Acetabular (Hip) Dysplasia in Adults

Acetabular (Hip) Dysplasia is a medical condition in which the hip sockets are not formed properly, so that they are too shallow to properly accommodate the hip joint.  This condition is more common in women than in men and may remain undiagnosed in childhood.  Many women suffering from hip dysplasia do not first experience hip pain until their late 20s or 30s.  Because the hip socket is shallow, extra pressure is placed upon the bone in the socket, causing it to deteriorate more quickly than in a ‘normal’ hip socket.  This is what causes pain to occur, as cysts and tears and eventually osteoarthritis begin to set in.

The first picture shows an X ray of a 29 year old woman with adult hip dysplasia. The second one shows an X ray of an elderly woman with normal hips.  Both of these pictures come from the Hip Dysplasia Institute Website.

Bilateral (both hips) Hip Dysplasia in a 29 year old female.

Normal hips in an Elderly Female

Hip Dysplasia is often diagnosed by measuring the centre-edge angle (C-E angle).  This is the angle from the centre of the hip joint, to the edge of the acetabulum (hip socket).  Normal hips have a centre edge angle of 25° or more.  This is explained more clearly in the diagram below.

Centre Edge Angle. Less than 25° may indicate hip dysplasia.

In adults, hip dysplasia can cause pain and mobility difficulties, especially as the condition of the joint worsens over time.  A common treatment for hip dysplasia is a peri-acetabular osteotomy (PAO).  This is an operation in which the pelvic bone surrounding the hip joint (acetabulum) is cut and realigned to alter the hip socket and provide more coverage for the hip joint.

X Ray of a PAO’d hip with screws holding the joint in its new position.

The new position is usually fixed in place with screws as you can see in X Ray 3.  This photograph comes from Louise’s great hiphoperation blog.

A PAO is quite a complex and major procedure which requires a lot of rehabilitation physiotherapy and aftercare.  Patients are usually on crutches for up to 8 weeks afterwards. It takes longer to recover from than a total hip replacement, but can potentially offer a better outcome because the original hip is preserved and patients typically have fewer restrictions on their movements and activities following surgery.

My surgeon is called Mr Johan Witt.  He works at the London Clinic and University College Hospital. You can find out more about hip dysplasia from his website:

http://www.hipjointsurgery.co.uk/hipdysplasia.html

Hip Chicks – keep on hobbling.

Other useful hip dysplasia links and blogs are:

Yahoo ‘Hip Women’ Group

Hip Chicks Unite

The Hip Dysplasia Institute

Hobbling Helly

WibblyWobbly’s blog

Princess PAO

Hip Hop Anonymous

My UK Hip Story

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