Hip dysplasia is an abnormality of the hip that often develops
before and after birth and possibly later during the adolescent
growth spirt. Grossly unstable hips are usually diagnosed
and treated in infancy and any residual problems typically
become manifest later in adulthood. At least 2/3rds of patients
with hip dysplasia were not aware of any abnormality of the
hip until the hip began to hurt as an adult. The problem tends
to run in families. 90% of dysplastic hips that require surgical
correction are in girls and women. In contrast, if hip dysplasia
occurs is diagnosed in a boy or man, it probably has a stronger
tendency to run in families. Relatives may choose to get a
single xray of the pelvis to see if they have hip dysplasia
too.
Most hip dysplasia involves under-development of the socket,
or acetabulum. This is referred to as acetabular dysplasia.
If the joint is round and rotates well and the hip does not
have advanced arthritis, the hip is usually best treated by
periacetabular osteotomy.
Sometimes, the ball of the femur is abnormally developed
and this is referred to as femoral dysplasia. Femoral dysplasia
can occur by itself or in combination with acetabular dysplasia.
If the femoral dysplasia occurs by itself and the hip is not
yet worn out, it can be corrected by femoral osteotomy to
correct the deformity, usually in combination with hip arthroscopy
to deal with whatever cartilage tears may have already occurred.
If the hip is affected by both acetabular and femoral dysplasia,
the problem can sometimes be treated just by correcting the
acetabular dysplasia. More severely involved hips require
correction of both the acetabulum and femur.
Dr. Murphy has spend over 20 years studying dysplastic
malformations of the hip. This work has included quantification
of the three-dimensional malformations, prediction of the
joint contact pressures in the dysplastic hip, and prediction
of joint contact pressure reduction achieved by periactetabular
osteotomy, and study of the natural history of untreated dysplasia.
Related work includes refinements of surgical techniques for
periacetabular osteotomy and methods of predicting outcomes
following surgical correction.
For more information about hip dysplasia, click on
the links below.
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