Adolescent Hip Dysplasia: Signs, Treatment, and Recovery

Adolescent hip dysplasia (AHD) is a condition that occurs when a young person’s (10-18 years old) hip joint develops abnormally. The hip is a ball and socket joint. For individuals with AHD, the hip socket (called the acetabulum) has developed too shallowly to fully cover and support the head of their thigh bone (femur), resulting in hip instability, muscle fatigue, and pain that worsens over time. This eventually leads to the development of hip arthritis, even as a young adult. 

Adolescent hip dysplasia is often a newly diagnosed condition for patients who had normal hip development as an infant. Adolescent hip dysplasia can also be a result of undiagnosed or previously treated infantile dysplasia.

Though the exact cause of AHD is not always known, early warning signs and symptoms of AHD that Gillette providers look for include:  

• Pain or discomfort in the groin or the front of the hip
• Muscular fatigue and pain on the outside of the hip or thigh
• Locking, catching, or popping of the hip  
• Limping with or without pain  
• Hip pain that increases when walking, standing, or running  
• Pain at night when resting

Muscle weakness and fatigue symptoms may be infrequent or mild initially but worsen over time. They may be most notable after activities or at the end of the day.  

The earlier adolescent hip dysplasia is identified and treated, the greater chances your child has for a successful correction. Gillette Children’s experts focus on treatment plans that preserve the natural hip and its function for as long as possible.  

Gillette Children’s orthopedic surgeon Alison Dittmer, MD, strongly advocates for early diagnosis and intervention for hip symptoms like pain, weakness, and muscle fatigue in teens. She says, “A full hip exam and timely treatment is a significant factor in preventing further joint deterioration and early-onset arthritis.” 

Gillette Children’s is unique in its hip preservation program. While “hip preservation” is a widely used term, Gillette Children’s brings exceptional depth to hip and joint preservation care by offering a team of providers well-versed in the full spectrum of nonsurgical and surgical treatments — including physical therapy, hip arthroscopy, periacetabular osteotomy (PAO), and complex osteotomies for femoral deformities. This breadth of experience allows Gillette’s tailored surgical plans to stand apart, basing treatment on each patient’s anatomy and pathology, rather than relying solely on one approach to restore hip stability, maintain an active lifestyle, and support healthy joint aging. 

To help your child attain the highest possible levels of health, independence, and happiness, we make it easy for you to access a variety of experts that are commonly involved in ADH treatment at Gillette. Your child will receive care from an experienced, multidisciplinary team, which may include an orthopedic surgeon, orthopedic advanced practice provider (APP), and physical therapist – all trained in treating complex hip conditions in pediatric and young adult patients. 

Full Spectrum Diagnostic Testing

Our specially trained pediatric orthopedic surgeons use the latest diagnostic techniques to evaluate your child’s hip needs. Tests may include ultrasound, arthrography, magnetic resonance imaging (MRI), gait analysis, CT scan and EOS low-dose x-ray imaging. Many of these imaging tests provide 3D modeling to assist our orthopedic surgeons in understanding the source of your child’s hip pain and optimizing treatment. 

Adolescent hip dysplasia treatment may involve surgical and nonsurgical options.

Nonsurgical Treatment

At Gillette, non-operative measures are often attempted first. This may include:  

• Guided activity modification  
• Physical therapy  
• NSAIDS (nonsteroidal anti-inflammatory drugs)  

Surgical Treatment

In many cases, hip preservation surgery is required. The aim of Gillette hip preservation procedures is to repair any damage to the soft tissue while reshaping or reorienting bones that disrupt proper joint function. Surgical management is tailored to the underlying structural problem of each individual patient’s hip and any subsequent joint damage that has occurred. AHD is surgically treated using one or more of the following techniques:  

• Periacetabular osteotomy (PAO)
• Hip arthroscopy
• Femoral osteotomy 

After hip surgery at Gillette Children’s, your continued care team members shift their focus towards physical therapy and successful recovery. Rehabilitation after surgery typically consists of six months of physical therapy. Individuals often return to selected activities in five to six months. Overall recovery continues for up to one year. The most intensive part of recovery is in the first three months after surgery. As one of the nation’s top providers of pediatric inpatient and outpatient rehabilitation therapies, Gillette experts create recovery programs with the highest level of effectiveness, knowledge, and care.  

Specialty physical therapy resources offered at Gillette Children’s that may be especially helpful in your child’s recovery include:  

• Aquatic (pool) therapy
• James R. Gage Gait and Motion Analysis Lab  
• Physical and occupational therapy (virtual options available)