Negative Consequences of Hip Dysplasia

Abnormal hip joint development causes 25-50% of all hip disease, according to an article by Goldstein and colleagues on hip dysplasia in the skeletally mature patient. An acetabulum that is dysplastic tends to be shallow and anteverted while the dysplastic femur tends to have a small femoral head and an increased neck shaft angle. These abnormalities cause increased joint contact pressures and lead to joint breakdown in the hip, and are associated with issues such as altered hip and knee biomechanics, hip instability, hip impingement, and labral or chondral dysfunction.

Developmentally, the altered joint surface contact also affects acetabular development: the well-formed contact pressure in healthy hip development helps to deepen the acetabulum. The shape and position of the acetabulum and femoral head will also influence the relative angle of the femoral neck, represented as retroversion or anteversion. Soft tissue changes occur in response to the altered bony mechanics that affect length-tension curves in the muscles and therefore affect muscle performance. Because of the primary and secondary dysfunctions that can occur with hip dysplasia, early recognition of hip dysfunction is important.

Measurements for hip position are easy to implement in the clinic and can include Craig's Test for femoral anteversion/retroversion. Treatment approaches focusing on hip abduction strengthening have been demonstrated to improve hip stability in patients with dysplastic hip. With shared structures including muscles between the hip and pelvis, pelvic rehabilitation providers must be able to assess the hip's influence on conditions of pelvic pain or other dysfunctions. To learn about detailed examination and treatment of the hip, there is still time to register for the Institute's upcoming continuing education course instructed by Ginger Garner.