Hip dysplasia in adults
The Hip dysplasia refers to a congenital roofing disorder of Femoral head. As a result, the femoral head can no longer be held in a centered position. This allows the femoral head to be removed from the Acetabulum slip out, causing strong Pain. Hip dysplasia is one of the most common causes of stress-related complaints in the world Groin.
Hip dsyplasia is one congenital malformation (please refer: Hip dysplasia in the child) of Hip joint.
The reasons for this are mainly in the pregnancye.g. tightness in the womb, breech position or lack of amniotic fluid.
But hereditary factors can also cause hip dysplasia. Usually the hip dysplasia gets right after the birth detected by an ultrasound examination. Nevertheless, there are still patients whose hip dysplasia is not in Newborn screening was recognized early. The reasons for this are inadequate early diagnosis in other countries or incorrect diagnosis due to the inexperience of the examiner.
The malformation of the hip joint and the insufficient roofing of the femoral head arise load-dependent stabbing Groin pain, as well as side hip joint pain. If the hip dysplasia is not identified and treated in time, the hip joint can suffer permanent damage. It can osteoarthritis changes of the hip joint arise, which cause severe pain with the slightest load, long periods of sitting or standing. As a result, the patients are severely restricted in their everyday movement. Often a walking distance of 20 meters is a difficult hurdle. In most cases, the affected patients have to cope with everyday life on a regular basis Painkiller take in.
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The hip joint is one of the joints that are exposed to the greatest stress.
The treatment of the hip (e.g. hip arthrosis, hip impingement, etc.) therefore requires a lot of experience.
I treat all hip diseases with a focus on conservative methods.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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As a rule, a thorough medical history in combination with a conventional one is sufficient X-ray overview of the pelvis to diagnose hip dysplasia. Here, the pelvis with the hip joints is x-rayed from front to back. The position of the femoral head covered by the acetabulum and the position of the femoral head in the joint must always be assessed. This information determines the subsequent therapy.
Various surgical therapy options are available, depending on the age and the physical condition. This has been in force for about 30 years 3-fold pelvic osteotomy according to Tönnis as a proven method for treating hip dyplasia in adulthood. The hip socket is surgically detached from the pelvic structure and placed in a normal roof position. Another option is the so-called Intertrochanteric derotation, variceal osteotomy on the thigh bone. This applies to children Salter osteotomy on the pelvic bone as the drug of choice. Many patients receive one in early adulthood artificial hipwhen the arthritic changes are too advanced. All hip joint operations are complicated. Operations on the pelvic bones in particular are technically not easy and should therefore only be carried out by specialized and experienced surgeons.
Physiotherapy / exercises
Physiotherapy exercises issue with a combination massage, strain- and Stabilization exercises a targeted therapy to improve symptoms of hip dysplasia and to delay joint wear and tear and a possibly necessary operation.
The massage is used to relieve muscle tension. The loosened muscles can thus ensure better stability and prevent premature joint wear. A Stretching the muscles ensures that muscles that have been shortened due to incorrect loading or relieving posture are stretched again. Also should Hip muscles strengthening exercises are performed. These are also taught by the physiotherapist. Patients should perform these exercises regularly at home. Such exercises should be used to maintain hip mobility.
The exercises that are performed for hip dysplasia should therefore always include the movements Abduction (spreading the leg to the side), Extension (Spreading the leg backwards) and Flexion (Hip flexion) contain. If possible, a rotation exercise should also be included. Above all, if pain develops, exercises should be stopped immediately.
- One possible exercise is that Hip raises or Pelvic raises Here the patient lies on his back and puts his legs up so that the knees are bent and the arms are placed next to the body. Now the pelvis is raised until the upper body and thighs line up. Exhale as you lift your pelvis. Then the pelvis is lowered again and inhaled. This exercise is repeated at least 10 times and after a break there should be at least a second set.
- The Straddle is particularly suitable around the Abductors (Muscle group on the legs that lift the leg to one side) to exercise and promote the splaying movement of the hips. Here the patient lies on his back again. The arms are placed next to the body again, this time the legs are straight. Now one leg, for example the left one, is spread to the side as far as possible and then brought back to the middle. Then the right leg is spread outwards as far as possible. This exercise is done about 10 times on each side.
- To practice flexion, the patient can do another exercise in the supine position. In the starting position, the legs are straight and the arms are placed next to the body. Now one of the legs is bent and with the help of the hands on the Rib cage drawn in as if one would Thigh want to rest on the chest. The other leg is still stretched out on the floor. This stretching position is maintained for a few seconds. Then the leg is put down again and the other leg is lifted and stretched. Also with this exercise, at least 10 repetitions on each side are useful.
Surgery for hip dysplasia
If conservative measures do not show any improvement in the symptoms of hip dysplasia, or if hip dysplasia has been recognized too late or is too pronounced, the femoral head can be put back into the acetabulum through an operation.
In most cases, the joint head is removed from the socket and the socket is then brought into a better position so that the femoral head lies better in the socket again.
If the hip dysplasia goes with one arthrosis hand in hand, in which all conservative measures were unable to alleviate the symptoms, is a Hip replacement necessary by means of an endoprosthesis. Whether the entire joint is replaced by an artificial hip or only parts of it depends on the degree of joint destruction.
For example, if the acetabulum was not damaged, it would be possible to preserve it and only the joint head of the Thighbone (Femur) to exchange (Dual head prosthesis). If both parts - i.e. the acetabulum and the head of the thigh bone - are damaged, a complete hip joint replacement is carried out using a prosthesis of the head of the femur and the Acetabulum (Total hip endoprosthesis).
Exercise for hip dysplasia
Even if there seems to be a greater danger, an existing one Hip dysplasia exacerbated by exercise, patients should even exercise around the muscular system around the hip joint to strengthen around.
Of course, care must be taken that only sport that is easy on the joints is exercised. These joint-friendly sports that can be practiced include, for example, cycling, swim (no breaststroke because of leg movement), Nordic walking, certain Yoga exercises and also Cross-country skiing.
Inline skating on smooth or even ground is also allowed. Sports that involve shock loads, rapid turns, and braking and acceleration movements are less beneficial for hip dysplasia.
These jointly stressful sports include to jog, tennis, squash, athletics or Martial arts.
In general, care should always be taken to ensure that the sports are carried out to a healthy extent and that excessive stress and pressure pain are avoided. Which sport is beneficial and which is not should always be discussed with the attending physician or physiotherapist.
The hip dysplasia in adults is introduced thanks to the Newborn screenings become rare. Nevertheless, there are still patients who also suffer from hip dysplasia and the associated consequences in adulthood. Because the hip dysplasia is left untreated Joint, muscle and ligament changes affected patients are severely restricted in their movement and also suffer from severe pain. Due to the deformities, only surgical interventions can alleviate the symptoms. Besides the Osteotomy many patients receive one artificial hip jointbecause the arthritic changes are too advanced.