Pediatric Hip Dysplasia Treatment Cost in India

In India, the average cost of treating hip dysplasia is roughly USD 5210 to USD 6310. Numerous healthcare facilities where targeted, specialized treatments are available.

Hip dysplasia is a condition where the hip joint is not properly formed in infants. The “ball” portion of the hip joint does not fit tightly into the “socket” portion in hip dysplasia.

DDH, or Developmental Hip Dysplasia, is another name for paediatric hip dysplasia.

This might make it difficult to walk. Hip dysplasia, which can affect one or both hips, is a condition in which the ball and socket joint of the hip is not properly aligned.

Babies and young children can develop hip dysplasia. Girls experience it more frequently than boys do.

Physical examination of the hips to look for any looseness or instability is the most common way to diagnose hip dysplasia.

The purpose of treatment is to keep the “ball” and “socket” portions of the hip joint in secure contact, thereby reducing pain and preserving the patient’s natural hip.

Hip dysplasia can be treated non-surgically if it is discovered during the first few months of life, but some cases might necessitate surgery.

A Pavlik harness, a non-surgical positioning device, may be used to keep a child’s hips flexed and abducted, correcting the alignment problems, if they are discovered in the early stages of infancy.

The harness is typically worn by infants for two to three months, or until the hip problems are resolved. Following surgery, patients are monitored for a number of years to ensure that the child’s hips continue to develop normally.

Types of hip dysplasia

The term “hip dysplasia” refers to a variety of conditions, including:

Dislocated Hip: when the cartilage on the ball and the cartilage on the socket do not make contact with one another.
Dislocatable Hip: when the ball of the socket is easily popped in and out.
Subluxatable Hip: occurs when the ball and socket cartilage touch but the ball is not properly seated in the socket.
Dysplastic Hip: When the acetabulum or hip socket is underdeveloped or insufficient to support the ball, it is said to have a dysplastic hip. This condition is more common in older adolescents and adults than in paediatric patients.

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Causes

Although the precise causes of hip dysplasia are still unknown, it appears that the condition is a developmental issue. It can happen prior to birth, following birth, and in rare instances during infancy. Additionally, some environmental factors, such as:

Other factors that affect pregnancy and birth include:

Moulding anomalies: Being squeezed into a uterus that is too small results in a head tilt (torticollis) and the inward turning of the front of the foot (metatarsus adductus).
Breech birth: When a baby is born breech, it comes out of the birth canal buttocks first. Hip dysplasia is ten times more common in breech birth babies than in headfirst babies.
Other elements: Hip dysplasia affects the left hip more frequently than the right hip in about 80% of cases, and it is more common in girls than in boys. However, the condition may affect both hips.
Genetics: Hip dysplasia is largely inherited, which is why it occurs. There is a one in a thousand chance that a baby will be born with a dislocated hip.

When compared to parents without a history of the condition, those who had hip dysplasia as children had a 12% higher risk of passing it on to their offspring.
A child’s risk of developing hip dysplasia is 6% higher if a sibling has the condition. All firstborns have a higher risk, even in children with no genetic connection.

The Risk Factor

Due to the small uterus and restricted space for the baby to move, firstborn babies are more vulnerable. The hip’s growth could be impacted by this. Other danger signs include:

Various other orthopaedic issues, like clubfoot
Girls experience it more frequently than boys do.
A history of hip dysplasia in the family
Having been born first
Babies who are born with their heads up and their feet down are said to be breech.
Very elastic ligaments.

What are the risks of treatments for hip dysplasia?

Surgery carries minimal risks, including those related to bleeding, infection, and anaesthesia. The condition known as avascular necrosis, also known as AVN or osteonecrosis, in which the bones of the hip joint do not receive enough blood, is something that paediatric orthopaedists take extra precautions to avoid.
This can happen if excessive pressure is used to reposition the femoral head, the ball of the hip joint, into the acetabulum, the socket. Avascular necrosis may cause the bone to grow abnormally.
If left untreated, these kids run a significant risk of growing up with osteoarthritis and the associated degenerative changes that bring on ongoing, progressive pain and stiffness.

Although exact figures are difficult to determine, some medical professionals believe that up to 50% of adults who eventually need hip replacements due to osteoarthritis first had a paediatric hip issue. Hip dysplasia is thought to be the cause of the majority of those cases.

Symptoms of Paediatric Hip Dysplasia

Although the pain may initially be mild, it may eventually become more severe and frequent. Hip dysplasia pain is brought on by an excessive amount of pressure being applied to the socket rim.
Hip joint arthritis may eventually result from this pressure on the rim of the hip socket.

The typical signs and symptoms are as follows:

On the side of the dislocated hip, the leg seems shorter.
It is possible for the leg to turn outward to the side of the dislocated hip.
Uneven skin folds may be present on the thighs or buttocks.
It could appear that there is more room between the legs than usual.

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Diagnosis

Sometimes hip dysplasia is detected at birth. Before sending the newborns home, the doctor might check them for this hip issue in the hospital.

