The exact causes of abnormal hip joint development are not always known. 

Adolescent hip dysplasia is a common condition. It often stems from an undiagnosed or untreated case of developmental dysplasia of the hip (DDH) in childhood. The symptoms of DDH can be very mild during infancy and childhood and as a result, go unnoticed. When the condition shows up in teens, it was likely present earlier in childhood.

Adolescent hip dysplasia typically appears as a child grows and becomes more active (in the early teen years). This can be a result of a rapid growth spurt, the need for the hip to bear more load as the child gets bigger, or increased activity.

Those who are more likely to have adolescent hip dysplasia include:

• Females
• First-degree relatives of someone already diagnosed with hip dysplasia (25% chance of developing hip dysplasia)
• Children with neuromuscular disorders
• Children with high activity levels

Usually a child will begin to complain of pain in the hip or groin area when they are active. Other symptoms may include:

• Decreased ability to participate in sports or recreational activities due to hip pain or fatigue
• Increasing pain in the hip or groin
• Decreased endurance
• Hip joint catching or locking
• A limp or change in the child’s gait (how they walk)
• A difference in leg lengths

Symptoms vary from mild to severe. They are usually progressive and worsen over time.

Treatment varies depending on the severity of the hip dysplasia. The care team at Cincinnati Children’s tailors treatment to each patient and may include::

• Activity modification
• Physical therapy
• Anti-inflammatory medications
• Surgery

Surgery is often recommended to prevent or delay early arthritis and to increase stability of the hip. The most common surgery for adolescents to young adults with hip dysplasia is periacetabular osteotomy (PAO).

Surgery typically involves reshaping and/or repositioning the hipbones to create a normal hip socket. PAO is often performed along with other procedures, such as hip arthroscopy, which helps restore the hip joint.

At Cincinnati Children’s, we treat patients with adolescent hip dysplasia ranging in age from the early teens up through their 40’s. We treat adults with the condition because hip dysplasia is a condition that starts in childhood and we have extensive experience managing the disease over a child’s lifetime.

Overall recovery typically takes up to one year, with the most intensive part in the first two to four months post surgery. Rehabilitation after surgery typically consists of three to six months of physical therapy, after which the individual often returns to selected activities. 

While the bones are healing, for the first six weeks to three months, patients are not able to put their full weight on the operated leg. Crutches are usually used during this time. Your doctor will let you know when physical therapy can start. Exercises will strengthen the hip joint and prepare the hip to carry weight again.

For patients undergoing surgery, the long-term results of PAO and associated procedures are very good. The most common benefit is relief of pain so individuals can maintain or increase their hip function. Results can vary depending on how severe the disease is, but typical outcomes are as follows:

• Ten years after surgery, more than 90% of patients continue to enjoy a successful outcome with relief of pain.
• Twenty years after surgery, 80% will have continued relief of pain and their condition will not have progressed to arthritis.

Some patients may develop arthritis later in life. Others may need a hip replacement in the future depending on how advanced the dysplasia was at the time of surgery.