What is hip dysplasia

Hip dysplasia is an underdeveloped hip joint: the pelvic socket is shallow and does not fully cover the head of the thigh bone. It is often found in childhood, but mild dysplasia is frequently first discovered in adults when pain appears.

Because the contact area is small, the rim of the socket and the labrum are overloaded. This leads to labral tears, cartilage damage and early osteoarthritis, called dysplastic hip osteoarthritis. Studies show that osteoarthritis develops considerably more often and earlier in dysplastic hips than in normally shaped joints.

Symptoms

Pain in the groin or at the side of the hip — at first after long walks or standing.
A feeling of fatigue and instability in the hip, limping by the end of the day.
Clicking or catching — a sign of labral damage.
As osteoarthritis develops — reduced movement and pain at rest.

Diagnosis

The key test is a standing pelvic X-ray. It is used to measure how well the head is covered (the lateral centre-edge angle): below 20° is dysplasia, 20–25° is borderline — and to stage osteoarthritis. MRI, ideally with contrast in the joint, shows the labrum and cartilage; CT helps plan surgery. Send your images for a second opinion.

Hip dysplasia: treatment options

The treatment plan is made by the clinic doctor after an examination and a review of your images. The table shows the options usually discussed for this diagnosis and how well they have been studied.

Option	What to expect	How well studied
Exercise therapy and physiotherapy	Reduces pain, strengthens muscles, improves function; the basis of treatment	Moderate evidence
Load management, weight loss	Takes load off the affected area; if overweight, losing 5–10% noticeably reduces pain	Moderate evidence
Painkillers and NSAIDs	Ease pain during flare-ups; long-term use is limited by side effects	Moderate evidence
Corticosteroid injection	Quickly reduces inflammation and pain, the effect is often temporary; frequent injections are undesirable	Limited or conflicting evidence
PRP / CGF	Concentrate from your own blood; may reduce pain, growth of new tissue has not been shown	Little data
Periacetabular osteotomy (PAO)	The socket is rotated to cover the head better; with preserved cartilage it reduces pain and may delay osteoarthritis	When indicated — the doctor decides
Hip replacement	For advanced osteoarthritis; technically more demanding in dysplasia	When indicated — the doctor decides

We send your request to several partner clinics. Some will suggest conservative treatment or injections, others surgery; each clinic quotes its own conditions and price. We help you compare the options.

When surgery is needed

Osteotomy (PAO) is discussed for young, active patients without advanced osteoarthritis: the surgeon rotates the socket so that it covers the head better. It is a major operation with a recovery of several months. If the cartilage is already badly worn, the joint cannot be preserved — then a hip replacement is discussed; in dysplasia it is technically more demanding and requires an experienced clinic.

Arthroscopy without correcting the joint shape can increase instability in marked dysplasia, so it is only performed for strict indications.

Recovery timeline

After an osteotomy patients usually walk with crutches for about 6–8 weeks and return to normal activity after about six months. After a hip replacement they walk with support from the first days, and rehabilitation takes 6–12 weeks. The clinic gives the exact timeline in each case.

What to prepare for a free review

Images: MRI, ultrasound or X-ray (DICOM files or photos of the screen) and their reports.
When and how the pain started, where exactly it hurts, what makes it worse or better.
Treatment so far: injections, physiotherapy, surgery — and how it helped.
Other conditions and medications, especially blood thinners.

With this information, a partner-clinic physician can say whether further tests are needed and which treatment options suit you.

When to see a doctor urgently

Sudden pain and inability to put weight on the leg after a fall.
Pain with fever, redness or chills.
Rapidly increasing pain at rest and at night.

Contraindications to injection treatment: active infection, active cancer, clotting disorders, pregnancy. Possible risks of injections are a temporary pain flare and swelling for 1–3 days and, rarely, infection; the treatment may also not work.

Scientific evidence

Reviews on dysplasia in young adults, on osteotomy and on how often dysplasia leads to osteoarthritis:

Schmitz MR et al. Developmental dysplasia of the hip in adolescents and young adults. J Am Acad Orthop Surg, 2020.
Clohisy JC et al. Periacetabular osteotomy: a systematic literature review. Clin Orthop Relat Res, 2009.
Wyles CC et al. The John Charnley Award: Redefining the natural history of osteoarthritis in patients with hip dysplasia and impingement. Clin Orthop Relat Res, 2017.

Frequently asked questions about hip dysplasia

Can hip dysplasia in adults be treated without surgery?

Exercises for the hip muscles, load management and painkillers reduce symptoms but do not change the shape of the joint. If pain affects daily life and the cartilage is still preserved, an osteotomy is discussed.

Up to what age is an osteotomy done?

The state of the cartilage matters more than age. It is usually done in young and middle-aged patients without advanced osteoarthritis; with advanced osteoarthritis a hip replacement is chosen.

Do PRP or stem cells help?

There is no evidence of benefit in dysplasia: they do not correct the shape of the joint. They are sometimes discussed for pain relief in early osteoarthritis, but they are not the basis of treatment.

Is dysplasia in children the same as in adults?

It is the same condition. In babies it is treated with splints or reduction in the first months of life; in adults it is about the consequences — overload and early osteoarthritis. Children are treated by a paediatric orthopaedist.

How can RegenPAS help?

RegenPAS is a patient service centre in Munich, not a clinic. We review your images and symptoms and send a request to several partner clinics at once. Clinics that can accept you send their own conditions and price; prices differ between clinics, and you choose the option that suits you. The coordinator replies within 24 hours, and a clinic physician’s preliminary opinion follows in 1–3 business days. We then arrange the appointment, visa invitation, interpreter, transfers and accommodation. Treatment decisions are made by the clinic physician. Contact a coordinator.

Suspect hip dysplasia? Send your X-ray — we reply within 24 hours

Send your MRI or ultrasound and describe where and when it hurts. The coordinator replies within 24 hours; a clinic physician gives an opinion in 1–3 business days.

Send images

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