What is the Hip?

The hip is a term frequently used to describe a large area of the body including the pelvis. The hip joint is the ball and socket joint where the top of the femur (bone in the thigh) that is shaped like a ball, the femoral head, fits into the “socket” or acetabulum of the pelvis. This joint is surrounded by a joint capsule, muscles, and ligaments increasing stability and facilitating its function.

What is hip dysplasia?

Hip dysplasia occurs when the hip socket is either too shallow or in an improper position to cover the whole head of the femur. This can lead to instability, but also puts increased pressure on the hip joint, leading it to wear out faster than if it were normally shaped.

Starting early on as teenagers and young adults, hip dysplasia can cause damage to the labrum, a ring of cartilage that follows and extends the bony rim of your socket frequently resulting in a hip labral tear. The function of the labrum as far as we understand it right now is to add stability to the hip and to help to preserve the overall integrity of the hip joint.  A deficient labrum can increase the chances of developing osteoarthritis.

Common causes

Most people with hip dysplasia are born with the condition or have developmental changes early in life resulting in dysplasia. During the last month of pregnancy, the womb can become so crowded that the baby’s hip moves out of its socket, causing the socket to be shallower than it should be. Hip dysplasia often runs in families and is more common in girls.

Adults with hip dysplasia often were not diagnosed during infancy. If the condition is mild, symptoms might not appear until teenage or young adult years.

Diagnosis and Examination

Initially, a medical history and physical examination by a musculoskeletal expert should be completed. If your doctor suspects you have adult hip dysplasia, she or he will likely suggest diagnostic imaging tests which typically include X-rays, MRI, CT scans with 3D reconstructions, and possibly a dynamic ultrasound evaluation. Diagnostic image-guided injections may be recommended as well.

Treatment Options

Teenagers and young adults diagnosed with hip dysplasia usually require surgery to re-align the hip joint. If hip dysplasia goes untreated, it will worsen over time and ultimately require full joint replacement surgery. Early hip preservation surgery can help postpone joint replacement surgery. In mild cases, surgery may be performed arthroscopically, using tools and cameras inserted through small incisions. In more severe cases, a doctor might suggest an osteotomy, frequently a periacetabular osteotomy (PAO), where the hip socket is cut free from the pelvis and re-positioned so that it is better aligned with the ball of the joint. Consult with your doctor to discuss the most appropriate treatment plan for you.

Rehabilitation

The recovery process depends on the type of treatment you receive, but will require physical therapy and a period of protected weight bearing. After hip surgery, it is important to follow up with your physician to be monitored for proper healing.