Acetabular Dysplasia (AD), or shallow hip sockets is a condition that typically leads to arthritis of the hip at an early age. The typical patient is female in the age range 40-60. The condition is a variant of Congenital Hip Dysplasia (CDH) where the hip does not form in the socket (acetabulum). This condition occurs in infants and is usually treated with braces and surgery.

Patients who present with early hip arthritis and AD have pain in the groin and thigh. They also have stiffness and loss of motion of the hip. Their leg may be shortened. Patients may begin to limp and will have difficulty pulling the legs completely apart.  If the condition progresses, arthritis ensues and the patient may require Total Hip Replacement (THA) as a treatment.

X-rays are the best diagnostic tool. The xray will show a shallow socket. Orthopaedic surgeons measure the amount of shallowness with a tool called the Center Edge Angle (CE). Also, a complete orthopaedi c physical exam and history can help the physician make the diagnosis. MRI and Ct are also useful.  Early in the condition, the hip may present with AD and have a tear of the labrum, which is a supportive structure around the socket’s edge. This can be treated and diagnosed by arthroscopic surgery.

Treatment in the early stages may be an attempt to “cover the Hip Ball”. This involves moving the pelvic bones into a new position (ostetomy) .These procedure are an extensive surgery.  Most patients who do not need surgery are treated with anti-inflammatory agents such as Celebrex or Advil. Physical therapy is useful. Ultimately, if the joint wears out, a Total Hip Replacement (THA) will be advisable. Fortunately, modern THA is very successful in this condition and most patients are pain free and can engage in light sports activities. The THA replaces the worn out joint with a new prosthetic joint which is placed in a deeper more anatomic position.