December 26, 2025

Adult Hip Dysplasia: Symptoms, Diagnosis & Treatment Guide

Prepared by Op. Dr. Sedat Duman and Op. Dr. Muhammed Duman.

Adult hip dysplasia is a structural issue where the hip socket (acetabulum) does not sufficiently cover the ball (femoral head). Over time, uneven load distribution can lead to labral tears, cartilage wear and early hip arthritis. If you have deep groin pain and/or limping, hip dysplasia should be considered.

What is hip dysplasia and why does it matter in adults?

A healthy hip works as a stable “ball-and-socket” joint. In dysplasia, the socket is shallow or oriented in a way that does not fully support the femoral head. This concentrates stress on a smaller area and may gradually damage the labrum and cartilage.

In many adults, dysplasia is not “new”—it often exists since childhood but stays unnoticed until symptoms start later in life.

Who is at higher risk?

History of hip dysplasia or hip dislocation in childhood (even if treated)
Family history of hip dysplasia
Childhood risk factors such as breech birth
Joint laxity / hypermobility (loose ligaments)
Unexplained groin pain in a young or middle-aged adult

Symptoms: What should make you suspicious?

Deep groin pain (most typical), sometimes radiating to the side of the hip or the knee
Pain with activity (long walking, stairs, squatting)
Limping or reduced walking endurance
Clicking, catching or locking (often related to labral involvement)
Reduced range of motion or stiffness
In long-standing cases: low back or knee pain due to altered biomechanics

Tip: Many patients describe the pain as a “groin problem” rather than a “hip problem.” That’s why it may be confused with back or soft-tissue issues.

How is adult hip dysplasia diagnosed?

1) Clinical assessment

Your orthopaedic specialist will evaluate your gait, hip range of motion, muscle strength, tenderness points and any leg-length difference. Clinical findings raise suspicion, but imaging confirms the diagnosis.

2) X-rays

Pelvic and hip X-rays are the foundation of diagnosis. They show how well the socket covers the femoral head and whether there are signs of arthritis. Measurements on X-rays help determine severity and guide treatment planning.

3) MRI / CT (when needed)

MRI: evaluates the labrum, cartilage and other soft tissues
CT: provides 3D bony anatomy and can help surgical planning in selected cases

The goal is not only to confirm dysplasia, but also to understand severity and cartilage status to choose the right treatment.

Treatment options

Treatment is personalised and depends on age, activity level, pain severity, dysplasia degree and whether arthritis is present. In general, options fall into non-surgical management and surgery.

Non-surgical management

Activity modification: reduce high-impact loading (running/jumping) when it worsens symptoms
Weight management: lowers joint load
Physiotherapy: hip stabiliser strengthening, movement education and flexibility
Pain control: medication when appropriate
Injections: may provide temporary relief in selected patients (decision after clinical evaluation)

Non-surgical treatments do not “change the socket shape,” but they can improve function and reduce pain—sometimes significantly.

Surgical treatment

1) Hip-preserving surgery (PAO – Periacetabular Osteotomy)

If cartilage is reasonably preserved and the patient’s profile is suitable, PAO can be considered. The main goal is to reorient the socket so it covers the femoral head better and spreads load more evenly. This can reduce pain and may slow down progression towards arthritis.

2) Total Hip Replacement

If there is advanced arthritis, marked cartilage loss, night/rest pain or major functional limitation, total hip replacement is often the most reliable option for pain relief and mobility. In dysplastic hips, anatomy may be different, so surgical planning is tailored to the individual.

Which option is right for me?
This decision depends on your clinical exam and imaging—especially cartilage status and arthritis severity. Correct indication is key to success.

Recovery: What to expect

After PAO: you may need a protected weight-bearing period and a structured rehab plan; full recovery typically takes months.
After hip replacement: early mobilisation is encouraged; walking and daily activities usually improve quickly, but rehab and follow-ups are essential.

The strongest predictors of good outcomes are accurate diagnosis, correct indication, experienced surgical team and consistent rehabilitation.

When should you see an orthopaedic specialist?

Groin/hip pain lasting longer than 2–3 weeks
Limping or clear drop in walking endurance
Catching/locking sensation in the hip
Recurring hip pain in a young or middle-aged adult
Family history of dysplasia plus new hip symptoms

Frequently Asked Questions

Can adult hip dysplasia correct itself?

No. Dysplasia is structural and does not resolve on its own. However, symptoms can be managed with non-surgical options, and in suitable cases, surgery can provide a long-term solution.

Does hip dysplasia lead to arthritis?

It can. Because load distribution is uneven, the labrum and cartilage may wear faster, increasing the risk of early hip osteoarthritis. Early diagnosis and the right treatment plan can help.

Is PAO suitable for everyone?

No. PAO is usually considered when cartilage is preserved and arthritis is not advanced. Your eligibility is determined by your exam and imaging findings.

When is total hip replacement the better option?

If arthritis is advanced, cartilage loss is significant, pain occurs at rest/night, or function is severely limited, total hip replacement is often the most reliable choice.

Can I exercise with hip dysplasia?

In many cases, low-impact activities (swimming, cycling, controlled walking) are preferred. High-impact sports may worsen symptoms. The best plan should be tailored after clinical assessment.

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Your symptoms may be related to hip dysplasia. Let’s clarify the diagnosis and the most suitable treatment options for you.

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