What is Hip Dysplasia?
We’ve all heard of cases where a pediatrician tells a family that their newborn has hips that “pop out of place.” The recommendation often involves applying multiple diapers or even using a harness to keep the legs in an open position so the femoral heads stay within the acetabulum during the first few months of life.
In some cases, as the child grows, the femoral heads do not remain fully within the acetabulum and lack proper support, tending to dislocate. This situation leads to faster-than-normal wear of the hip joint for the person’s age. Often, individuals in their 20s or 30s experience pain during physical activities. If left untreated with corrective bone surgeries, these cases may develop joint degeneration known as osteoarthritis.
A very common deformity arises due to abnormal hip growth caused by impaired blood circulation to these bones during development. This condition is known as Legg-Calvé-Perthes disease. Ultimately, it results in a situation quite similar to dysplasia, requiring timely intervention. In both cases, the earlier the corrective surgery is performed, the better the long-term outcom
Treatment of Hip Dysplasia
Treatment of Hip Dysplasia
In all cases, the goal of treatment is to normalize the situation by providing adequate coverage to the femoral head. For children, various surgical techniques are available to restore this coverage. In young adults, depending on the type of dysplasia, the approach may involve either increasing coverage (Chiari osteotomy) or altering the orientation of the acetabulum (Ganz’s three-dimensional periacetabular osteotomy). Our center is a reference point for this pathology. Professor Vilarrubias introduced Chiari’s osteotomy from Vienna to Spain in the 1970s, and Dr. Manuel Ribas was the first to perform Ganz’s osteotomy in Barcelona, now carried out using a minimally invasive approach.
Dr. Manuel Ribas is the surgeon in Spain with the most extensive experience in Ganz’s periacetabular osteotomy, having performed over 100 cases. This experience has allowed him to develop a minimally invasive approach. The minimally invasive technique results in intraoperative bleeding that is three times less than the conventional approach described by Professor Reinhold Ganz, as well as faster postoperative recovery. Several athletes with moderate dysplasia have benefited from this technical variation. It is now well established that Ganz’s periacetabular osteotomy, which preserves the natural cartilage contact between the acetabulum and femur, significantly slows the progression to osteoarthritis in these patients, thereby reducing the likelihood of needing a hip replacement in the medium term.
In some cases, it is necessary to correct the femur to normalize the hip structure. One of the most successful techniques we have implemented is Vilarrubias’s femoral neck reconstruction osteotomy.
