Rehabilitation for Hip Dysplasia

Rehabilitation for hip dysplasia, or developmental dislocation of the hip (DDH), is sometimes a treatment to remedy the condition itself and sometimes a treatment after surgery. It is extremely important that hip dysplasia be diagnosed and treated as early as possible because left untreated it results in severe osteoarthritis later in life.

Rehabilitation for Hip Dysplasia in Children

For very mild cases of dysplasia in children, physical therapy can be beneficial in promoting hip function, strengthening the joint and maximizing the patient's range of motion. In the case of newborns and very young children, whose bones are more malleable, nonsurgical braces and casts can make all the difference. Although these devices limit mobility for several months, they move the hip into proper alignment, almost always correcting the condition permanently.

Nonsurgical Rehab for Hip Dysplasia in Children

There are several noninvasive treatments available for hip dysplasia in children. The earlier treatment is begun, the more successful it is. In young babies, a Pavlik harness is normally used to keep the hip in its proper position. This harness is worn 24 hours a day for 6 to 12 weeks. About 90 percent of newborns treated with the Pavlik harness fully recover from hip dysplasia.

In children over 6 months of age, the Pavlik harness may not be enough to correct the dysplasia. If necessary, the child will be put under anesthesia until the hip assumes its proper position and then placed in a spica cast. Although this cast is necessary to remedy the dysplasia, it allows less movement and must be replaced approximately every 6 weeks. The child will usually remain in a cast for about 4 months. In most cases, the child is weaned gradually from the Spica cast and begins to move naturally very quickly so intensive physical therapy is unnecessary.

Surgery for Hip Dysplasia in Children

When a child is one year old or older when diagnosed with hip dysplasia, or when the spica cast has not successfully corrected the problem, surgical intervention is often necessary to position the hip joint properly. The younger the child at the time of surgery, the greater the chance for a successful outcome. The types of surgery performed, in order of complexity are: hip reduction, hip osteotomy and hip arthroplasty (replacement).

Rehabilitation for Hip Dysplasia in Adults

Weight loss and other lifestyle changes can improve the condition in adults. For mild cases, physical therapy may be sufficient to lubricate the joint, lessen pain, and ease mobility. When the arthritis in the hip is more advanced, hip arthroplasty, commonly known as hip replacement surgery, is necessary. In some cases, the surgery may be performed prophylactically, while the patient is still asymptomatic, but this is rare since it is impossible to predict when the hip will become seriously arthritic and unnecessary surgery is never a good idea.

Nonsurgical Rehabilitation for Hip Dysplasia in Adults

Physical therapy includes leg stretching, particularly hip abductions, during which the leg is moved out from the body.

Postsurgical Rehabilitation for Hip Dysplasia in Adults

Physical therapy begins as soon as possible after the procedure, often the very next day. Most patients go home within a week after hip surgery, but need to continue outpatient rehabilitation from home.

In cases where more intensive rehabilitation is necessary, or where there is no one at home to help during recovery, patients frequently go to inpatient rehabilitation centers. The goal of rehabilitation is to strengthen the affected muscles and to prevent excessive scarring and contracture.

Physical therapy exercises begin with the patient seated and progress to walking and climbing stairs, first with, and then without, supportive devices. Rehabilitation includes occupational therapy and at-home exercises to help patients learn new ways to function effectively in everyday activities. Therapists instruct patients on how to perform ordinary tasks without worsening their condition by bending to the floor, crossing the legs or sitting on low surfaces.

The length of short-term recovery, when a patient is able to be walk unassisted and perform most household tasks, and long-term recovery, when a patient is fully independent, may vary quite considerably from 6 weeks to 6 months.

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