Medical Q&As

Congenital dislocation of the hip - prognosis?

I was born with congenital dislocation of the hip. If I have a child what are the chances of the child having it and how is it treated these days? My experience was complicated because the socket didnít develop properly and I required surgery at the age of 12, which involved bone grafting.

Most dislocations of the hip occur after birth and are related to instability in the hip joint. The hip joint is classified as a ball and socket joint, which means that the ball or head of the femur fits into a socket at the side of the pelvis, which is known as the acetabulum. In congenital dislocation of the hip the ball slips out of the socket. The condition occurs in 0.25 to 0.85% of newborn infants and is 8 times more common in females. Congenital dislocation usually occurs on one side only and usually affects the left hip. The condition can occur if the ligaments in the capsule of the hip joint are very lax and it can be associated with a breech presentation at birth. All knew born babies are screened for the condition. Essentially the examining doctor attempts to identify if the hips are dislocatable and if so the child is treated. Over 90% of dislocatable hips stabilize within the first few months of life but it is not possible to predict which ones will remain unstable if left untreated: hence the need to treat all newborn infants that are found to have dislocatable hips. The aim of treatment is to maintain the hip in flexion and abduction, which is maintained with a special orthopaedic device called a Pavlik harness. It is unusual for children to require orthopaedic surgery for this condition. In some families there may be an hereditary element but this is rare.