Dysplastic Hip in Adults

A dysplastic hip is a hip joint in which the socket is not deep enough to fully cover and support the ball of the hip joint. This can put extra stress on the tissues and cartilage around the hip and may cause pain, damage to the joint and, over time, arthritis.

Some people have hip dysplasia from childhood but do not develop symptoms until they are adults.

What is a dysplastic hip?

The hip is a ball-and-socket joint. The ball at the top of the thigh bone (femur) fits into a socket in the pelvis.

Normally, the socket covers the ball well and allows the hip to move smoothly.

In a dysplastic hip, the socket is relatively shallow and does not cover the ball as well as it should. The severity can vary from person to person.

Some people with hip dysplasia have no symptoms. In others, the abnormal stress on the hip can gradually damage the tissues and cartilage of the joint.

What are the symptoms of hip dysplasia?

You may have:

• Pain in the groin or around the hip

• Pain that gets worse with walking, running or exercise

• Clicking or catching in the hip

• A feeling that the hip is unstable

• Stiffness or difficulty moving the hip

• Difficulty with prolonged walking or standing

• Pain during sports or other physical activities

Some people may have hip dysplasia without having any symptoms.

Why does a dysplastic hip cause pain?

When the socket does not cover the ball properly, the forces passing through the hip may be concentrated over a smaller area.

Over time, this can damage the tissues and cartilage around the hip. In some people, this can eventually lead to arthritis.

How is a dysplastic hip diagnosed?

Your doctor will first ask about your symptoms and examine your hip.

X-rays are usually the most important test. They show the shape of the hip and how well the socket covers the ball.

An MRI may sometimes be needed to look for damage to the cartilage or other tissues around the hip.

Additional scans may be needed in some patients, particularly when surgery is being considered.

Does everyone with a dysplastic hip need treatment?

No.

Some people have hip dysplasia but do not have any symptoms and may not need treatment.

If symptoms are mild, treatment may include:

• Exercise and physiotherapy

• Modifying activities that cause pain

• Medicines when appropriate

• Strengthening the muscles around the hip

The treatment depends on your symptoms and the condition of your hip, not just how the hip looks on an X-ray.

Can hip dysplasia be treated without surgery?

Yes.

Many people can manage their symptoms with exercise, physiotherapy and changes to activities.

These treatments can help reduce pain and improve the strength and control of the muscles around the hip. However, they do not change the shape of the hip socket.

If pain continues or the hip is becoming damaged, surgery may need to be considered.

When is surgery considered?

Surgery may be considered when:

• Pain continues despite appropriate non-surgical treatment

• The hip is affecting your daily activities or sports

• The hip is showing signs of damage

• There is a significant risk of further damage to the joint

The type of surgery depends on the condition of the hip.

What type of surgery may be recommended?

If the hip is painful but the joint is still in good condition, hip-preserving surgery such as periacetabular osteotomy (PAO) may be considered in selected patients. If the hip has already developed significant arthritis and the joint is badly damaged, total hip replacement may be recommended.

Will I need a hip replacement if I have hip dysplasia?

Not necessarily.

Having a dysplastic hip does not automatically mean that you will need a hip replacement.

If the hip is still in good condition, hip-preserving treatment may be possible in selected patients. If significant arthritis has developed and the joint is badly damaged, hip replacement may provide better pain relief and function.

What happens if hip dysplasia is not treated?

Not everyone with hip dysplasia will develop problems.

However, in some people, continued abnormal stress on the hip can gradually damage the cartilage and lead to arthritis.

If you have persistent pain or increasing difficulty with your hip, it is therefore worth getting it assessed rather than simply ignoring the symptoms.

Can I play sports with hip dysplasia?

It depends on your symptoms and the condition of your hip.

If you have no pain, you may be able to remain active.

If running, jumping or other activities repeatedly cause pain, modifying those activities may help. Persistent pain during sports should be assessed to determine the cause and the best way to manage it.

When should I see an orthopaedic surgeon?

You should consider seeing an orthopaedic surgeon if you have:

• Persistent hip or groin pain

• Pain while walking, running or exercising

• Repeated clicking or catching in the hip

• A feeling that the hip is unstable

• Increasing stiffness or difficulty moving the hip

• Known hip dysplasia with new or worsening symptoms

• Hip pain that is affecting your work, sleep, sports or daily activities

Early assessment can help determine the condition of your hip and whether treatment is necessary.