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Hip conditions

Hip conditions

With a comprehensive program dedicated to the treatment of hip conditions, the Shriners Hospitals for Children - Portland staff specializes in providing care for both common and rare conditions affecting children's hips. Using innovative technology and a multi-disciplinary approach, we are able to provide the best care for your child in a convenient, wrap-around care environment.

Hip conditions treated

  • Developmental dysplasia of the hip (DDH)

    DDH represents a large spectrum of situations where the hip is not developing normally. The hip's ball-and-socket joint depends on the ball-shaped femoral head, to fit neatly into the socket where it can move easily. DDH is when the femoral head isn't sufficiently covered by the socket or is dislocated, or if the socket is misshapen or shallow. Because it can range so much in severity, each case of DDH requires its own customized treatment plan.

  • Femoral acetabular impingement (FAI)

    This is a hip disorder that is typically discovered during adolescence, oftentimes in active children. FAI is a mismatch in the shape of the hip socket and/or femoral head, resulting in labral tears or groin pain. If left untreated, it can damage the joint's protective cartilage and soft tissue.

  • Legg-Calve Perthes disease

    Legg-Calvé-Perthes disease, or Perthes disease, is a condition that is caused by disrupted blood flow to the femoral head. This may result in necrosis and collapse of the bone in the femoral head. New bone eventually replaces the old, but the previous rounded shape of the bone may now be abnormal. Legg-Calvé-Perthes disease is a childhood bone disorder that typically only affects one hip, although roughly 10 % of children experience it in both hips. Symptoms tend to appear between the ages of 4 and 8, and boys are four times more likely to get Perthes disease.

    When blood stops flowing to the femoral head, it begins breaking down and losing its round shape, making it difficult to fit and move in the hip socket as it should. This impacts mobility, causes pain, and can lead to early onset osteoarthritis.

  • Slipped capital femoral epiphysis

    This condition also affects the ball-shaped femoral head. It's a situation where the epiphysis (growth plate) of the femoral head slips off the top of the thighbone. This triggers pain that can come on gradually or all at once. The cause of SCFE isn't clear, but it tends to occur during accelerated growth periods like puberty. Many children who experience it in one hip will also experience it in the other at some point, though this isn't always the case.

Treatment for hip conditions

Hip disorders often impact mobility, which can be particularly challenging for a growing child. Treatment options will vary, but each child will receive an individualized treatment plan that utilizes the most advanced and innovative techniques. Our focus is early detection and a customized treatment plan that is as noninvasive as possible. Below are some treatment options offered at the Portland Shriners Hospital.

Developmental dysplasia of the hip (DDH)

  • Nonsurgical: These methods are most common when a baby is less than 6 months of age. They typically consist of bracing a baby in such a way so that the hips are kept in a better position for hip joint development. The goal is to influence the natural growth processes so a deeper and more stable hip socket is developed. Positioning encourages normal hip joint development over time.
  • Surgical: Surgical interventions are indicated in older patients which may involve reducing the hip joint, reshaping or reorienting the hip socket or changing the position of the femoral head. After most surgical procedures, a spica (body) cast is used to keep the hip aligned in the corrected position while the tissues around the hip joint heal and remodel into a proper hip joint.

Legg-Calvé-Perthes disease

  • Non-surgical: The main objective of treatment is to maintain the roundness of the femoral head. Children under 6 years old tend to respond best to non-surgical interventions, which may include anti-inflammatory medications, activity restrictions (crutches or a wheelchair to reduce weight bearing), bracing or casting, and physical therapy to maintain motion.
  • Surgical: Surgery of the femur or the socket may be necessary to improve the shape of the joint so that the femoral head remains covered by the socket, and to prevent future arthritis.

Femoroacetabular impingement

  • Non-surgical: Treatment consists of activity modification and physical therapy to strengthen and stabilize the muscles around the hip to decrease pain and maintain mobility.
  • Surgical: If there is significant impingement or labral tears, hip arthroscopy can repair the labral pathology and take away the abnormal bone to decrease the impingement. Significant dysplasia may require pelvic realignment osteotomies.

Slipped capital femoral epiphysis (SCFE)

  • A brief surgery is often performed to prevent further slipping by placing a screw in the femoral head. Treating the child's SCFE as soon as symptoms develop greatly increases the likelihood of a successful outcome. However, since a significant percentage of children with SCFE in one hip will eventually develop the condition in the other hip, patients should continue to be followed by their orthopaedist until they are fully grown. Occasionally, realignment procedures are required after the SCFE is healed to reestablish normal hip motion.

Read about how the care Jace received from the Portland Shriners Hospital staff allowed him to continue to lead an active lifestyle.

Collaborative approach to care

The Portland Shriners Hospital’s pediatric orthopaedic staff works collaboratively with our onsite radiology department, motion analysis center, prosthetics and orthotics team, and rehabilitation staff to provide wrap-around care to each patient. Regardless of your child’s medical condition, you can expect to benefit from the expertise of our team who is dedicated to the needs of your child. Shriners Hospitals for Children — Portland is designed with convenience in mind for patients and their families, offering a full range of services under one roof to ensure patients receive an optimal outcome. The medical staff members at Shriners Hospitals for Children — Portland are leaders in the fields of pediatric orthopaedics, anesthesiology, pain management and rehabilitation, so patient families can expect to benefit from the expertise of our pediatric-trained specialists.

The medical care team: