Hip Dysplasia

Synonyms in a broader sense

Hip luxation, hip arthrosis, conversion surgery, Salter operation, Chiari operation, containment, triple osteotomy, 3-fold osteotomy, derotation femoral osteotomy.

Definition

Hip dysplasia is a childhood maturation disorder with disturbance of the acetabular roof ossification. In further development, the femoral head can dislocate from the acetabulum = luxate and a hip luxation can develop. Hip dysplasia is a high-risk factor for the development of hip arthrosis (coxarthrosis). Due to the lack of an acetabular roof (bay window), the transfer of weight from the thigh (femur) to the pelvis becomes unfavorable due to the lack of congruence between the joint partners

Gender distribution

The sex ratio female to male is 4:1.

Risk factors

There are several risk factors that promote the development of hip dysplasia. Factors during pregnancy are certainly proven: Another risk factor is a weakness of the connective tissue: genetic factors play an important role:

  • Due to a so-called breech presentation, the hips in the uterus are strongly bent, which prevents the acetabular roof from developing properly.
  • Lack of amniotic fluid, which leaves the child insufficient freedom of movement.
  • First-time mothers have an increased risk because the tight abdominal muscles and uterus also restrict the movement of the fetus.
  • Premature Births
  • All risk factors are combined with increased ligament laxity, which means that there is too much elasticity of the capsule and ligaments. This makes it easier for the femoral head to slide out of the socket.
  • The laxity of the ligaments will be increased by the female sex hormones estrogen and progesterone.
  • Children of parents with hip dysplasia or hip luxation have a 5-10 times higher risk
  • Chromosomal alterations which can be combined with hip dysplasia are trisomy 18 = Edwards syndrome, Ulrich-Turner syndrome = X0 syndrome, arthrogryposis multiplex congenita. These diseases are usually combined with other congenital malformations, such as clubfeet.