Hip dysplasia treatment by age: newborn to walking
Written by Dr. Mutasem Aldhoon, pediatric orthopedic consultant · Medically reviewed by the Baby Hip Center pediatric orthopedic team · Last reviewed September 1, 2026
Under six months, most hips are treated with a Pavlik harness or abduction brace. From six to eighteen months, a closed reduction under anaesthetic with a spica cast is usual. After walking age, open surgery and sometimes bone reshaping are more often needed. Age is the single biggest factor in which treatment is offered.
Parents often assume severity decides treatment. It contributes, but age decides more: the younger the baby, the more the socket can still remodel on its own once the hip is held in the right place.
Treatment by age band
| Age | Usual first treatment | Why |
|---|---|---|
| Birth to 6 months | Pavlik harness or abduction brace, full time for 6-12 weeks | The socket is still highly mouldable and the hip is easily held in place |
| 6 to 18 months | Closed reduction under anaesthetic, then a spica cast for around 3 months | The hip is stiffer and soft tissues have tightened; a harness can no longer seat it |
| 18 months to 3 years | Open reduction, often with a pelvic or femoral osteotomy | The socket has grown misshapen and needs redirecting as well as reducing |
| Over 3 years | Open reduction with bone reshaping, and sometimes femoral shortening | The femur and socket have both adapted to the dislocated position |
What a spica cast involves
After the hip is guided back into the socket under anaesthetic, a cast from chest to legs holds it there — usually for around six weeks, then a further period in a fresh cast or brace. An MRI or CT is often done immediately afterwards to confirm the hip is genuinely seated. Life in a spica is demanding for the family: car seat, feeding, nappies and sleep all need adapting, and most units will show you how before you go home.
Follow-up does not end when treatment does
A hip that is corrected in infancy can still grow slightly shallow later, and residual dysplasia found at four or eight years old is easier to treat than the same problem found in adulthood. Most teams therefore keep a treated hip under periodic X-ray review until skeletal maturity. If your child was treated as a baby and has never been rechecked, that is a reasonable thing to ask about.
Untreated dysplasia in adulthood
The reason all of this effort goes into infancy is what happens decades later: untreated dysplasia is one of the leading causes of hip arthritis and hip replacement in young adults. Treatment in the first months is short, non-surgical and highly effective by comparison.
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Read next
- The Pavlik harness: week by week, and what to expect
How the Pavlik harness works, the usual 6-12 week timeline, bathing and skin care, sleep and clothing, and what happens if it does not work.
- Do double nappies treat hip dysplasia?
Double nappying is widely suggested and rarely effective as a treatment. What the evidence shows, and what it can and cannot be used for.
- Reading your baby's hip ultrasound: Graf types I to IV explained
What Graf type I, IIa, IIb, IIc, III and IV mean on your baby's hip ultrasound report, and what each type usually means for treatment.
This page is general information about developmental dysplasia of the hip, not a diagnosis of your own baby. It does not replace examination by your baby's doctor, and it is not for emergencies.