COXA VERA

Coxa vera is an unusual hip condition in which there is a discrepancy of growth in the round ball of the hip (femoral head) and the upper end of the thigh bone. This discrepancy leads to a shepherd’s crook deformity of the hip.

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Coxa Vera

Coxa vera is a medical term that refers to an abnormal hip joint. The word “coxa” is Latin for hip, and “vera” means true or genuine. Coxa vera refers to a hip joint that has developed abnormally, typically due to a congenital or developmental condition. This condition can result in a variety of problems, including pain, decreased mobility, and a deformity of the hip joint. This condition is a relatively uncommon condition, but it can negatively impact a person’s quality of life and daily activities. Treatment options for coxa vera can range from physical therapy and lifestyle modifications to surgery.

Coxa Vera affects about one in 25,000 kids, with either hip and males and females being equally affected. It results in a decrease in the angle between the femoral head, and the ball of the joint. It gives the leg the appearance of being shorter and can cause a limp. The problem frequently doesn’t become obvious until a child is two or three years old.

Coxa Vera Symptoms

Coxa vera can cause a variety of symptoms, depending on the severity and the age of the patient. Some common symptoms of this condition include:

Pain in the hip joint is a common symptom of coxa vera, and it can range from a dull ache to a sharp, stabbing pain. The pain may be generated in the hip itself, or it may radiate down the leg.
Patients with coxa vera may experience difficulty moving their hip joint, including difficulty walking, standing, or climbing stairs.
Coxa vera can cause a deformity of the hip joint, including a shortening of the affected limb, a noticeable tilt to one side, or a bowing of the thigh bone.
Some patients with coxa vera may experience a feeling of instability in their hip joint, particularly when walking or standing.
Patients with coxa vera may develop a limp as a result of pain or difficulty walking.

If your child is experiencing any of these symptoms, it is important to seek medical attention. A doctor can perform an examination and imaging tests to confirm a diagnosis of coxa vera and determine the best course of treatment for your child.

QUESTIONS AND ANSWERS

What is coxa vera in children, and how does it occur?

Coxa vera is a condition where the angle between the femoral head and the femoral neck is decreased, resulting in a reduced angle. It can be congenital (present at birth) or acquired. Congenital coxa vera is usually a result of abnormal development during fetal growth, while acquired coxa vera can be caused by conditions such as Perthes disease, fractures, or infections affecting the hip joint.

What are the common symptoms and signs of coxa vera in children?

Children with coxa vera may present with a range of symptoms, including limping, pain in the hip or groin area, limited range of motion in the hip joint, and difficulty walking or bearing weight on the affected leg. The affected hip may also appear to turn inward or outward, and there may be differences in leg length. In some cases, there may be no obvious symptoms, especially in mild cases.

How does a doctor diagnose and treat a child with coxa vera?

Diagnosis typically involves a thorough physical examination, medical history review, and imaging studies such as X-rays, CT scans, or MRI to assess the hip joint’s structure and confirm the coxa vera deformity. Treatment varies based on the severity of the condition and may include observation, physical therapy, and orthotic devices in milder cases. In more severe cases or when conservative measures fail, surgical intervention may be necessary to correct the hip angle. Surgical procedures may involve osteotomies (bone cuts) to realign the femur or other corrective measures.

The Medical City Children’s Orthopedics and Spine Specialists doctors specialize in children and adolescents. Our doctors treat Coxa Vera in children and definitely stop the pain and fix the hip condition.

Coxa Vera Causes

Coxa vera is a congenital condition, which means it is present at birth. The exact cause of this condition is not well understood. However, this condition appears to stem from a combination of genetic and environmental factors. Some theories suggest that coxa vera stems from:

Abnormal development of the hip joint: The hip joint is a ball-and-socket joint that is formed by the head of the thigh bone (femur) fitting into a socket in the pelvis (acetabulum). In some cases, the acetabulum may not form properly, which can cause the hip joint to develop abnormally.
Abnormal growth patterns: In some cases, coxa vera may come from a mismatch in the growth patterns of the bones in the hip joint, which can result in an abnormality of the joint.
Environmental factors: Exposure to certain environmental factors, such as certain chemicals or drugs, during pregnancy has been associated with an increased risk of this condition in some cases.
A malformation in which the fracture remains in an inversion.
Loss of reduction due to insufficient stability of the fracture.
Nonunion or delayed union.
Premature proximal femoral physis closure accompanied by increased trochanter expansion.

