and managed early, many hips develop well. Milder dysplasia detected later in life can often still be addressed with joint-preserving surgery while the joint remains well preserved. Recovery depends on the specific treatment undertaken and will be explained according to your circumstances.

Frequently Asked Questions

Is DDH the same as hip dysplasia in adults?

They are closely related. DDH refers to abnormal hip development present from birth or infancy, while the term hip dysplasia is often used for the persisting shallow or poorly covered socket seen in adolescents and adults. Milder DDH that was not detected early can present later as adolescent or adult hip dysplasia.

Why is DDH screened for in newborns?

Detecting DDH early allows simpler, less invasive treatment — often bracing in infancy — and gives the hip the best chance to develop normally. Detection later in life may require more involved treatment, which is why newborn screening and examination are important.

Can DDH found in adulthood still be treated?

Yes. Where dysplasia persists into adulthood and the joint is still well preserved, joint-preserving surgery such as periacetabular osteotomy may be considered. Where the joint is significantly worn, hip replacement may be appropriate. The right approach depends on the individual situation.

Medical Disclaimer
The information on this page is intended as general patient education and does not constitute medical advice. Every patient is different, and treatment decisions should always be made in consultation with a qualified medical professional based on your individual circumstances, health history, and imaging. Outcomes from treatment vary between patients and cannot be guaranteed. If you have concerns about your hip health, please contact Dr Slattery’s rooms to arrange a consultation.