The hip or coxofemoral joint is a complex strong joint that supports the entire weight of the human body having an important role in both statics and locomotion. Children and babies who develop hip dysplasia have an insufficiently developed hip joint, in the sense that either the acetabular (glenoid) cavity is not deep enough, or the femoral head is not well fixed. Hip dysplasia can be congenital (present at birth), or it can be devoid in the first year of the child's life. Studies show that children who have been wrapped with their knees and right legs have an increased risk of developing hip dysplasia.

The hip joint is the largest joint in the body and consists of:

1. The spherical head of the femoral bone which represents practically about 2/3 of the joint
2. The acetabular or glenoid cavity (part of the coxal bone) in which the femoral head is fixed
Basically, the hip joint connects the femur (thigh bone) to the pelvis. The surrounding ligaments and the joint capsule keep the hip joint safe.

✓ Heredity, hip dysplasia can be inherited from parents, girls being more prone to develop hip dysplasia

✓ children born naturally, in pelvic position are more likely to develop hip dysplasia, compared to children born naturally, in a normal position (when the head comes out first)

✓ amniotic fluid in small quantity can predispose children to develop hip dysplasia in intrauterine life

In newborns and children between the ages of 1 and 6 months, an orthosis or harness type device is used specially designed to keep the balance in the correct position and also to allow the free movement of the legs and the change of diapers. It can be worn for 1-2 months.

In children aged between 6 months and 2 years, the repositioning of the hip in the correct position is made by the closed reduction (repositioning of the femoral head in the acetabulated cavity) followed by a period of immobilization in the plastered apparatus to fix the corrected position.

Milder cases of hip dysplasia remain asymptomatic until adolescence or adulthood, a situation in which the cartilage that covers the joint can be damaged. Symptoms can occur in case of intense effort, especially when flexion movements are made and is manifested with pain in the groin or in the lateral area of the hip. Spontaneous blockage of the hip joint or instability of the joint are also among the symptoms of hip dysplasia. In addition to these, the mobility of the hip will be reduced.

Physical therapy, through specific exercise programs, combined with physiotherapy and manual therapy, pursue:

➢ increasing the joint mobility by re-educating the movements at the hip level, especially those of flexion, abduction (lateral movement of the foot) and external rotation
➢ toning the buttock muscles, the tensor of the wide fascia (located on the side of the thigh) of the flexor and rotator muscles, with a role in immobilizing the hip when walking
➢ increasing stability and controlled movement
➢ reducing pain

Physiotherapy can be applied in the form of thermotherapy (local heat use) or hot baths and electrotherapy. Manual therapy and massage help reduce pain and muscle contractions but also to accelerate local circulation.

Surgical treatment is indicated if the therapeutic measures listed above do not have the expected results. Depending on the wear of the joint, either the correction of the acetabular cavity is performed to allow a better fixation of the femoral head or the installation of a hip prosthesis (in the case of a massive wear of the joint).

After the period of post-operative immobilization, the physical therapy program begins.