As a result of this abnormality, the way that force is normally transmitted between the bone surfaces is altered. The labrum can end up bearing the forces that should normally be distributed evenly throughout the hip joint. In addition, more force is placed on a smaller surface of the hip cartilage and labrum. Over time, the smooth articular cartilage becomes frayed and wears away and the labrum becomes torn or damaged. These degenerative changes can progress to early osteoarthritis.

The severity of hip dysplasia can vary from patient to patient. In mild cases, the head of the femur may simply be loose in the socket. In more severe cases, there may be complete instability in the joint and/or the femoral head may be completely dislocated out of the socket. Symptoms: Hip dysplasia in younger children is not a painful condition. However, over time, pain results when the altered forces in the hip cause degenerative changes to occur in the articular cartilage and the labrum. In most cases, this pain is:

• Located in the groin area, although it may sometimes be more toward the outside of the hip

• Occasional and mild initially, but may increase in frequency and intensity over time

• Worse with activity or near the end of the day

Some patients may also experience the feeling of locking, catching or popping within the groin. Periacetabular osteotomy (PAO). Currently, the osteotomy procedure most commonly used to treat adolescent hip dysplasia is a periacetabular osteotomy (PAO). “Periacetabular” means “around the acetabulum.”

In most cases, PAO takes from 2 to 3 hours to perform. During the surgery, the doctor makes four cuts in the pelvic bone around the hip joint to loosen the acetabulum. He then rotates the acetabulum, repositioning it into a more normal position over the femoral head. The doctor will use x-rays to direct the bony cuts and to ensure that the acetabulum is repositioned correctly. Once the bone is repositioned, the doctor inserts several small screws to hold it in place until it heals. If you are suffering from this condition, please feel free to contact our office for a consultation.