Hip dysplasia, also known as developmental dysplasia of the hip (DDH), is a condition where the hip socket is too shallow to fully support the ball shaped top of the femur. This results in the hip joint being loose and, in severe cases, the femur can slip out of the socket. While often diagnosed at birth, many cases are not discovered until adolescence or young adulthood.
In adults and adolescents, the symptoms of hip dysplasia can be subtle at first and often mimic other hip injuries.
Groin Pain: A deep ache in the groin area that may increase with activity or during long periods of standing.
Hip Instability: A sensation that the hip is loose, sliding, or unable to support the body’s weight.
Limping: A change in walking pattern to compensate for joint instability or pain.
Snapping or Popping: Audible or felt clicking in the joint, which can indicate that the labrum is being pinched or torn due to the shallow socket.
Uneven Leg Length: In some cases, one leg may appear shorter than the other if the hip is partially dislocated.
Physical Exam
X-rays: The most important tool for diagnosis to evaluate for variations in the normal bony anatomy.
MRI: Often used to check for damage to the labrum or the articular cartilage, which frequently occurs when the bone structure is poorly aligned.
CT Scan: Provides a three dimensional view of the hip, helping plan for corrective procedures by showing the exact shape of the socket.
The goal of treatment is to reposition the joint to prevent early onset osteoarthritis and provide long term stability. If caught early in adulthood, a PAO surgery can often preserve the natural hip joint for decades. Physical therapy is a vital component of any treatment plan, focusing on strengthening the gluteal muscles and the core to help hold the femur in place more securely.
Treatment Approach:
Physical therapy to strengthen the surrounding muscles and stabilize the joint.
Surgical (PAO): Periacetabular osteotomy, where the socket is cut and rotated to better cover the ball of the femur.
Severe/Advanced: Total Hip Replacement if the joint has already developed significant arthritis.