Acetabular Dysplasia

What is acetabular dysplasia?

Acetabular dysplasia is a condition defined by inadequate development of the acetabulum, which is shallow and “dish shaped” rather than “cup shaped”.  The condition is most commonly associated with a subtle abnormality of the hip joint at birth (congenital hip dislocation) and usually remains undetected for many years. Sometimes acetabular dysplasia can develop as the result of other childhood hip conditions such as infection, trauma or Perthes disease.

 

 

What is the natural course of acetabular dysplasia?

Figure: Severe acetabular dysplasia

Hip joints which are abnormally shallow are predisposed to progressive damage to the cartilage. This leads to osteoarthritis. Acetabular dysplasia is one of the leading causes of hip joint osteoarthritis, particularly in women.

Acetabular dysplasia causes symptoms when enough damage has occurred in the joint.  The first symptom is often mild groin discomfort.  Once the joint becomes painful, gradual deterioration of the hip joint can reliably be predicted, although the time course is unpredictable.  A reduction in activity levels may reduce symptoms. Most patients experience ongoing discomfort which gradually worsens over many years, even decades. Patients with very shallow hip joint sockets who have developed symptoms around the age of 20 rarely get beyond their early thirties without requiring an artificial joint replacement.

 

What is the treatment for acetabular dysplasia?

Hip replacement is the surgical treatment for acetabular dysplasia.  There are a number of considerations in deciding the best time to do this operation.  Artificial joint replacements are reliable and safe. However, younger patients have a much higher chance over their lifespan of requiring increasingly complex re-operations to revise failed artificial joint replacements. In selected patients, early surgical intervention can slow or prevent the progression of joint damage and improve symptoms.  Knowing which procedure is most appropriate for an individual patient requires clinical assessment.