Complex Hip Cases

Some hips are anatomically different from birth or have been significantly altered by disease. Developmental dysplasia of the hip (DDH) results in a shallow socket that leads to premature wear, while sickle-cell disease can compromise blood supply to the femoral head. Such cases require a surgeon who carefully plans around the unusual anatomy — rather than merely operating through it.

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Signs that matter

If you recognize two or more of these symptoms, a professional assessment is your best next step.

Hip pain beginning at an unusually young age (20s–40s).
A history of childhood hip conditions or previous brace treatment.
Sickle-cell disease accompanied by new onset of groin or hip pain.
A persistent, deep ache following periods of standing or walking.
A progressively worsening limp or a noticeable difference in leg length.

Treatment options

Non-surgical first — always the starting point where possible

Targeted physiotherapy and activity guidance.
Pain management and disease-specific care.
Coordination with hematology for sickle-cell patients.
Monitoring with periodic imaging.

Surgical solutions — when conservative care is no longer enough

Total hip replacement adapted to dysplastic anatomy.
Reconstruction for avascular necrosis (AVN).
Custom planning — 3D templating of the socket.
Revision of previous childhood surgery.

When is surgery the best option?

In cases of DDH and sickle-cell hip disease, surgical timing is a matter of strategy: operating too early can compromise the implant's lifespan, while delaying too long causes the bone stock to deteriorate. The optimal time is when pain significantly limits your daily life and imaging confirms disease progression — at this point, a carefully planned reconstruction can restore the function that your anatomy never naturally provided.

COMMON QUESTIONS

Asked in
clinic, daily

Is hip replacement harder with DDH?+

It requires more extensive planning, as the socket is typically shallow and the femur is often small; however, in experienced hands, surgical outcomes are excellent.

I have sickle-cell disease. Is surgery safe for me?+

Yes, it is safe with the right preparation. We coordinate closely with the hematology team before, during, and after surgery to manage the condition safely.

Can AVN be treated without a replacement?+

In the early stages, it is sometimes possible; a procedure called core decompression can be helpful. However, once the femoral head has collapsed, hip replacement becomes the most reliable solution.