Physiotherapists are ideally placed to reduce the long wait – often years – for a diagnosisof acetabular hip dysplasia. This would improve quality of life and the outcome for patients, says Liz Evans.
Although well recognised in infants, when it is known as developmental dysplasia of the hip, hip dysplasia in adolescents and young adults is poorly understood. This treatable condition is commonly referred to as acetabular hip dysplasia (AHD) because it is identified in the mature or near mature skeleton by a shallow, sometimes poorly oriented acetabulum (Troelsen 2012). The abnormal biomechanics this causes leads to disabling hip pain and dysfunction, which rapidly develops into premature, secondary osteoarthritis (OA). The problem is that poor recognition leads to delayed or misdiagnosis of AHD and the consequences can be devastating for the patient.
Acetabular hip dysplasia leading to premature, secondary osteoarthritis (OA) means that, shockingly, people as young as 18 may lose their native joint to total hip replacement (THR). The associations of THR with older people and the limited activity THR causes, means that young people are understandably devastated by the prospect.
Alternatively, when hip dysplasia is recognised early, joint-retaining, corrective surgery known as periacetabular osteotomy (PAO) is often the surgery of choice. This is highly specialised surgery carried out only by a select and very limited number of surgeons in the UK.
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