Our daughter was born with a condition called osteocondrodysplasia. The two main problems she has affect both her hips and her spine. They say she may need surgery when she gets older to help her hips. How will we know if this is necessary?

Osteochondrodysplasia is a general term for a disorder in the development (dysplasia) of bone (osteo) and cartilage (chondro). Hip, spine, and limb deformities are commonly linked with this condition.

A common hip problem is coxa vara. Coxa vara refers to the angle of the femur (thigh bone) as it supports the femoral head in the hip socket. The normal femoral neck angle is about 150 degrees at birth.

As the bones grow and develop, the shape changes. By the time we are adults, this angle is about 125 degrees. Less than 110-degrees creates this condition of coxa vara. The opposite (too much angle) is called coxa valga. Coxa valga is very rare with osteochondrodysplasia.

Surgery is advised when there is pain, loss of hip motion, and a leg-length discrepancy. With a loss of femoral neck angulation the femoral neck is short. In some cases, the hip socket is flat. The head of the femur may be in pieces rather than one solid, round feature. All of these changes cause the affected leg to be shorter than the uninvolved limb. The result is often a noticeable limp when walking.

If the coxa valga doesn’t improve and/or if the other symptoms mentioned become a problem, surgery may be needed. Usually, this is put off for as long as possible in order to ensure a successful result. Surgery too early when the bones are still growing and shifting can cause recurrence of the problem and development of arthritis later. The surgeon will use X-rays to measure the angle and keep track of its progress as the child grows and develops.