That lingering hip pain might be more than just ageing or from activity
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Madam Ang Hui San lived with hip pain for years before finding out she had hip dysplasia.
ST PHOTO: BRIAN TEO
Follow topic:
- Hip dysplasia is when the hip socket does not fully cover the thighbone, causing pain and impacting daily activities.
- Diagnosis often occurs in infancy, but some cases are detected later, potentially leading to osteoarthritis if untreated.
- The Bernese periacetabular osteotomy realigns the hip socket, improving stability; recovery involves physiotherapy over several months.
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SINGAPORE – Madam Ang Hui San had been feeling pain in her right hip since her late 20s, but for years, she told herself it was nothing more than a minor inconvenience. It flared up when she walked long distances, carried heavy bags or lifted her leg to step onto a platform.
After the birth of her second child in 2021, the pain worsened.
“It became more intense and frequent. The pain also got worse with increased activity levels. There were times when I had to limp,” says the 41-year-old senior executive in a government agency.
Madam Ang tried acupuncture and visited a chiropractor, but neither provided relief. She then sought a referral to a specialist at Alexandra Hospital.
There, a battery of X-rays uncovered the problem: hip dysplasia, a condition where the hip socket does not fully cover the ball of the upper thighbone, which can cause instability and pain.
The doctor gave her two options: lose weight or undergo surgery to realign her hip joint. Madam Ang, who is married and has two children aged four and six, opted for surgery.
Hip dysplasia is not always caught early.
According to Adjunct Associate Professor Andrew Lim, head of paediatric orthopaedics at National University Hospital’s (NUH) department of orthopaedic surgery, about one in 1,000 people have the condition. Those at higher risk include firstborn girls, babies in breech position and people with a family history of hip dysplasia.
Hip dysplasia is usually picked up during neonatal screening, when doctors check on the baby’s hip stability. However, some cases remain undetected until the older child, adolescent or young adult complains of pain with activity, which often gets worse over time, says Prof Lim.
“This is due to undercoverage of the hip socket over the ball (femoral head), resulting in excessive pressure over a smaller weight-bearing area of the hip joint, leading to early wear and tear which progressively worsens,” he notes.
If left untreated, it could result in progressive degeneration of the hip joint or osteoarthritis.
At NUH, doctors see about 20 such cases each year, up from just a handful annually 10 years ago.
“We are seeing more referrals now, likely due to growing awareness and the availability of hip preservation surgery not only for children, but adolescents and young adults as well,” says Prof Lim.
Hip dysplasia is typically detected during newborn screening, but some cases go unnoticed until pain arises later in childhood, adolescence or early adulthood.
ST PHOTO: BRIAN TEO
The go-to procedure for suitable adult patients with hip dysplasia is the Bernese periacetabular osteotomy. It involves cutting and repositioning the hip socket to better cover the ball of the hip joint, improving stability and reducing pain.
Madam Ang underwent the procedure at NUH in September 2023.
Five days after surgery, she managed to stand and take a few steps with a walking frame.
Adjunct Associate Professor Andrew Lim, head of paediatric orthopaedics at NUH’s department of orthopaedic surgery, explaining Madam Ang Hui San’s condition.
ST PHOTO: BRIAN TEO
Recovery happens in stages, says Prof Lim, and it typically takes three to six months for the bone to heal and the hip muscles to regain strength.
About 10 days after surgery, Madam Ang was transferred to St Luke’s Hospital, where she continued physiotherapy. She was discharged about two weeks later, but had to continue physiotherapy until May 2024.
Before the surgery, even something as routine as putting on underwear was a struggle for her. “I had to sit on the toilet bowl because I couldn’t lift my leg,” she recalls.
Now, she lives pain-free and even tried bowling recently. “There was some soreness, but no pain,” she says.
Amrita Kaur is a journalist at The Straits Times, where she covers the evolving healthcare landscape in Singapore, including mental health and wellness.