Hip dysplasia, however, might not be identified until later check-ups. These tests may also be required for your child:

X-rays: Images of internal organs, bones, and tissues are produced during this test.
Ultrasound /Sound waves (sonography): A computer and high-frequency sound waves are used in this test to produce images of the organs, tissues, and blood vessels. It is employed to observe internal organs in action and to gauge blood flow through different vessels.

Treatment for Children

Hip dysplasia can be treated in various ways:

Conservative therapy, which includes both:

Medication
Physical therapy

Maybe these are the first line of defence in treating mild cases of hip dysplasia.

If conservative treatment is ineffective at relieving your pain, the patient(family)/the doctor may consider surgical intervention.

Medication:

Oral painkillers can be taken to help with hip pain relief and reduce hip inflammation.
Though it can be helpful, medication cannot cure hip dysplasia and only provides short-term relief.

Physical therapy:

Physical therapy can aid in reducing hip pain brought on by hip dysplasia.
This may lessen hip dysplasia-related pain, but it won’t make the hip socket’s lack of coverage better.

The Pavlik Harness:

The Pavlik harness, a flexible brace that gently guides the head of the femur into the socket or acetabulum and promotes the healthy development of the affected joint, is the first line of treatment for hip dysplasia in children under the age of six months.
In general, the harness is worn for a total of three months, initially full-time and then, as stability is attained and the hip position improves, part-time.
In children under six months of age, the Pavlik harness is effective in treating about 85% of dislocated hips.

Reduction:

The orthopaedist frequently suggests either closed or open reduction for the small percentage of patients for whom treatment with the harness is unsuccessful and for children in whom the diagnosis is not made until they are 6 months old.
In an invasive surgical procedure called reduction, the bones are realigned or put back in their proper positions. For older kids, the hip has become more fixed in the dislocated position and is less amenable to realignment, so the Pavlik harness is not a good treatment option.

Injections:

To reduce the discomfort and swelling around the hip joint, an injection containing both a corticosteroid and an anaesthetic (numbing medicine) may be advised.
To confirm that hip pain is being caused by the hip joint, a hip injection may also be prescribed.

Surgery:

Periacetabular osteotomy (PAO), a surgical procedure, is one of the treatment options for hip dysplasia in children 12 years of age and older.
The acetabulum is rotated during this orthopaedic procedure by carefully making 4 cuts in the pelvis bone.
Surgery’s objectives include reorienting the acetabulum to better cover the femoral head and reduce abnormal forces acting on the acetabulum’s rim.
Once the pressure is applied to the acetabular rim is reduced, a patient’s pain can be relieved. Preserving the hip joint and lowering the likelihood that the patient will develop arthritis are additional objectives of this procedure.

Treatment of Hip Dysplasia in Infants

The course of treatment is determined by your child’s symptoms, age, and general health. The severity of the condition also plays a role.

The purpose of treatment is to restore the femoral head to the hip socket so that the hip can grow normally. Baby treatment options can vary. They may consist of:

A unique harness or brace: When a baby is under 6 months old, the Pavlik harness is frequently used to stabilise the hip while allowing some movement in the legs. The medical professional who is caring for your child puts the harness on and adjusts it as needed. The hip dysplasia may be cured by the harness. However, occasionally the hip may still be partially or totally dislocated.

Casting: The use of a cast may be beneficial if the child has hip dysplasia which is known as Spica cast.

Surgery: The child might require surgery to realign the hip if the other treatments are unsuccessful or if hip dysplasia is discovered between the ages of 6 months and 2 years.

Following surgery, the child will need to wear a Spica cast for up to 6 months.

This particular cast stabilises the hip while it heals. The child will require a special brace or physical therapy exercises to strengthen the muscles in the legs and hip area after the cast is removed.
Many infants who have hip dysplasia do well with the Pavlik harness and, if necessary, casting if it is discovered early.

Self-Curable

Some mild cases of developmental hip dysplasia in children, especially those that affect infants, can eventually go away on their own.

Results of the Surgery for Hip Dysplasia

The likelihood of a successful outcome—a hip that appears normal during a physical examination and on an x-ray—increases the earlier the condition is treated.
Up until they are skeletally mature (when growth is finished), young hip dysplasia patients receive routine check-ups.
To ensure that normal development continues, this is done.
A dislocated hip that was successfully reduced in some instances might still experience dysplasia years later, necessitating additional care.

Success rate

The following four conditions must be met for treatment to be successful:

An appropriate indication, a typical DDH, cooperative parents who have the necessary knowledge of the condition, and a high-quality harness are all requirements.
The treatment’s overall success rate over the short, mid or long-term ranges from 45% to 100% and is typically over 75%.

Verified By Dr. Surbhi Suden

Dr. Surbhi Suden is one of the founders of Lyfboat and a doctor with a renowned name in the Medical tourism industry. She has been working with international patients since 2008 and is a deeply committed professional with a long term vision of transforming the current healthcare scenarios.

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