Adult Hip Dysplasia Specialist

Hip dysplasia in adults is a condition where the hip socket does not fully cover the ball portion of the upper thighbone. This partial coverage can lead to joint problems. The prevalence of hip dysplasia varies, but it is recognized as a significant cause of hip osteoarthritis in adults. The condition can lead to pain and mobility issues.

  • Are your symptoms affecting your quality of life? Consult our MOH-accredited hip dysplasia specialist for a comprehensive diagnosis of your condition & a personalised treatment plan.
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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

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Understanding the Anatomy of the Hip

The hip is a ball-and-socket joint, one of the largest joints in the human body. It plays a crucial role in supporting the body’s weight and allowing for a wide range of movement. The key components of the hip joint include the femur (thighbone), specifically the femoral head which forms the ball part of the joint, and the acetabulum, a cup-shaped socket in the pelvic bone.

The femoral head fits into the acetabulum, creating a joint that allows for significant mobility while being stable. The surfaces of both the femoral head and the acetabulum are covered with articular cartilage, a smooth tissue that cushions the bones and enables them to move easily. Surrounding the joint is a complex arrangement of ligaments, tendons, and muscles that provide additional support and control the movements of the hip.

In a healthy hip, the femoral head and acetabulum align perfectly, allowing for smooth, pain-free movement. In cases of hip dysplasia, this alignment is disrupted, leading to issues with joint stability and movement.

Causes of Hip Dysplasia in Adults

Adult hip dysplasia primarily originates from developmental issues that occur during the early stages of hip formation. While it can be diagnosed in infancy or childhood, in some cases, it remains undetected until adulthood. Several factors contribute to the development of hip dysplasia in adults:

  • Genetic Predisposition - There is a hereditary aspect to hip dysplasia, suggesting a genetic predisposition in some individuals.
  • Developmental Factors - Improper development of the hip joint during fetal growth can result in dysplasia. This may be influenced by environmental factors or the baby’s position in the womb.
  • Childhood Hip Problems - Conditions like developmental dysplasia of the hip (DDH) in infancy, if not adequately treated, can lead to hip dysplasia in adulthood.
  • Lifestyle and Environmental Factors - Factors such as obesity or certain activities might exacerbate underlying hip issues, contributing to the development of dysplasia in later life.

Symptoms and Early Detection

Identifying hip dysplasia in adults at an early stage is crucial for effective management and treatment. The symptoms can vary in intensity and may develop gradually, making early detection challenging. Key symptoms include:


  • Pain in the Hip or Groin Area: Often the first and most common symptom, pain can occur during activities such as walking or running, and may also be present during rest in advanced cases.
  • Stiffness and Reduced Range of Motion: Difficulty in movements like bending or rotating the hip may be a sign of hip dysplasia.
  • Limping or Altered Gait: A change in walking pattern, often due to discomfort or reduced hip mobility, can indicate underlying hip dysplasia.
  • Discomfort in Prolonged Sitting: Pain or discomfort when sitting for extended periods, especially in low chairs, can be a symptom.
  • Audible Clicking or Popping Sounds: Some individuals may experience clicking or popping noises in the hip joint during movement.

Early detection often involves a clinical examination by a healthcare professional, who may look for signs of hip dysplasia and assess the range of motion in the hip. If hip dysplasia is suspected, further diagnostic imaging tests, such as X-rays or MRIs, are typically recommended to confirm the diagnosis and assess the severity of the condition.

How Do I Know if I Have Hip Dysplasia?

Identifying hip dysplasia in adolescents or young adults typically begins with recognising specific symptoms, notably hip pain and/or a limp. The key points to consider are:

  • Location and Nature of Pain: The pain associated with hip dysplasia is often felt in the groin area and/or the lateral aspect of the hip. This pain tends to increase with activity and diminishes with rest.
  • Sensations During Movement: Many individuals experience sensations like catching, snapping, or popping in the hip, particularly during activities.
  • Persistent Symptoms and Seeking Opinions: It is not uncommon for adult patients with hip dysplasia to consult multiple healthcare providers and experience symptoms for several years before receiving a correct diagnosis. If hip pain worsens without a clear reason, it is advisable to seek a second opinion.
  • Professional Medical Assessment: Consulting with a healthcare provider for a thorough evaluation is essential. This includes a review of medical history, physical examination focusing on hip mobility and alignment, and possibly diagnostic imaging tests like X-rays or MRIs.
  • Awareness of Symptoms and Timely Action: Being vigilant about persistent hip pain, changes in mobility, or unusual sensations in the hip area, and seeking timely medical advice are crucial steps in identifying hip dysplasia.

