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Hip Dysplasia

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What Is Hip Dysplasia?

Hip dysplasia, or acetabular dysplasia, is a disorder that results in an incorrectly shaped hip socket. Often, the hip socket does not fully cover the head of the femur (thigh bone), creating an unstable hip. It's usually present at birth.

Hip dysplasia is common. Doctors treat about 1 out of 100 infants for hip dysplasia.

But sometimes the symptoms don't appear until later in life, and the disease goes undiagnosed until adulthood.

Left untreated, it can lead to painful hip problems in adults. It's the leading cause of hip arthritis for people under 60.

Causes of hip dysplasia

Doctors don't know exactly what causes hip dysplasia, but they do know it runs in families.

It occurs most often in the left hip, possibly due to the baby's position in the womb.

Hip dysplasia risk factors and complications

Hip dysplasia happens more often in:

  • Girls.
  • First-born babies.
  • Large babies without much space to move in the womb.
  • Babies born feet first (breech).
  • People with a family history of hip dysplasia.

Pediatricians check for hip dysplasia in babies by gently moving the legs around. If they suspect hip dysplasia, they'll order an ultrasound to be sure.

Sometimes babies need to wear a brace to mold the ball of the joint into shape.

But hip dysplasia often goes undetected. It rarely causes pain in children.

Over time, the hip joint becomes unstable and movement is painful.

How to prevent hip dysplasia

There's no real way to prevent hip dysplasia from happening. But the earlier doctors catch it, the more they can do to prevent it from getting worse.

Doctors may prescribe activity adjustments, physical therapy, or surgery.

Why choose UPMC Orthopaedic Care for hip dysplasia?

U.S. News and World Report ranks us as one of the best orthopaedic programs in the nation. Here are just a few of the reasons why:

  • Experts in sports medicine. As experts in preventing and treating sports-related injuries, we know the problems athletes face. We know you want to stay active and keep playing the sport you love. We use the most advanced treatments and therapies to make that happen.
  • Interconnected services. We offer one place for all your orthopaedic needs. Our doctors, nurses, and physical therapists provide complete care — from diagnosis through recovery and rehab. We coordinate all of your care, so all you have to focus on is getting better.
  • Many ways to rehab. We have more than 70 locations throughout the region where you can go for outpatient rehab.
  • Unmatched in research. We are leaders in the western Pa. region for NIH-funded orthopaedic research and clinical trials. We're always seeking better ways to diagnose and treat conditions such as sports hernia.
  • Specialty programs. With specialists in each type of orthopaedic injury and condition, we have the experts to cater to your specific needs. The Hip Preservation Program at UPMC Orthopaedic Care specializes in hip problems from the mild to the severe, including hip dysplasia.

Hip Dysplasia Symptoms and Diagnosis

Hip pain occurs with many different conditions. Only a doctor can diagnose hip dysplasia with certainty.

If you notice one or more of these hip dysplasia symptoms, you should see a doctor.

  • Limp (with or without pain).
  • Pain in the front of the groin.
  • Muscle ache on the side or front of the hip.
  • Hip pain that increases when walking, standing, or running.
  • Hip pain at night when resting.
  • A popping, locking, snapping — often painful — feeling in the hip joint.
  • Hip pain that gets worse over time.

Diagnosing hip dysplasia

Doctors diagnose hip dysplasia through both an exam and tests.

  • Physical exam. The doctor will have you move your hip through a range of motion. They will look for pelvic tilt, a limp, or a difference in leg length. They'll also ask if you have pain when walking or standing.
  • X-rays. A shallow hip socket will be visible on an x-ray taken at a certain angle. (To get accurate x-rays, it's vital to see a doctor who specializes in hip problems.)
  • CT scan. A CT scan is more detailed than an x-ray and can help your doctor see how severe your hip dysplasia may be.
  • MRI. An MRI can show the doctor if there's damage to the cartilage around the hip bone.

Hip Dysplasia Treatment

The earlier doctors diagnose hip dysplasia, the more treatment options you'll have.

The doctors at the Hip Preservation Program at UPMC Orthopaedic Care are experts in treating diseases of the hip. Their goal is always to preserve and restore hip function, so you can lead an active and normal life.

Without treatment, your hip will become more and more painful, and may eventually wear out leading to arthritis.

Types of treatment for hip dysplasia

Your doctor may suggest one or more of the following options:

Lifestyle changes

If your hip dysplasia hasn't caused much damage to the bone or cartilage, lifestyle changes, and activity adjustments may help.

  • Losing weight will relieve pressure on the hip joint.
  • Switching from a high-impact sport like running to a low-impact one like swimming or biking may also reduce wear and tear.

Your doctor may prescribe physical therapy to increase joint function and range of motion.

Medicine to treat hip dysplasia

Doctors might give you an injection or prescribe anti-inflammatory drugs to relieve pain and help delay or avoid surgery. Physical therapy, focused on strengthening, is essential. 

Hip surgery

Sometimes surgery is the best treatment for hip dysplasia.

The type will depend on your age, level of activity, and if hip damage has occurred.

Periacetabular osteotomy (PAO) surgery

If possible, your doctor will try to preserve your natural hip, especially if you're younger than 40. PAO surgery can delay the need for a total hip replacement for typically 10 or 20 years.

In PAO surgery, the doctor:

  • Makes four cuts in the pelvic bone.
  • Rotates the hip socket to a more normal position.
  • Uses screws to hold the bones in place.

The surgery takes two to three hours and you'll stay in the hospital for a few days afterward.

Hip replacement

If the joint surface and cartilage is very thin or worn, your doctor may suggest a total hip replacement. Surgery takes one to two hours and you may go home the same day.

Doctors urge you to stay active while you heal from hip replacement surgery. Walking a little more each day will help increase your range of motion.

You should be able to resume most normal activities within three to six weeks after surgery.

Physical therapy can help as you transition back to your normal routine.