HappyHips

Teenage and Young adult Hip Dysplasia and Impingement.

Possible Treatments

Non-surgical treatment

There are many types of nonsurgical treatments for hip dysplasia, with much of it focusing on reducing inflammation or supporting pain health.

Glucosamine and chondroitin sulphate can be taken for joint health. Although it can reduce hip pain, there is contradictory evidence about whether it can be effective in treating osteoarthritis. Another treatment can be implementing anti-inflammatory foods into your diets.

 

Your Diet

A common Asian spice called turmeric has been found to be as effective as drugs such as hydrocortisone. So if you like a bit of Asian food, don’t forget to sprinkle a bit of turmeric onto your food.

 

Salmon as we know is high in omega-3 acids which is also found to douse inflammation, as is oily fish. If you’re not a fish fan you can get all the benefits form high quality fish oil supplements.

 

Green tea has been found to be strong in anti-inflammatory compounds. It’s not necessarily the nicest tasting thing, but you can and should always drink plenty of water as a good alternative!

 

Fruits, like papaya, pineapples and blueberries can be seen to reduce inflammation, sports injuries, trauma and other kinds of swelling. They are found to be high in anti-oxidants which are high in anti-inflammatory protection, so if you like your berries start munching.

 

We always hear how too much oil is bad for you; however Extra Virgin Olive Oil has been found to have a rich supply of monounsaturated fats, which means that it is high in anti-inflammatory properties which can lower arthritis. So carry on using oil, just make sure it’s Extra Virgin Olive Oil!

 

Sweet potato has been found to have powerful anti-oxidants that heal inflammation in the body. So instead of potato change to sweet potato -this usually tastes better too!

 

Working together, these nutrients are powerful antioxidants that help to heal inflammation in the body.

 

On the other hand, certain foods in the nightshade family can increase inflammation. An example of these are tomatoes, potatoes, eggplant and red pepper. You do not necessarily have to cut back on them entirely but it may be beneficial to eat them in lower volume.

Medical alternatives

A doctor can also give corticosteroids to reduce inflammation which can reduce pain. A common side effect is called a cortisone flare, which is where the cortisone crystallizes and can become painful for a few days. Some studies however have shown that cortisone can weaken tendons and soften cartilage, therefore the amount of injections maybe limited. However the injections are a temporary solution, so although they may help with the pain for a limited period of time it will not fix the underlying problem of hip anatomy.

 

There are some simple steps you can take in order to relieve pain associated with hip dysplasia;

      Hot and cold massage can help with the pain. Ice can be used when the area is inflamed or feels hot. Whereas heat can warm up the joint when it is cold.

 

      Regular, low or non-impact exercise such as swimming, hydrotherapy or cycling can improve musculature strength and provide a good range of motion. If you have strong muscles these act as shock absorbers giving better support for the hip joint.

 

  Pilates can also strengthen and stretch muscles, which improves overall flexibility and core strength. However some surgeons do limit certain movements, especially if you have had a joint replacement.

 

      Weight loss can make a significant difference to the stress you put on your hip. For example losing 10kg will result in a 60kg less force on your hip!

 

      Physiotherapy can help to increase musculature strength and flexibility around the joint, therefore reducing pain. Strengthening individual muscles can help the body better align itself and teach you to use your core muscles which helps you to walk better.

 

Non-surgical intervention is helpful for pain management when the joint has not had much deterioration. However non-operative methods do not provide long lasting solutions because the joint has not formed properly. So it is important not to prolong the waiting time when cartilage can support surgical procedures.

 

Surgical treatment

Arthroscopy

Arthroscopic surgery can sometimes be called keyhole surgery. It is where procedures can be performed on soft tissue surrounding the hip, which can sometimes postpone more major surgery. Several small incisions are used, therefore there is less damage to muscles and soft tissue. A camera is inserted into the joint allowing the surgeon to see the images on a TV screen. Instruments are then inserted to fix the problem.

For those patients requiring any kind of major surgery like an osteotomy or replacement, an arthroscopy can address painful soft tissue conditions. Some examples of these include, torn labrum, femoral-acetabular impingement or just to simply look inside the joint.

The benefits of an arthroscopy mean there is less pain and more importantly a much quicker stay in hospital so recovery is much quicker than major surgery. There are always risks associated with any type of surgery. These risks will always be discussed with your surgeon before any consent to a procedure is carried out.  

 

Femoral osteotomy

A femoral osteotomy is where the surgeon cuts through the femur and re-positions the femur so that there is more coverage of the acetabulum over the femoral head. An L-shaped plate and some pins are used to keep the femur in the desired position.

You can spend up to several weeks using crutches and several months on physiotherapy to strengthen the hip and leg muscles. Other soft tissue arthroscopy procedures can be performed allowing for less surgery to take place at a later date. After a year the metal plate and pins can be removed if they are causing discomfort. This is to allow the bone sufficient time to heal. The procedure is usually performed as a day case procedure going through the same incision.

