Acetabular (Hip) Dysplasia

Acetabular dysplasia is a condition defined by inadequate development of an individual's acetabulum. The resulting acetabulum is shallow and "dish shaped" rather than "cup shaped.” The upper portion (roof) of the acetabulum is obliquely inclined outward rather than having the normal horizontal orientation.

Symptoms and causes

Because of these abnormalities, the superior and usually anterior femoral head are incompletely covered by this dysplastic acetabulum. Individuals with acetabular dysplasia usually develop through childhood and adolescence without symptoms or knowledge of their abnormality.

By the age of 30 however the patient typically experiences pain from their hip and they often seek medical evaluation and an X-ray discloses the abnormality (acetabular dysplasia). Other patients may have been treated for hip problems as an infant or child.

Diagnosis

Acetabular dysplasia is associated with an abnormally high stress on the outer edge (rim) of the acetabulum which leads to degeneration of the articular cartilage (arthritis). It is also possible for breakdown of the acetabular labrum (rim cartilage of the acetabulum) or a fatigue fracture of the rim of the acetabulum to occur as a result of this rim overload. Any one or a combination of these conditions can cause hip pain sufficient for the patient to seek medical evaluation and treatment. When the diagnosis of acetabular dysplasia is made, the X-ray also usually shows a sign of arthritis which is most commonly an acetabular cyst though increased bone density, a femoral head cyst, osteophytes (bone spurs), and/or cartilage thinning may also be present.

If the dysplasia is left uncorrected, worsening of the arthritis is predictable and often progresses to a severe status within a few years and sometimes even a few months. For the patient, this means increasing hip pain, progressive loss of hip motion, and worsening functionality.

Treatment options

Periacetabular Osteotomy (PAO) is a surgical treatment for acetabular dysplasia that preserves and enhances the patient's own hip joint rather than replacing it with an artificial part.

The goal is to alleviate the patient's pain, restore function, and maximize the functional life of their dysplastic hip.  Read More on PAO.