The common hip condition you may not know you have

If you’ve ever enjoyed a Cirque du Soleil show, marveled at the world’s top ballerinas or cheered as a hockey goaltender slid across the crease to make a miraculous kick save, you’ve likely noticed the unusual flexibility of those performers, dancers and athletes.

It turns out, many of them have something in common — a condition called “hip dysplasia,” which may aid in allowing that greater flexibility, though potentially at a painful physical cost.

“For a person with hip dysplasia, the hip socket doesn’t fully cover the top of the thighbone,” says Dr. Mahi Trivellas, lead physician at the new Sharp Memorial Hospital Hip Preservation Clinic, who is also affiliated with Sharp Community Medical Group.

“In simple terms, the leg doesn’t fit into the hip joint quite right. It’s very shallow, which means it’s much easier to dislocate. Hip dysplasia may or may not cause problems in your life, but depending on your physical activities, you may end up experiencing pain.”

A common condition

Most people who have hip dysplasia are born with it, with statistics showing around 10% of newborns show signs of hip instability and 1% are treated for hip dysplasia. However, if not spotted and treated in the first months of life, the condition often goes unnoticed for years. Many people with hip dysplasia don’t know they have it.

It tends to emerge in the teen years or early adulthood and is far more common in women than men. “I see it a lot with patients who are dancers and cheerleaders,” says Dr. Trivellas. “Their hip dysplasia leads to their success. It’s what allows them to be flexible and get their legs into positions that don’t look natural, especially when combined with hypermobility, which is when your tissues and joints are more flexible.”

This flexibility, during which the femur (thighbone) slides fully or partially out of the hip socket, puts added strain on the surrounding tissues, which take on the task of trying to hold the bone in the joint. That wear and tear, which can be exacerbated and accelerated through strenuous physical activities, including exercise, athletics and childbirth, can lead to pain.

“Sometimes it’s just some soreness from your body straining to keep the femur in the socket. But if the pain lasts for several weeks and is impacting your life, you should see a physician,” says Dr. Trivellas.

While rarer, hip dysplasia can also be caused later in life by giving birth, especially during a breach birth which may cause hip dislocation, or through repeated stressful physical activity, such as hockey goaltenders using the common butterfly technique.

A range of treatment options

While more than 544,000 Americans have hip replacement surgery each year, the goal of the Sharp Memorial Hospital Hip Preservation Clinic is to help patients avoid or postpone the need for replacement for as long as possible.

For some active younger patients experiencing pain due to hip dysplasia, physical therapy may help. “The most important thing you can do for prevention is to strengthen,” suggests Dr. Trivellas. “We can look at how much joint coverage you have and come up with an individual plan to strengthen the hips, core, glutes and quads to help them withstand all the work they have to do to keep the femur in the socket.”

Among other options is periacetabular osteotomy (PAO), a surgery which Sharp Memorial Hospital Hip Preservation Clinic Medical Director Dr. Richard Santore was at the forefront in developing. During a PAO, the surgeon cuts and turns the pelvis to make the femur fit with better coverage.

Dr. Trivellas says this can be a good option for many patients. “For those who are a bit younger, having a PAO can delay the need for a hip replacement for up to 20 years. We can give pain relief and keep our patients active without having to replace their entire hip with metal.

“It’s always better to keep your own hip, when possible,” she says. “A hip replacement doesn’t last forever, so if we can use other treatments, therapies or procedures to relieve the pain and preserve your hip for another decade or two, it’s far better for our patients.”

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