Understanding Hip Dysplasia


Adolescent Hip Dysplasia is usually one of two types. The first type is adolescent hip dysplasia that never fully recovered after treatment during early childhood. The second type is more common, and like adult hip dysplasia is caused by a shallow socket that never became deep enough to fully support the forces acting on the hip joint.

Many adolescents with the first type that was treated in childhood often have abnormalities of the socket and the ball — the acetabulum and the femoral head. When symptomatic or when getting worse, this generally requires surgery to correct both the acetabulum and the femoral head abnormalities.

Adolescents with the second type have fewer problems on the femoral head side of the joint and can usually be managed by surgery on the pelvic side only.

The treatment of these two types of hip dysplasia require special skill and additional training, but it is often possible to repair both types of adolescent hips with today’s surgical techniques.

Managing Your Treatment

Asking questions and being honest about how you are feeling is a powerful tool in your health care. As a teen, be sure to communicate your needs and hurdles. When you visit the doctor, your parents may ask most of the questions, but don’t be afraid to ask your own questions. Good doctors are very interested in your feelings and questions. You can also ask to have the doctor step out of the room for a minute if you want to speak to your parents privately, or to give them questions to ask the doctor when he/she returns. 

As you know, social media is today’s way of sharing and expressing yourself. That’s one reason why IHDI has Facebook, Twitter and YouTube accounts for you to post your experiences and connect with others just like you. You can also contact IHDI for answers to questions you can’t find on the IHDI website. So, please connect with us for a better understanding of Hip Dysplasia.

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How do I know if I have hip dysplasia?

The first sign of hip dysplasia in an adolescent or young adult is typically hip pain and/or a limp. This is usually in the groin area and/or side of the hip. Pain is usually increased by activity and diminished by rest. Often there is a sensation of catching, snapping or popping in addition to pain with activities. Patients with adolescent hip dysplasia may see more than three healthcare providers and have symptoms for a long time before a correct diagnosis is made, so you may want to consider getting a second opinion if your hip pain is getting worse for no apparent reason. To learn more about symptoms and diagnosis, click here. 

Is there a cure for hip dysplasia?

Sooner or later, most people with hip dysplasia need surgery to build better support for the hip. In the early stages of arthritis from hip dysplasia, some of the cartilage surface may be intact and hip preservation surgery is possible to re-align the joint. Re-aligning the joint allows the remaining joint surface to be in a better position for weight-bearing. Doctors often compare the joint surface to the tread on a tire that wears down with use. When the tire is out of balance, the tread will wear out faster. Sometimes the tire tread has uneven wear with large areas intact. If the tires are rotated before the tire wears out completely, then the remaining tread is in a better position to last longer. To learn more about hip preservation surgery, click here.

More surgery can also help many adolescents with dysplasia that’s still present after childhood treatment. These usually require surgery on the pelvis and on the femur to restore support for both sides of the hip joint.

Sometimes the abnormal shape of the joint leads to tears in the soft rim of the socket because of instability. This rim is called the labrum and a torn labrum can sometimes be repaired by arthroscopic surgery. Athletes with trauma causing a torn labrum often benefit from arthroscopic surgery. However, arthroscopic surgery is rarely a long-term solution for hip dysplasia unless the underlying bone deformity is corrected at the same time as labral repair. To learn more about arthroscopic surgery, click here.

Are there non-surgical treatments available for adolescent hip dysplasia?

Unfortunately, non-surgical methods rarely provide a lasting solution for hip dysplasia because the joint itself is not properly formed. To learn more about non-surgical treatments, click here. Some lifestyle changes can be made to preserve the life of the hip joint. Using a cane or losing weight are the best ways to decrease the pressure on your hip joint, and a little weight loss can make a big difference.

Hip Anatomy and Terminology

The hip is the largest “ball-and-socket” joint in the body. It is held together by ligaments, tendons, and a joint capsule.

The ball is called the “femoral [fem-er-uhl] head,” which is the top of the femur or thigh bone.

The socket is called the “acetabulum” [as-i-tab-yuh-luhm] and is a part of the pelvis.

The femoral head fits into the acetabulum forming the hip joint. They fit together so the ball can rotate freely in the socket.

Articular cartilage is a very smooth surface that covers the femoral head and the acetabulum so that the hip joint glides easily during motion.

The labrum is a soft rim that lines the edge of the acetabulum. The labrum creates a seal of the hip joint. This seal helps keep an oily fluid called synovial fluid inside the hip joint. The labrum also helps stabilize the hip. The hip is also stabilized by the surrounding muscles, ligaments, tendons and joint capsule.

Doctors use a number of different terms for hip dysplasia depending on severity and time of occurrence. These names include:

  • Hip Dysplasia
  • Developmental Dislocation of the Hip (DDH)
  • Hip Dislocation
  • Developmental Dysplasia of the Hip (DDH)
  • Acetabular Dysplasia
  • Congenital Dislocation of the Hip (CDH)

Abductor muscles lift the leg to the side and keep the pelvis level when walking. If the hip socket is shallow, then these muscles must work harder.

Psoas muscle also called the Iliopsoas muscle. This is a flexor of the hip and must work harder when the hip socket is shallow. The section that runs across the front of the pelvis and hip joint may cause a snapping feeling or noise as the hip moves underneath this muscle.   

Adductor muscles are the inner thigh muscles that bring the thighs together. These are rarely painful in people.