Hip health awareness


By Danielle Zerella

Sienna in her Pavlik harness

Sharni Hamann, Reporter

Eight infants are diagnosed with hip dysplasia every day, yet this common condition has a history of going undetected.

Hip dysplasia, sometimes called developmental dysplasia of the hip (DDH), is a non-life-threatening condition causing instability in the hip joint. The hip joint is a ball and socket joint with the top of the femur bone, the femoral head, acting as the ball and the curved hollow of the pelvis, the acetabulum, acting as the socket. Hip dysplasia occurs when the ball and socket don’t fit together in their ‘normal’ position.

According to a survey conducted by Healthy Hips Australia, only 57% of parents in Australia had heard of hip dysplasia before their child’s diagnosis.

The diagnosis is sometimes made at birth, although it can develop at a later age, which is where the trouble lies. The key indicator is ‘clicky hips’, the click sound is from the leg bone slipping out of the leg socket when the hip is moved. Other symptoms include uneven legs and severe pain.

Robyn Cilli, a midwife at King Edward Memorial Hospital, explained the simple way paediatricians and child health nurses check for hip dysplasia in newborns, “they’ll bend the knees up, then just move them out to see if they dislocate out of their sockets.”

The factors that play a large role in having hip dysplasia include genetic predisposition, breech birth and incorrect swaddling of the infant. If left untreated it can lead to deformities, severe pain and arthritis resulting in surgery.

Danielle Zerella was diagnosed with hip dysplasia shortly after she was born, however, due to limited awareness of the subject, she wasn’t treated properly at an early age.  A keen sports player, including basketball and netball, her hips began to cause problems as she grew older. Eventually, as a young adult, her right hip developed arthritis.

Zerella was 27 when she had periacetabular osteotomy surgery (PAO). This surgery stopped arthritis in her right hip from developing further and eliminated the possibility of having a hip replacement. For the surgery, they cut Zerella’s “pelvis in three places, rotated it and pinned it back together.”

The rehabilitation process for PAO surgery can take between four to six months, the latter being the case for Zerella. Hip replacement recovery is far quicker, estimated at just four to six weeks. The pros of opting for PAO far outweigh the cons according to Zerella as “it’s well worth it.” PAO will give her more longevity in her hip as opposed to hip replacement surgery, as hip replacements have to be done every 10 years and become less successful with each attempt taken.

Reflecting on the pain before her surgery Zerella said, “I struggled with sleep because of the pain, and of course like with anything you feel it [the pain] more at night when you haven’t got any distractions. So, I would be needing to change positions because of the pain, I would have to take Panadol and Nurofen every couple of nights just to have a good night’s sleep.”

Supplied by Healthy Hips Australia
Hip Dysplasia Infographic

Now her little girl Sienna, who is just 7 months old, has hip dysplasia. Sienna was a prime candidate for hip dysplasia due to her family genetics, gender and the fact that she was the first born. Since just 6-weeks-old Sienna has been in a Pavlik harness for 23 hours a day with check-ups every three months and brace adjustments every three weeks.

The impact of this condition is more than just wearing a brace. According to Zerella, babies can lose the little moments and quality contact time with their parents with the brace being obstructive. In some cases mothers have to stop breastfeeding early on. Sienna is missing milestones other babies her age are meeting, such as crawling, sitting up on her own and walking . However, Zerella is extremely thankful her daughter is getting the life-changing treatment earlier on than she did.

Non-for-profit organisation Healthy Hips Australia is raising awareness for this condition. Established by Sarah Twomey, an occupational therapist and mother of two children with hip dysplasia, the organisation works with several Australian children’s hospitals and creates a community to support parents of children with hip dysplasia. It aims to help them be proactive in treatments that can change their children’s lives and ensure that they don’t feel isolated.

From 1 – 7 April Healthy Hips Australia is promoting Healthy Hips Week encouraging parents to be aware of the condition, to learn about it and make sure their children are checked at the recommended intervals.

Twomey hopes that parents understand that, “hip dysplasia isn’t life threatening but it can be life changing. Educate yourself about the risk factors for it, and potential signs and symptoms too. If you are concerned talk to your GP.”

She added: “It is okay to feel saddened by the diagnosis. Our hip kids are incredibly resilient though, and it is often hardest on us the parents, so be kind to yourself, seek support and know you are not alone.”

Zerella encourages other parents to make sure their children are being checked, “from what I’ve heard, treatment early is your best bet to avoid surgery,” and for that you need to be aware that it exists, and that it can develop at an older age.

For more information head to the Healthy Hips Australia website.