<unk>  presents a nearly perfect equilibrium between the arthritis, movement/mobility problems and pain associated with the developmental malformation, and the arthritis, movement/mobility problems and pain that are, as often as not in moderate to severe cases, inflicted by the treatment itself. However, given the very real possibility of a limp, constant and/or debilitating pain, complicated treatment and impaired mobility later in life, careful developmental monitoring is indicated and early intervention is often the best result. The worst possible consequence of non treatment is developing early arthritis, sometimes even during teenage years. All treatment aims to delay the onset of arthritis, but no treatment is fully successful in avoiding it; and, all available treatments bear the risk of inflicting equivalent damage. Most unfortunately, studies have as yet been unable to find a method of predicting outcomes in either the surgical/orthopedic treatment of the condition in infants and young children, or the surgical treatment of these early treatments' negative outcomes later in life (such as arthritis, avascular necrosis, trochanteric bursitis, and bone spurs of up to 3.5 cm just medial of the gluteus maximus insertion point on the greater trochanter due to excessive friction). Harnesses, casts, and traction Early<unk>  can often be treated using a Pavlik harness (see photograph) or the Frejka pillow/splint in the first year of life with usually normal results. Complications can occur when using the Pavlik harness. Cases of femoral nerve palsy and avascular necrosis of the femoral head have been reported with the use of the Pavlik harness, but whether these cases were due to improper application of the device or a complication encountered in the course of the disorder remains unresolved. Complications arise mainly because the sheet of the iliopsoas muscle pushes the circumflex artery against the neck of the femur and decreases blood flow to the femoral head, so the Frejka pillow is not indicated in all the forms of the developmental dysplasia of the<unk> . File:Saeugling mit angelegter spreizhose.Baby wearing a Pavlik harness File:Pavlik.Diagram of Pavlik harness File:Frejka.Diagram of Frejka pillow File:Tractie.Traction Other devices employed include the spica cast, particularly following surgical closed reduction, open reduction, or osteotomy in babies and young children. Traction is sometimes used in the weeks leading up to a surgery to help stretch ligaments in the<unk>  joint, although its use is controversial and varies amongst physicians. Surgery In older children the adductor and iliopsoas muscles may have to be treated surgically because they adapt to the dislocated joint position (contracture). Braces and splints are often used following either of these methods to continue treatment. Although some children "outgrow" untreated mild<unk>  and some forms of untreated dysplasia cause little or no impairment of quality of life, studies have as yet been unable to find a method of predicting outcomes. On the other hand, it has often been documented that starting treatment late leads to complications and ends in poor results.<unk>  replacement and osteotomy<unk>  is often cited as causing osteoarthritis of the<unk>  at a comparatively young age. Dislocated load bearing surfaces lead to increased and unusual wear, although there are studies that contradict these findings (see). Peri-acetabular osteotomy (PAO) surgery can be used to realign the<unk>  joint in some adolescents and adults. Subsequent treatment with total<unk>  arthroplasty <unk>  replacement) is complicated by a need for revision surgery (replacing the artificial joint) owing to skeletal changes as the body matures, loosening/wear or bone resorption.<unk>  resurfacing is another option for correcting<unk>  in adults. It is a type of<unk>  replacement that preserves more bone, and may work for younger<unk>  patients. Osteotomies are either used in conjunction with arthroplasty or by themselves to correct misalignment.
Hip dysplasia
Hip dislocation
Radial dysplasia
Cemento-osseous dysplasia
Achondroplasia
Multiple epiphyseal dysplasia
Metaphyseal dysplasia
Dysostosis