Treatment varies depending on how severe the hip dysplasia is. The care team at Cincinnati Children’s tailors treatment to each patient.
In mild cases, the first line of treatment is often close observation. In these cases, the doctors work closely with the parents to watch for signs of progression with the hope that the condition will resolve on its own.
In situations when the dysplasia becomes more serious and observation is not enough, treatment options may include:
If the hip dislocation is moderate, treatment often consists of a Velcro harness from the chest down to the legs. This is called a Pavlik harness (named for the physician who developed it). It keeps the hips in a frog-like position, with the hips spread out and knees bent.
Your baby will need to remain in the harness for six to 12 weeks. During that time, we monitor your child’s progress with physical exams and ultrasounds. This treatment is effective in about 90 percent of babies with DDH. It can be used on children up to 6-9 months of age.
Those babies whose hips do not improve with the Pavlik harness may need a different kind of brace such as the Rhino brace or Ilfeld brace. In many cases, the child may need surgery.
Closed reduction is a surgery where the child’s hip is repositioned into the socket. Often other procedures may be done at the same time, such as a tendon release, where the tendon is cut to allow the hip to spread more easily. After the surgery, your child will be put into a hip spica cast for at least six weeks to allow the hip to properly heal.
If a closed reduction doesn’t work, an open reduction may be needed. This is a more invasive surgery used in more severe cases of hip dysplasia. Open reductions are usually performed when a child is over 1 year old. In this surgery, an incision will be made in the front of the hip to open the hip joint. The surgeon will remove tissue from the hip joint so that the ball of the hip will fit into the socket better. Bones of the pelvis and the femur may also need to be cut and repositioned to keep the ball in the socket better. As with a closed reduction, your child will be put into a hip spica cast after surgery. Often a child will then need a hip abduction brace (also called a Rhino brace) to finish the healing process.
With all of these treatments, children usually don’t require rehabilitation afterward.