It is important to note that in many cases, the exact cause of coxa vera is not known. Nevertheless, a diagnosis of this condition can help guide the treatment and management of the condition.

Coxa Vera Diagnosis

Coxa vera is typically diagnosed through a combination of physical examination, medical history, and imaging tests. Your doctor may perform the following tests to diagnose coxa vera:

Your doctor will perform a thorough examination of your child’s hip joint, including checking for pain, deformities, and any limitations in range of motion.
Your doctor will take a detailed history of your child’s symptoms, including when they began, how long your child has had them, and any treatments your child has received.
Your doctor may order imaging tests to get a better look at the bones and tissues of your child’s hip joint. These tests may include X-rays, MRIs, or CT scans.
In some cases, your doctor may perform additional tests to rule out other conditions.

A diagnosis of coxa vera is important to help guide the treatment and management of the condition. Early and accurate diagnosis can help prevent further damage to the hip joint and surrounding tissues. Early diagnosis will also help improve your child’s overall prognosis.

Surgery Considerations

The decision to undergo surgery for Coxa Vera is based on a variety of factors. Surgeons consider the severity of the condition, the age and health of the patient, and other medical conditions. Some of the parameters that are used to consider surgery for coxa vera include:

Pain: If conservative treatments, such as physical therapy and pain management, are not effectively controlling pain, doctors will suggest surgery.
Limitations in mobility: If the hip joint is unstable or if there are significant limitations in the range of motion, doctors will suggest surgery.
Deformity: If there is a noticeable deformity of the hip joint, such as a shortening of the affected limb, a tilt to one side, or a bowing of the thigh bone, doctors will suggest surgery.
Age: Children and young adults with coxa vera may definitely benefit from surgery, as their bones are still growing and their bodies are more adaptable to changes.
Overall health: Doctors will consider the overall health of the patient, including the presence of any other medical conditions before performing surgery.

It is important to note that each case of coxa vera is unique. Doctors will make the decision of surgery on a case-by-case basis. Your doctor can help you understand the potential benefits and risks of surgery. This will allow parents to make an informed decision about the best course of treatment.

Treatment

Doctors may recommend surgery for Coxa Vera if conservative treatment methods like physical therapy and lifestyle modifications do not work. in controlling symptoms. Surgery can help to realign the hip joint and reduce pain and deformity. Some of the reasons that doctors recommend surgery to treat coxa vera include:

Pain relief: Surgery can help to relieve pain in the hip joint caused by coxa vera.
Improved mobility: Surgery can help to improve the stability and mobility of the hip joint. Thus, making it easier to perform daily activities and reduce the risk of future injury.
Correction of deformity: Surgery can help to correct deformities caused by coxa vera. For instance, shortening of the affected limb, a noticeable tilt to one side, or a bowing of the thigh bone.
Prevention of further damage: Surgery can help to prevent further damage to the hip joint and surrounding tissues. This will reduce the risk of long-term complications.
Improved quality of life: By reducing pain, improving mobility, and correcting deformities, surgery can help to improve a person’s overall quality of life.

It is important to note that surgery is not always necessary for coxa vera. Therefore, the decision to undergo surgery is ultimately a personal one that parents should make in consultation with their doctor.

Checkups

Children should frequently get checked following surgery until their growth is finished since the deformity can come back regardless of the osteotomy technique. Enhancing the H-E angle to less than 38 degrees can reduce the likelihood of recurrence. Many children with coxa vera also have concomitant femoral hypoplasia and limb-length disparity, which both need watching and may eventually necessitate limb-length equalization. This requires monitoring in addition to looking for recurrence of the varus deformity. The functional results of surgical correction are frequently poor to fair, and residual gait abnormalities are frequent, according to long-term research.

Bottom Line

There are not a lot of articles currently accessible about coxa vera since this condition is rather uncommon. The best course of action is surgery. In the case of acquired coxa vera from a fracture, the doctors and surgeons must be hip experts. The Surgeons must be familiar with the proximal femur and femoral neck as they require precise reduction and firm fixation. These medical procedures need experts and the doctors and surgeons at the Medical City Children’s Orthopedics and Spine Specialists have the knowledge, skills, and abilities to help children with this condition.

If you come to one of our Medical City Children’s Orthopedics & Spine Specialists offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, Texas, our pediatric orthopedic doctors will examine your child and recommend the best treatment option to repair the problem and allow your child to grow without a major hip problem.

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Footnote:

Radio Paedia: Coxa Vera

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