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Osteotomy

Adolescent Hip Dysplasia

The hip is a "ball-and-socket" joint. In a normal hip, the ball at the upper end of the femur (thighbone) fits firmly into the socket, which is a curved portion of the pelvis called the acetabulum. In a young person with hip dysplasia, the hip joint has not developed normally—the acetabulum is too shallow to adequately support and cover the head of the femur. This abnormality can cause a painful hip and the early development of osteoarthritis, a condition in which the articular cartilage in the joint wears away and bone rubs against bone.

Adolescent hip dysplasia is usually the end result of developmental dysplasia of the hip (DDH), a condition that occurs at birth or in early childhood. Although infants are routinely screened for DDH, some cases remain undetected or are mild enough that they are left untreated. These patients may not show symptoms of hip dysplasia until reaching adolescence.

Treatment for adolescent hip dysplasia focuses on relieving pain while preserving the patient's natural hip joint for as long as possible. In many cases, this is achieved through surgery to restore the normal anatomy of the joint and delay or prevent the onset of painful osteoarthritis.

Anatomy

In a healthy hip, the head of the femur stays firmly within the acetabulum The hip is one of the body's largest joints. It is a "ball-and-socket" joint. The socket is formed by the acetabulum, which is a part of the large pelvis bone. The ball is the femoral head, which is the upper end of the femur (thighbone). The bone surfaces of the ball and socket are covered with articular cartilage, a smooth, slippery substance that protects and cushions the bones and enables them to move easily.

The acetabulum is ringed by strong fibrocartilage called the labrum. The labrum forms a gasket around the socket, creating a tight seal and helping to hold the femoral head in place.

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