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Hip Dysplasia in Infants

What is hip dysplasia?

Hip dysplasia is a term for a wide range of developmental hip problems in babies and children. Hip dysplasia—also called Developmental Dysplasia of the Hip or DDH—occurs when one or more areas of the hip joint have not developed properly.

In a typical hip joint, the upper end of the thigh bone (femur) fits well into the curved portion of the pelvis called the acetabulum, forming a ball-and-socket joint. A typical acetabulum is cup-shaped and completely covers the head of the femur.

In children with hip dysplasia, the acetabulum is often shaped more like a saucer than a cup. If the acetabulum is too shallow to adequately support and cover the head of the femur, the joint can become unstable and in some cases, even dislocate.

Causes of hip dysplasia

Although the exact cause of hip dysplasia is unknown, we know there is a higher occurrence:

  • In girls as compared to boys
  • In babies who were born in the breech position
  • In children with a family history of hip dysplasia

Diagnosing hip dysplasia

Hip dysplasia in babies

Hip dysplasia is rarely noticed by parents because it doesn't usually cause your baby pain or discomfort.

Because of this, infants are routinely screened for signs of hip dysplasia at their well-baby visits. If your primary care provider notices a concern with your baby’s hips, they will refer you to a pediatric orthopedic specialist, such as the Children’s Mercy hip care team. Symptoms your primary care provider may notice include:

  • An instability in your baby's hip
  • Feeling a hip "click"
  • Notice one hip has decreased motion during the exam

A pelvic X-ray or sonogram can help your child’s doctor diagnose hip dysplasia.

Hip dysplasia in older children

Often, there are no immediate symptoms of hip dysplasia in older children and adolescents. Over time, your child may begin to experience symptoms such as pain, a feeling of instability (“catching” or “locking” in the hip joint), or a decrease in the ability to participate in sports or daily activities.

Related conditions

Left untreated, hip dysplasia can lead to the development of osteoarthritis, a condition in which the articular cartilage in the joint wears away. Early intervention and treatment can help prevent your child from developing advanced arthritis in their hip joint.

Treatment for hip dysplasia

There are different options for treating your infant’s hip dysplasia, depending on their age and the type and severity of their hip condition. We can treat most babies under six months old with non-surgical options.

Bracing and harness therapy

Infants under six months may benefit from using a harness or brace that holds their hips in the correct position as they grow to help their hip develop normally. Your provider will determine whether a harness or brace is best for your child's hip.

As your baby grows, their cartilage will gradually start turning to bone around 4-6 months old. Harness and brace therapy helps guide their growing bones into healthy alignment so that by the time they begin to be mobile, their hips are correctly positioned.

Brace therapy

A removable static brace is used for stable hips that do not dislocated easily. The brace holds your child's hips in the correct position as they grow. This allows their position of their hip to align normally.

The severity of your child's hip dysplasia will determine if the brace should be worn part time or all the time. Children typically wear the brace for 2-4 months.

Harness therapy

A Pavlik harness holds your baby’s hips in a frog-like position so the hip joint stays in place and heals itself.

Your baby wears the harness all the time for 6 weeks and then usually can transition to a removable harness for 2-4 months after that. Since the harness is worn all the time, they have been designed for caregivers to provide diaper and clothing changes while the children also wear the harness.

A harness helps guide their growing bones into healthy alignment so that by the time they begin to be mobile, their hips are correctly positioned. 

Other procedures for hip dysplasia

In some cases, reductions are necessary to treat hip dysplasia. 

Closed reduction

  • If your child wears a brace and it isn't effective, or your child is diagnosed with hip dysplasia when they are between 6-12 months old (too old to be treated with a brace), your orthopedic specialist might recommend a closed reduction.
  • A closed reduction is a procedure where your child's hip is gently manipulated back into place by the doctor while they are asleep under anesthesia. Your child will wear a cast for 5-6 weeks after the procedure while the hip heals in the correct position. Some children will need a second cast for an additional 5-6 weeks.
  • While this is not a surgery, this procedure is completed using general anesthesia to keep your child comfortable and is completed in an operating room. 

Open reduction

  • If a closed reduction isn't effective, an open reduction might be recommended. An open reduction is a surgery to correct hip dysplasia. In some cases, especially for children between 1 and 2 years old, the orthopedic specialist may first try a closed reduction and then move to an open reduction if necessary.
  • The recovery time is the same for both procedures, since both require 5-6 weeks of wearing a cast afterward.


Hip Preservation Program for adolescents

Hip preservation is a treatment approach that aims to relieve painful symptoms, restore hip function, and allow young people with hip conditions to participate in an active lifestyle. Our therapeutic and surgical interventions can help preserve the life of your child’s own hip and delay or avoid a total hip replacement.