Developmental Dysplasia of the Hip (DDH) is a condition where the hip joint does not properly develop, causing instability and potential dislocation of the hip. Surgical intervention may be necessary to correct this condition, especially in cases where other treatments have been ineffective. This surgical procedure aims to improve the stability and function of the hip joint, allowing for normal development and movement.
The surgical procedure for DDH typically involves a combination of soft tissue and/or bony procedures to realign the hip joint. The specific techniques used will depend on the severity of the dysplasia and the patient's individual needs. Common surgical approaches include:
1. Open Reduction: This involves making an incision to access the hip joint and manually repositioning the hip socket (acetabulum) to improve its coverage of the femoral head.
2. Pelvic Osteotomy: In cases where the acetabulum is shallow, a pelvic osteotomy may be performed to reshape the pelvic bone, creating a deeper socket for the femoral head.
3. Femoral Osteotomy: In cases where the head of the femur needs to be re-positioned to make the hip stable a femoral osteotomy may be performed.
4. Hip Spica Casting: Following surgery, the hip may be immobilised in a hip spica cast to maintain the corrected position and aid in healing.
Before surgery, patients will undergo a thorough evaluation, including imaging studies such as X-rays and possibly MRI scans. It's important to inform your surgeon of any medications you are taking, as well as any allergies or medical conditions you have. Your surgeon will provide specific instructions on fasting before surgery and may recommend preoperative physical therapy to optimize hip function.
Preparing the home for surgery is just as important and depending on which surgery is to be performed the preparation can vary. Some general considerations to make include:
The recovery process will vary depending on the complexity of the surgery and individual patient factors.
Your child will wake up in recovery and you will called by the nurses once it is safe to be by their side. You will spend the night in hospital and as long as the child is safe and comfortable you may go home the following morning.
The first 2 weeks are generally slow with recovery aimed at pain control, adjusting to life in the cast (if required) and focussing on letting the wounds heal.
Whilst in a cast or brace recovery is all about time and letting the bones heal and soft-tissues settle down. Once you are out of the case or brace, you will work with Physiotherapists to work on range of motion, stretching and strengthening exercises.
Every surgery comes risks and potential complications.
General risks of infection, bleeding, damage to nearby structures are uncommon.
Specific to the surgical management of DDH risks include:
The goals of surgery for DDH are to improve hip stability, function, and overall quality of life. With proper surgical technique and rehabilitation, the majority of patients experience significant improvements in hip symptoms and function. Long-term outcomes are generally favourable, although ongoing monitoring may be necessary to detect and manage any potential complications.
Surgery for Developmental Dysplasia of the Hip is a complex procedure aimed at improving the stability and function of the hip joint. By addressing the underlying anatomical abnormalities, surgery can help prevent further damage and allow for normal hip development and function. Dr Shales will work closely with you to develop a treatment plan tailored to your individual needs, with the ultimate goal of achieving the best possible outcomes.
Here are a number of the questions we often get asked.
Hospital stay duration varies depending on the specific procedure and individual patient factors. The majority of cases are able to go home the day after surgery. Your surgeon will provide you with an estimated timeline for your hospital stay.
The ongoing use of a brace will depend on the severity of DDH and the age of the child.
In some cases, additional surgeries may be necessary, particularly if complications arise or if further interventions are needed to address residual hip problems. Your surgeon will monitor your progress closely and discuss any additional treatment options as needed.
