Conditions & Treatments
Hip conditions may affect children at any age. Hip dysplasia is a condition where the hip socket does not form correctly and can be associated with hip dislocation at birth or abnormal development of the socket as the child grows. This condition, if left untreated, can lead to early hip problems in adulthood, including arthritis. Your child's surgeon may try nonsurgical methods to help the hip develop normally, such as braces or casts.
Some hip conditions require surgical treatment in order to allow the hip joint to develop normally. These procedures may include realigning the pelvic and thigh bones and reconstructing the hip joint, procedures known as pelvic and femoral osteotomies. Some osteotomies are appropriate only in small children, while others may be beneficial for older children with hip dysplasia. One such osteotomy, the periacetabular (PAO) or "Ganz" osteotomy, may prevent the development of early arthritis in older children with hip dysplasia. Emory is one of a small number of centers in the region where this osteotomy is performed.
The goal of the PAO is to reduce or eliminate pain, restore function, and maximize the functional life of the dysplastic hip. PAO is designed to correct the major primary mechanical problems in acetabular dysplasia. These problems include excessive pressure of the femoral head on the rim of the acetabulum and instability of the femoral head within the acetabulum.
Between four and twelve months after PAO surgery, most patients undergo screw removal as a brief outpatient procedure. After the PAO has healed and motion and strength have returned to a steady state, we encourage the highest level of “reasonable” activity that the hip joint will allow. A corrected dysplastic acetabulum is still at risk for damage by overuse. Pounding types of activities, such as jogging are not encouraged. Though many of our patients are able to jog and even run marathons without a problem, the long-term impact on their joints is not yet known.
In patients who, along with their physician, select periacetabular osteotomy as the treatment of choice, we expect that their pain and function will be greatly improved by the surgery for a minimum of ten years and, hopefully, for a lifetime. The pediatric orthpaedic surgeon will discuss this treatment option in more depth if appropriate for your child.
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