Harnesses, casts, and traction
Early hip dysplasia can often be treated using a Pavlik harness (see photograph) or the Frejka pillow/splint in the first year of life with usually normal results. Cases of femoral head avascular necrosis have been reported with the use of the Pavlik harness, but whether these cases were due to improper application of the device or a complication encountered in the course of the disorder remains unresolved. Complications arise mainly because the sheet of the iliopsoas muscle pushes circumflex artery against the neck of the femur and decreases blood flow to the femoral head. That is the reason why the Frejka pillow is not indicated in all the forms of the developmental dysplasia of the hip.Image:Saeugling mit angelegter spreizhose.jpg|baby wearing a Pavlik harness
Image:Pavlik.jpg|Diagram of Pavlik harness
Image:Frejka.jpg|Diagram of Frejka pillow
Image:Tractie.jpg|Traction
Other devices employed include the spica cast, particularly following surgical closed reduction. A few weeks in traction can be used as part of a treatment plan.
Surgery
In older children the hip abductor and iliopsoas muscles have to be treated surgically because they adapt to the dislocated joint position (contracture).Braces and splints are often used following either of these methods to continue treatment.
Although some children "outgrow" untreated mild hip dysplasia and some forms of untreated dysplasia cause little or no impairment of quality of life, studies have as yet been unable to find a method of predicting outcomes. On the other hand, it has often been documented that starting treatment late leads to complications and ends in poor results.
Stem cells
One avenue of research is using stem cells. They are applied in grafting (bone grafting) or by seeding porous arthroplasty prosthesis with autologous fibroblasts or chondrocyte progenitor cells to assist in firmly anchoring the artificial material in the bone bed.Hip replacement and osteotomy
Hip dysplasia is often cited as causing osteoarthritis of the hip at a comparatively young age. Dislocated load bearing surfaces lead to increased and unusual wear. Although there are studies that contradict these findings. (see ) Subsequent treatment with total hip arthroplasty (hip replacement) is complicated by a need for revision surgery (replacing the artificial joint) due to skeletal changes as the body matures, loosening/wear or bone resorption.Osteotomies are either used in conjunction with arthroplasty or by themselves to correct misalignment.
Adapted from the Wikipedia article Hip dysplasia (human), under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki
