Hip dysplasia
what is it?
Hip dysplasia is a term used to describe a hip joint that is not the correct shape and/or in the correct position to completely cover the head of the femur (thigh bone). The hip is a ball and socket joint and in hip dysplasia, the socket (acetabulum) is too shallow to offer adequate stability to the joint. This results in increased force and wear on the labrum and cartilage. Depending on the severity, individuals may experience dislocation or subluxation during everyday activities.
How is it treated?
Unfortunately, conservative approaches such as activity modification and NSAID use do not provide a lasting solution because the underlying problem is the abnormal structure of the joint. Symptoms only get worse with time and often lead to early onset osteoarthritis (OA). Therefore, the current best surgical option is a periacetabular osteotomy (PAO). PAO is a hip preservation procedure in which the acetabulum is fractured in 3 places and re-oriented with screws to better cover the femoral head. This surgery is preferred for younger patients so long as the articular cartilage has not sustained too much damage. A dGEMRIC MRI is often used to determine if a patient has enough cartilage to have a successful outcome following PAO. If not, the only other surgical option is a total hip arthroplasty (THA) aka total hip replacement.
dgemric index |
The above graph illustrates the relationship between dGEMRIC scores and PAO failure. My dGEMRIC index score was 380 ms and, as you can see, my risk of failure was rapidly increasing. Failure was defined as early arthroplasty (total hip replacement). Full publication of this study can be seen here.