Hip Dysplasia in the Child, Adolescent and Adult

The hip joint is a simple ball-in-socket structure. The ball-shaped femoral head rotates inside a cup-shaped socket called the acetabulum. Usually this joint works smoothly, with little friction or wear.

The well-fitting surfaces of the femoral head and acetabulum which face each other are each lined with a layer of articular cartilage and lubricated by a thin film of synovial fluid which reduces friction inside the normal hip to less than 1/10 that of an ice cube gliding on ice. The labrum is a rim of fibrous cartilage, which lines the outer edge of the acetabulum. It serves to stabilize and cushion the hip joint.

In some people, the hip becomes symptomatic � painful, stiff, weak, unstable, or maybe even a combination of these symptoms.

Hip Impingement

Hip impingement can occur from deformities of the femur (cam impingement), acetabulum (pincer impingement), or as a result of a combination of the two abnormalities.

Cam impingement is caused by a squeezing or jamming of an abnormally shaped femoral head and head-neck junction into the acetabulum (socket) during certain types of motion, such as tying one's shoe, or riding a bike.

Pincer impingement is caused by direct contact between the femoral head-neck junction and a section of the acetabular rim.

Impingement of the hip can also be caused by conditions such as Legg-Calve-Perthes disease, slipped capital femoral epiphysis, misshapen femoral head, abnormally tilted head, a bump on the femoral neck, or post traumatic deformities, such as Coxa Vara.

Perthes Disease

Perthe's disease is condition that occurs as a result of a temporary loss of blood supply to the hip. Despite huge advances in research in Perthes there is very little consensus on Perthes treatments and natural history. Dr Balakumar is a specialist in treating active and residual Perthes.

The loss of blood supply results in the rounded head of the femur collapsing. The area becomes inflamed and irritated. Perthes is really a complex process of stages. Treatment of Perthes requires periods of immobilization and decreased activities . The long term prognosis varies depending on the age of presentation and sex.

Slipped Upper Femoral Epiphysis (SCFE or SUFE)

Slipped Upper Femoral Epiphysis (SCFE or SUFE) is a very common condition in the rapidly growing child. It results in effect a slippage of the femoral head (ball) from the rest of the femur. It is like a fracture through the ball/neck junction, but it behaves very differently.

Imaging in Hip Disorders

When investigating someone with a hip disorder, Dr Balakumar aims to ascertain where the pathology is originating from. After thorough history and examination, Dr Balakumar will then utilize imaging to confirm his diagnosis.

Especially if your clinician is considering surgery, then he or she should have convincing imaging suggestive of the pathology. The imaging usually tells the �truth� however it can often be misread or misinterpreted by clinicians. Dr Balakumar would often order a 4 plain X-rays. A standing X-ray pelvis(AP-frontal plane), A standing faux profile (side view of the socket), a Von Rosen view (for hip dysplasia) and a frog lateral view (a side view of the head).

Contact Mr Jit Balakumar

Consulting at:

64 Chapman Street
North Melbourne VIC 3051
Ph: (03) 9329 5525
Fax: (03) 9329 4969

Melbourne Orthopaedic Group
33 The Avenue
Windsor VIC 3181
Ph: (03) 9573 9659
Fax: (03) 9521 2037

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� 2012-2014 Jit Balakumar - Paediatric & Adult Orthopaedic Surgeon, Melbourne

Hip Dysplasia in the Child, Adolescent and Adult

Hip Impingement

Perthes Disease

Slipped Upper Femoral Epiphysis (SCFE or SUFE)

Imaging in Hip Disorders

Jit Balakumar

Contact Mr Jit Balakumar

New Patients

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