Adolescent Hip Dysplasia: Symptoms, Diagnosis & Treatment

Overview of Adolescent Hip Dysplasia (AHD)

• Occurs when the hip joint doesn't develop normally.
• Can be recognized shortly after birth or later in life as adolescent hip dysplasia.
• In a healthy hip joint, the ball of the femur fits well in the pelvic socket; in AHD, they don't fit properly, causing pain and potential early arthritis.

Causes of AHD

• Exact causes are not always known.
• Often results from undiagnosed/untreated developmental dysplasia of the hip (DDH) in childhood.
• May emerge due to rapid growth spurts or increased activity during early teen years.

Prevalence

• More common in females.
• 25% chance of occurrence in first-degree relatives of those diagnosed.
• Higher risk in children with neuromuscular disorders.

Symptoms

• Pain in hip or groin area during activity.
• Decreased ability to engage in sports or activities due to pain or fatigue.
• Symptoms can include:
  • Hip/groin pain
  • Decreased endurance
  • Hip joint catching or locking
  • Limp or altered gait
  • Leg length differences
• Symptoms are progressive from mild to severe.

Diagnosis

• Physical examination by doctors.
• Imaging tests like X-rays, MRIs, or CT scans may be used to assess the hip joint.

Treatment Options

• Treatment tailored to severity and individual patient needs.
• Options include:
  • Activity modification
  • Physical therapy
  • Anti-inflammatory medications
  • Surgery (common for stability, pain relief, and delaying total hip replacement)
• Common surgery: Periacetabular Osteotomy (PAO), often combined with hip arthroscopy.

Surgical Recovery

• Post-surgery rehabilitation includes six months of physical therapy.
• Return to selected activities in 4-6 months; full recovery up to a year.
• Initial 4-6 weeks post-surgery: limited weight-bearing on the operated leg using crutches.
• Strengthening exercises begin 4-6 weeks after surgery.

Long-Term Outlook

• Positive long-term outcomes post-surgery.
• 90% experience pain relief 10 years after surgery; 75% still pain-free after 20 years.
• Some may develop arthritis or need hip replacement depending on dysplasia severity at surgery.
• Ongoing monitoring of joint health; transition to adult care when appropriate.

Additional Resources

• Cincinnati Children's Hip Preservation Program offers comprehensive care, including conditions treated, treatment options, patient resources, and research initiatives.
• Contact Cincinnati Children's for appointments, second opinions, or additional information on hip dysplasia.