➤ Hip dysplasia is a leading precursor of osteoarthritis and is seen in 20% to 40% of patients with osteoarthritis of the hip.
➤ An increase in mechanical stress on the cartilage matrix with failure of the acetabular labrum represents the major pathomechanism of degeneration.
➤ Because the prevalence of associated femoral deformities is high (>50%), the structural anatomy of the dysplastic hip must be assessed in multiple planes using radiographs and, if needed, advanced imaging modalities.
➤ Acetabular osteotomy (periacetabular and/or rotational) is the most commonly used procedure for the treatment of the majority of dysplastic hips in adults.
➤ Modern total hip replacement remains an excellent option for the more arthritic joints. Difficulties can arise from anatomical abnormalities and previous operations.
1Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada.
2Washington University Orthopedics—BJC Institute of Health, St. Louis, Missouri
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