After Bollywood actor Varun Dhawan recently shared that his daughter has been diagnosed with Developmental Dysplasia of the Hip (DDH), the condition has come into sharper public focus. While not widely discussed, DDH is a relatively common issue in infants—and one where early diagnosis can make a significant difference.

“If left untreated, it can affect a child’s ability to crawl, walk, and run, and may lead to pain, limping, or early arthritis over time,” says Dr Raju Vaishya, Senior Consultant, Orthopaedic and Joint Replacement Surgery at Indraprastha Apollo Hospital.

It is a condition where a child’s hip joint does not form properly. Normally, the ball at the top of the thigh bone fits securely into the hip socket. In children with DDH, the fit may be loose, unstable, or completely dislocated.

The condition may not always be visible at birth, making early screening extremely important. While it can cause mobility issues if left untreated, early detection and treatment can lead to the children living a normal life.

Globally, it affects about 0.5% to 1.5% of babies — some children may have very mild instability that resolves on its own while others may have more severe forms requiring treatment. In India, there are an estimated 0 to 2.6 cases per 1,000 live births. This number is possibly an undercount as the mild cases may go undiagnosed.

Girls, first-born children, those born in a breech position (feet-first position, instead of the normal head-first), and those with a family history of DDH are at a higher risk for it.

The challenge for India is the complexity, considering that most children get diagnosed at the age of one or two years — later than ideal, says Dr Vaishya. Therefore, there is a need for screening programmes to ensure that it gets diagnosed and treated early on.

Dr Vaishya says that the condition is often identified during routine newborn examinations. Doctors are able to spot instability in the hip joint, even though parents may not observe any visible signs.

In slightly older babies, parents may begin to notice subtle indicators such as unequal leg lengths, limited movement of one leg, or asymmetry in thigh folds. In late-presenting cases, which are still common in India, Dr Vaishya says that children may come in with delayed walking, limping or an abnormal gait, or one leg appearing shorter than the other. Late diagnosis remains a challenge, especially in settings where routine screening is not consistently practiced.

DDH is highly treatable and often curable, particularly when diagnosed early.

In newborns up to six months of age, Dr Vaishya explains, a soft brace is commonly used to keep the hip in the correct position and allow it to develop normally. In children between six months and two years, treatment may involve a closed reduction—where the hip is repositioned without surgery—followed by immobilisation in a cast. Older children may require surgical intervention to realign the joint.

Most children may not need the surgery if the condition is identified early enough, he said.

“When detected and managed early, most children grow up with normal walking and running abilities, experience no pain, and have near-normal hip function,” says Dr Vaishya.

He adds: “However, if the condition is missed or treated late, it can lead to persistent limping, chronic hip pain, reduced mobility, and early onset arthritis, sometimes as early as the third or fourth decade of life.” In severe untreated cases, individuals may eventually require hip replacement surgery, he said.