Self-diagnosis is not reliable. Professional medical evaluation is necessary to accurately diagnose hip dysplasia and differentiate it from other conditions that may cause similar symptoms.

Diagnosis Of Adult Hip Dysplasia

The diagnosis of adult hip dysplasia involves a series of steps to accurately assess the condition of the hip joint:

Initial Clinical Assessment

A healthcare professional conducts a physical examination to evaluate symptoms, hip mobility, and joint alignment. This assessment includes observing the patient’s walk, range of motion in the hip, and checking for any discomfort or abnormal movements.

Medical History Review

A thorough discussion of the patient’s medical history, including any previous hip problems, family history of hip dysplasia, and developmental milestones, provides important context for the diagnosis.

Imaging

X-rays are the primary tool for diagnosing hip dysplasia. They provide clear images of the hip joint, showing the alignment of the femoral head and acetabulum, and any signs of joint wear or osteoarthritis.

In some cases, additional imaging methods such as Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans may be used to gain a more detailed view of the hip joint and surrounding tissues.

Consultation with Specialists

Referral to an orthopaedic specialist with experience in hip dysplasia is often part of the diagnostic process. They can provide a more comprehensive evaluation and discuss potential treatment options.

Are There Non-Surgical Treatments Available for Adult Hip Dysplasia?

Non-surgical treatments may provide temporary relief, but they often do not offer a lasting solution, as the joint’s fundamental malformation remains unaddressed.

  • Weight Management
    Losing weight is one of the most effective non-surgical approaches. Even a modest reduction in weight can significantly decrease the pressure on the hip joint, thereby reducing pain and slowing the progression of damage.
  • Use of Assistive Devices
    Employing a cane or similar assistive devices can help in distributing weight away from the affected hip, offering relief from discomfort.
  • Physical Therapy and Exercise
    While these can improve muscle strength and joint flexibility, their role is more about managing symptoms rather than correcting the underlying dysplasia.
  • Pain Management
    Medications like NSAIDs can be used for pain relief, but they should be taken as directed and are not a substitute for addressing the structural issues of the hip.

Surgical Interventions

For adult hip dysplasia, various surgical interventions are available, each tailored to the specific needs of the patient based on the severity and progression of the condition:


  • Hip Arthroscopy: This is used concomitantly with periacetabular osteotomy (PAO) to address labral pathology or evaluate chondral injuries. Hip arthroscopy alone is not recommended as it doesn’t treat the underlying cause.
  • Periacetabular Osteotomy (PAO): Involves osteotomies in the pubis, ilium, and ischium near the acetabulum for three-dimensional correction. Performed via a modified Smith-Petersen approach, it may lead to a retroverted acetabular cup post-hip arthroplasty.
  • Salvage Osteotomies: Includes Chiari and Shelf Osteotomies. The Chiari Osteotomy involves shifting the ilium laterally, while the Shelf Osteotomy adds a bone buttress to the lateral acetabulum.
  • Hip Resurfacing: Involves a posterior approach and is limited by its inability to address limb length, with risks including postoperative femoral neck fracture.
  • Total Hip Arthroplasty (THR): Uses various approaches with specific techniques like trochanteric osteotomy for improved visualization. The goal is to restore normal hip biomechanics, potentially requiring femoral shortening and medialization of components for stability.

Schedule An Appointment With Us

Are Your Symptoms Affecting Your Quality Of Life?

Consult our MOH-accredited hip dysplasia specialist for a comprehensive diagnosis of your condition & a personalised treatment plan.

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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

With over 18 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.

  • Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
  • Member, Royal College of Surgeons of Edinburgh (MRCSEd)
  • Master of Medicine (Orthopaedic Surgery), National University of Singapore
  • Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
  • Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany

 

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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
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    Mount Elizabeth Novena Specialist Centre
    38 Irrawaddy Road, #08-62/63
    Singapore 329563