Dysplasia
The hip is a ball-and-socket joint, with the femoral head forming the ball and the acetabulum forming the socket. Hip dysplasia is a congenital condition, meaning it is present from birth, in which the acetabulum is too shallow. This under-coverage of the femoral head means the socket does not fully support the femur, concentrating weight on a smaller area of the joint.
This imbalance can lead to hip instability, labral tears, and early-onset arthritis. If left untreated, hip dysplasia may increase the likelihood of needing a hip replacement at a younger age.
Causes
Hip dysplasia is a developmental condition that can result from factors affecting the hip joint during early development, including:
- Injury in utero or during early childhood
- Infections during early development
- Position in the uterus
Certain patients are more likely to develop hip dysplasia:
- Females
- First-born children
- Large birth weight
- Breech position at birth
- Family history of developmental hip dysplasia
Hip dysplasia can contribute to early wear-and-tear of the hip joint, increasing the risk for osteoarthritis over time.
Symptoms
Patients with hip dysplasia may experience:
- Constant, achy hip pain
- Intermittent catching or locking sensations
- Groin or buttock pain
- Difficulty walking or performing daily activities
- Instability in the hip joint
- Excessive flexibility
Diagnosis
Diagnosis of hip dysplasia involves a comprehensive evaluation by Dr. Benjamin Domb and his team, including:
- X-Rays: Assess for abnormalities in the hip bones that suggest dysplasia.
- MRI: Evaluates cartilage, soft tissues, and bone structures of the hip.
- Physical Examination: Tests range of motion, joint stability, and pain with specialized maneuvers.
- Medical History: Reviews lifestyle, previous injuries or surgeries, and current symptoms.
Treatment Options
Treatment depends on the severity of the dysplasia, symptoms, and patient goals.
- Activity Modification and Rest: Avoiding certain activities can reduce stress on the hip joint.
- Physical Therapy: Strengthens surrounding muscles and improves hip stability and mobility.
- Medications: Anti-inflammatory medications may help manage pain and swelling.
If conservative treatments are insufficient, surgical intervention may be necessary to restore function and relieve pain.
Surgical Options
- Hip Arthroscopy: For mild dysplasia, minimally invasive arthroscopy can be performed to repair labral tears, remove damaged tissue, and tighten the hip capsule.
- Peri-Acetabular Osteotomy (PAO): Severe dysplasia may require a PAO, a procedure that corrects the bony alignment of the hip socket. Dr. Benjamin Domb and his team often combine arthroscopy with PAO to both repair labral damage and correct the underlying mechanical deformity. This combined approach addresses the source of pain and restores proper joint mechanics.
