Hip Dysplasia: Diagnosis, Treatment and Management Beyond Infancy

  Hip Dysplasia

Written by: Duncan Nichols-Delay



Introduction:

    Hip Dysplasia is a medical condition where the hip socket, also known as the acetabulum, covers a smaller amount of the head of the femur. Typically, during infancy, the hips are checked regularly to ensure that there is no instability. Roughly 40% of infants have instability but due to the growing period in infancy, this is typically seen as a minor issue. According to Asturias about 5 in 1000 will eventually develop hip dysplasia. If it goes undiagnosed, it is believed to be a leading cause in the development of hip osteoarthritis, which is when the cartilage within the hip breaks down. Gala reports that 20-40% of those with hip osteoarthritis also have hip dysplasia.  

        Jorgensen talked about how many will get a diagnosis later in life, typically as teenagers, where a common complaint is groin pain for an extended period of time. Hip Dysplasia is more commonly found in females compared to males, and typically found in those born in a breech position which is when you are born feet first.

        Currently, there is limited research on the treatment of hip dysplasia. In many cases of hip dysplasia, surgery (typically a periacetabular osteotomy as described by Stanford Medicine here) is performed to realign the acetabulum of the hip. This is typically completed if non-surgical treatments such as physical therapy does not fix pain and other issues that may be present. Currently, for many with borderline dysplasia, there may be limited options, as surgical interventions might not be an option.

Diagnosis:

        Hip Dysplasia is currently diagnosed through a radiograph, where they look at what is called the lateral-center-edge angle (LCEA). A vertical line is drawn from the centre of the femoral head, and another line is created from the centre to the most lateral weight bearing part of the acetabular sulcus as shown below. If the angle created is less than 20o then it is considered hip dysplasia. Somewhere between 20-25o is considered borderline dysplasia. A normal hip is expected to be between 25-40o. 

Image from O'Brien (2023)

Practical Applications:
  • Early diagnosis of HD is important, delayed treatment can speed up deteriorating changes of the hip
  • Using physical therapy as a treatment will rely on individualized approaches, based on the degree of hip dysplasia
  • An emphasis on education and creation of a long-term strength training program will be important to support long-term hip function

Call to Action:
  • Future research should be conducted on management of Borderline Hip Dysplasia
  • More studies should look at comparison of physical therapy as a viable treatment option
  • Continue to create more education on Hip Dysplasia for those with the medical condition
More information can be seen at hipdysplasia.org/

Video from Boston Children's Hospital: Understanding Hip Dysplasia

About the Author:



        Duncan Nichols-Delay is a current senior at Westfield State University, who is graduating in the spring of 2026. He will be graduating with a B.S. in Movement Science, Sports Medicine Concentation with a minor in psychology. After graduation he plans to pursue a Doctorate in Physical Therapy. He can be contacted at duncannicholsdelay@gmail.com

He can be followed on LinkedIn

References:

Asturias, A., Kiani, S., Sadjadi, R., & Swarup, I. (2025). The Treatment of Hip Dysplasia in Adolescent Patients. Current Reviews in Musculoskeletal Medicine. https://doi.org/10.1007/s12178-025-09953-y


Gala, L., Clohisy, J. C., & Beaulé, P. E. (2016). Hip Dysplasia in the Young Adult. The Journal of Bone and Joint Surgery, 98(1), 63–73. https://doi.org/10.2106/jbjs.o.00109


Jorgensen, M. D., Frederiksen, S. B., Sørensen, D., & Jacobsen, J. S. (2021). Experiences of living with developmental dysplasia of the hip in adults not eligible for surgical treatment: a qualitative study. BMJ Open, 11(12), e052486.https://doi.org/10.1136/bmjopen-2021-052486


Latchem-Hastings, J. (2021, February 18). Get CreActive – Raising Awareness of Adult Hip Dysplasia. Cardiff University. https://blogs.cardiff.ac.uk/centre-for-trials-research/get-creactive-raising-awareness-of-adult-hip-dysplasia/ 


Loder, R. T., & Skopelja, E. N. (2011). The Epidemiology and Demographics of Hip Dysplasia. ISRN Orthopedics, 2011, 1–46. https://doi.org/10.5402/2011/238607


O’Brien, M. J. M., Heerey, J., Semciw, A. I., Mechlenburg, I., Jacobsen, J. S., King, M. G., Scholes, M. J., Lawrenson, P. R., Crossley, K., Agricola, R., Souza, R. B., & Kemp, J. L. (2023). Does hip muscle strength and functional performance differ between football players with and without hip dysplasia? Physical Therapy in Sport: Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, 64, 1–7. https://doi.org/10.1016/j.ptsp.2023.08.002







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