The benefits of a femoral osteotomy, means that there is an increased range of motion, a significant reduction pain and a good gait for the patient. It can in some cases entirely remove the need for a total hip replacement during the patients’ lifetime. There are always risks associated with any type of surgery. These risks will always be discussed with your surgeon before any consent to a procedure is carried out. 

 

Peri-acetabular osteotomy

This peri-acetabular osteotomy is one the most common pelvis osteotomies that are carried out on patients ranging from the age of 10 to the age of 40. It is best performed when there is little or no evidence of osteoarthritis in the joint. It is used where the roof of the acetabulum does not sufficiently cover the femoral head. After a series of cuts, the surgeon can rotate the acetabulum to a better position to cover the femoral head. Research has suggested that a PAO can halt the destruction of the joint or prolong the life of the joint, postponing the use of a total hip replacement.

After surgery you can be on minimal weight bearing for the first 6-8 weeks, followed my weight bearing with one crutch until the muscles have sufficiently recovered. Physiotherapy and musculature strengthening can take up to several months as muscles are affected by surgery, and can weaken after a long period of being on crutches. There are always risks associated with any type of surgery. These risks will always be discussed with your surgeon before any consent to a procedure is carried out. 

After 6 months the pins can be removed if they are causing discomfort. This is to allow the bone sufficient time to heal. The procedure is usually performed as a day case procedure going through the same incision. They can also be removed if there is need for further surgery such as a bone graft or a total hip replacement.

There are several advantages of a PAO. The patients’ pain level is significantly reduced after recovery. It is performed through just one incision. It does not alter the shape of the pelvis, therefore allowing for vaginal childbirth. The surgeon can repair the labrum if needs be through the same incision. The patient can walk soon after surgery as the blood flow to the acetabulum remains uninterrupted.

 

Hip resurfacing

Hip resurfacing is a newer hip replacement technique designed for younger patients. Because of their age, patients will need more than one procedure in their lifetime. Instead of removing the head and neck of the femur, only the head is trimmed and a round metal cup is placed on it. The socket is fitted with a cup and the body’s own fluids lubricate the joint. The procedure is new, which means there is no long term data regarding the surgery’s success rate, although the data does look promising.

There are many advantages to a hip resurfacing. Much less bone is removed in surgery and the bone around the implant tends to remain healthy and strong, therefore providing a good basis for a THR in the future. There is a much less risk of dislocation compared to a THR as it better replicates the normal anatomy of a hip joint.

Hip resurfacing however is not for all patients. This is because it requires a 70% contact between the bone and metal socket, so is not always an option for those with hip dysplasia. In some cases the surgeon may determine that hip resurfacing is not an appropriate option only once the patient is on the operating table. This can be because hip dysplasia patients have often had previous reconstructive surgeries which can make hip resurfacing surgery very difficult. Therefore the surgeon may choose to perform a replacement instead to avoid further complications. There are always risks associated with any type of surgery. These risks will always be discussed with your surgeon before any consent to a procedure is carried out. 

 

Total hip replacement

Typically, total hip replacement surgery is carried when pain from osteoarthritis drastically affects the quality of life. Hip dysplasia can speed up the wear of cartilage, due to the unsymmetrical anatomy of the hip joint. A loss of blood supply to the femoral head called avascular necrosis can also necessitate a hip replacement.

The basic design of the prosthesis is very similar regardless of the materials used or manufacturer. The femoral head and neck are removed, through an incision. An angled shaft with a smooth balled implant is then inserted into the femur. The socket of the joint is then smoothed and fitted with a cup which can be either cemented or left uncemented. Ceramic joints which are more commonly used will encourage THRs in younger patients who are more active who need a THR. This means that younger patients no longer need to wait due to their age.

There are many advantages to a THR. Sometimes if the affected leg is short, the leg can be lengthened during surgery eliminating back pain caused by an unstable gait. The most obvious benefit is the immediate reduction in pain within the joint, as the diseased hip is completely removed. It can greatly increase your range of motion which can become stiff from arthritis. It also greatly improves your independence and quality of life. There are always risks associated with any type of surgery. These risks will always be discussed with your surgeon before any consent to a procedure is carried out. 

 

Hip replacement revision

Unfortunately, the majority of THRs have a limited life. The success of a revision relies on the quality and quantity of available bone. Regular check-ups will make sure your THR is working well, therefore keeping the revision simple. Where there is not enough bone, grafts are used to build up the joint. Revisions are usually required after normal wear and tear. But sometimes loosening of the joint can also necessitate a revision.

The advantages of a revision are very similar to a THR. However there is often a higher risk of complications than a THR. Those who are young when their THR is carried, a revision is almost inevitable; however newer materials seem to be improving the overall life span of the joint. There are always risks associated with any type of surgery. These risks will always be discussed with your surgeon before any consent to a procedure is carried out. 

 

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All information provided on this website is not by medical professionals and has not been checked by any medical professional. It is purely the opinions of this site's members only. All information on this site is writtern by the site members only. If you wish to use anything writtern on the sites' pages please can you contact the HappyHips' office team for permission to do so.