Hip Dysplasia in Adults: Understanding Risks, Imaging, and Treatment Options
Published by Dr Oliver Khoo at Tuesday, November 25, 2025
Hip dysplasia is often thought of as a childhood condition, but many adults are living with undiagnosed or longstanding dysplasia without realising it. For some, symptoms surface slowly over time—hip stiffness after long walks, groin pain during certain movements, or a feeling that the hip “clicks” or doesn’t sit right. While these signs may seem mild at first, adult hip dysplasia can have significant long-term implications, particularly when it comes to the future risk of osteoarthritis.
This article explores how hip dysplasia affects adult hips over time, why imaging matters, when surgical options might be considered, and how timing can influence outcomes.
Hip dysplasia refers to a shallow or underdeveloped hip socket (acetabulum). In a healthy hip, the ball of the femur fits deeply and securely into the socket. With dysplasia, the shallow socket provides less coverage, which leads to excess load on the labrum and cartilage, causing damage over time.
While some adults know they were diagnosed as children, many only discover the condition later in life—often when pain, instability, or reduced mobility develops.
The biggest long-term concern with adult hip dysplasia is early osteoarthritis (OA). Because the joint is not properly aligned, the cartilage wears down faster. Adults with dysplasia may develop OA decades earlier than someone with a normal hip.
Not all hip dysplasia worsens at the same rate, but the condition is generally progressive. Many adults experience:
Without intervention, dysplasia can lead to moderate to severe osteoarthritis, which may eventually require a hip replacement.
Accurate imaging is essential for diagnosing dysplasia and understanding its severity. For adults, the following techniques provide the clearest picture:
The first-line imaging tool to assess:
Useful for detecting:
Provides detailed 3D imaging that helps surgeons evaluate:
A combination of imaging helps clinicians build a complete understanding of how dysplasia is affecting your hip and what treatment pathway may be appropriate.
In early or mild cases, conservative management can support symptom relief, though it cannot correct the underlying structural issue. Strategies include:
While these approaches may delay symptoms, they do not prevent future arthritis if the structural dysplasia is significant. For adults with moderate or severe dysplasia, non-surgical options may help with comfort but often aren’t enough to stop long-term joint degeneration.
Surgery may be recommended when structural issues are causing symptoms, labral damage, or early cartilage wear. The main goals are to improve hip stability, restore normal mechanics, and reduce arthritis risk.
This is the most common reconstructive surgery for adult hip dysplasia and is designed to correct the alignment of the hip.
A PAO involves:
Ideal candidate:
Young adults or middle-aged adults with minimal arthritis and symptomatic dysplasia.
Benefits:
Often used in combination with PAO or in milder dysplasia.
Useful for addressing:
Important note:
Arthroscopy alone does not correct the structural abnormality. It is rarely effective as a stand-alone solution when significant dysplasia is present.
Considered when:
With modern implants, hip replacements deliver excellent long-term outcomes, even for dysplastic hips, though the surgery can be more complex due to altered anatomy.
Timing plays a critical role in preventing or delaying arthritis progression.
Once arthritis is advanced, joint preservation surgeries like PAO may no longer be viable. Early assessment helps determine the right approach before irreversible damage occurs.
When left untreated:
Most patients who benefit from PAO are:
The healthier the cartilage, the better the long-term results.
With correct diagnosis and timely management, many adults maintain excellent mobility and function. The long-term prognosis depends on factors such as:
Patients who undergo PAO before significant arthritis develops often delay or avoid hip replacement altogether.
Regular monitoring, early intervention, and consistent strengthening can all contribute to keeping the hip healthy for longer.
No. Because it is a structural condition, dysplasia does not resolve without surgical correction. Conservative care may ease symptoms but cannot reshape the hip socket.
Not guaranteed, but the risk is significantly higher. Early detection and, when appropriate, surgical correction can dramatically reduce the likelihood of developing early arthritis.
Symptoms such as groin pain, clicking, catching, or instability are common in dysplasia but can also occur in labral tears or impingement. Imaging and clinical assessment are essential for accurate diagnosis.
Yes, it is a major reconstructive procedure, but it is highly effective in the right candidates. Recovery takes time, but long-term preservation of the natural hip is the key benefit.
Most people can continue low-impact exercise such as cycling, swimming, Pilates, and strength training. High-impact activities may provoke symptoms or accelerate wear.
If substantial arthritis is already present or if symptoms severely limit daily activities, hip replacement may be recommended instead of joint preservation surgery.