Hipdysplasiaphysio.com was set up by Holly Soper-Doyle; a Specialist musculoskeletal Physiotherapist at The Royal National Orthopaedic Hospital (stanmore) and owner of Integrum Physiotherapy in North London.
Holly identified that there was a gap in the available resources for rehabilitation of hip dysplasia, both conservative management and pre & post-operatively, and wanted to provide a resource for both patients and physios alike.
She helps to mentor hip dysplasia patients all over the world on social media, and after identifying a number of issues with rehabilitation differences, wanted to provide an evidence based, educational website with rehabilitation guidelines.
This website is dedicated to helping people understand hip dysplasia and highlight the correct rehabilitation both pre and post-operatively, and new research available
Hip dysplasia is a condition defined by the socket (acetabulum) of the hip joint being too shallow. Hip dysplasia may be present from birth or can develop during growth.
It is more prevalent in women (8:2) than men, and is known to be a common cause of developing early onset osteoarthritis.
There is evidence of genetic links to developing hip dysplasia, it is 12 times more likely if there is a family history. Predisposing risk factors include; position in the womb, breech birth, female gender and carrying positions as an infant, these can all lead to increased ligament laxity and poor bony congruency,
Patients who have hip dysplasia often start to get symptoms in their late teens, 20’s or 30’s. Due to the shallow hip socket, there are increased shearing forces on the joint and after an undefined period of time, damage starts to occur around the front edge of the socket, resulting in pain.
One of the first signs in hip dysplasia is often pain from a tear in the labrum (a piece of cartilage that provides negative suction to the joint). Symptoms including pain in the anterior hip joint, along with catching, painful clicking and symptoms of giving way.
Once the pain begins it is a sign that the joint is no longer able to withstand the resultant increased shearing forces (due to the shallow socket). Consequently the joint begins to degenerate with damage occurring to the articular cartilage (the gliding surface of the joint) resulting in the gradual development of osteoarthritis.
If left undiagnosed and/or untreated the joint can degenerate so much that it results in bone on bone contact and therefore requires a hip replacement.
Hip dysplasia can be diagnosed using a plain x-ray of the pelvis.
The medical professional should look at the lateral centre edge angle of each hip socket (this highlights if there is a degree of uncovering of the femoral head). A dysplastic hip is defined by a lateral centre edge angle of less than 20 degrees and borderline dysplasia if 20-25 degrees. Normal values should be between 25-40 degrees.
CT and/or MRI can be used to further define the integrity of the joint and surrounding structures and the resultant damage that has occurred.
To clinically diagnosed a labral tear an MR Arthrogram must be performed as it is more sensitive and specific in detecting labral tears than a normal MRI. This involves injection of dye into the hip joint and then an MRI.
Highlighting important research into hip dysplasia and both surgical and conservative management.
Having qualified as a Physiotherapist from Brunel University in 2007, Holly has over ten years of extensive clinical experience after working in a variety of different specialities including: multiple NHS trusts, Headley Court (the Ministry of Defence rehabilitation centre), Premiership sports teams including Chelsea and QPR. In 2018, Holly was appointed as an Honorary clinical lecturer at UCL, teaching on a masters in Rehabilitation and also earned a Postgraduate Diploma with distinction in Veterinary Physiotherapy.
Holly currently works part time at the Royal National Orthopaedic Hospital (Stanmore) as a specialist musculoskeletal Physiotherapist, where she enjoys close links with some of the country's leading consultants. She has a specialist interest in hip pathology, and is currently starting some pioneering research into hip rehabilitation. She also owns her own business in North London-Integrum Physiotherapy.
As well as her extensive clinical experience, Holly herself has personal experience of living with DDH She was diagnosed in 2011 at the age of 25 with hip dysplasia bilaterally and underwent a Peri-acetabular Osteotomy in late 2011. Due to significant blood loss during the operation the rotation was not sufficient enough and she then required a salvage procedure- in 2013 a combined procedure consisting of a Shelf-acetabuloplasty
and arthroscopy with labral repair.
She is passionate about helping people to manage DDH and rehabilitate to the best of their ability.
This website is dedicated to helping people understand hip dysplasia and highlight the correct rehabilitation.
Please contact us directly with any questions, or comments.