Hip Dysplasia in Adults: Symptoms and Treatment

Quick answer

Adult hip dysplasia causes groin pain and instability; physiotherapy helps, and surgery can protect the joint

In hip dysplasia, the acetabulum (socket) is shallow or angled, so the femoral head is less covered and load is concentrated on a smaller area. It is more common in women, in first-born babies, after breech position and in people with a family history. In adults, symptoms usually start in the teens to 40s and include groin pain, pain on the side of the hip, pain with walking, standing or sport, clicking, catching or locking (often from a labral tear), a limp, and a feeling of the hip giving way. Many people with dysplasia are also hypermobile. Diagnosis is by examination and standing X-rays, which measure how much of the ball is covered; CT and MRI assess cartilage and the labrum. Treatment depends on age, severity and the state of the cartilage. Physiotherapy focusing on hip and core strength, control and activity modification helps symptoms. Periacetabular osteotomy (PAO), which reorients the socket, is considered for younger adults without significant arthritis to protect the joint. Hip replacement is an option when arthritis is advanced. Seek assessment for persistent groin pain in a young adult.

What hip dysplasia is

The hip is a ball-and-socket joint. In dysplasia, the socket does not cover the ball fully, so the joint is less stable and load is concentrated on the edge of the socket, stressing the cartilage and labrum, a ring of cartilage around the socket.

From babies to adults

Babies are checked for developmental dysplasia of the hip (DDH) at birth and in early infancy, and many are successfully treated with a harness. Mild cases can be missed and only cause symptoms years later.

Symptoms in adults

Groin pain, often with activity.
Pain on the side or front of the hip.
Clicking, catching or locking.
A feeling of instability or giving way.
A limp or fatigue around the hip after walking.
Pain sitting for long periods or with hip flexion.

See hip pain when walking.

Risk factors

Female sex.
Family history of hip dysplasia.
Breech position before birth.
First-born babies.
Joint hypermobility.

Labral tears and early arthritis

The extra load on the edge of the socket can tear the labrum, causing sharp groin pain and catching. Over years, cartilage damage can lead to early osteoarthritis, sometimes in the 30s to 50s. Early diagnosis helps protect the joint.

Diagnosis

A physiotherapist or orthopaedic surgeon examines hip movement, strength and specific provocation tests. Standing X-rays measure the coverage of the femoral head (for example, the lateral centre-edge angle). CT gives 3D detail, and MRI shows the labrum and cartilage.

Physiotherapy

Strengthening the gluteal muscles, especially the gluteus medius.
Core and pelvic control exercises.
Balance and proprioception training.
Avoiding extreme ranges that provoke pain.
Gradual return to activity with load management.

See hip muscles and hip mobility exercises.

Activity and sport

Low-impact activities such as cycling, swimming and walking are usually well tolerated. Deep squats, extreme stretches and high-impact sports may aggravate symptoms. Hypermobile people should focus on stability rather than flexibility.

Periacetabular osteotomy (PAO)

In younger adults with dysplasia and well-preserved cartilage, PAO surgery cuts the pelvis around the socket and rotates it to improve coverage of the ball. It aims to reduce pain and delay or prevent arthritis. Recovery takes several months with crutches and rehabilitation.

Hip arthroscopy

Keyhole surgery can treat labral tears, but in significant dysplasia it may not address the underlying instability and is often combined with or replaced by PAO.

Hip replacement

When arthritis is advanced, total hip replacement relieves pain and restores function. Dysplasia can make the operation more complex.

See hip replacement recovery.

Pregnancy and hip dysplasia

Hormonal ligament laxity in pregnancy can increase hip symptoms. Physiotherapy, pacing and supportive positions help. Most women with hip dysplasia can have a vaginal birth; discuss any concerns with your midwife or obstetrician.

Hip dysplasia and hypermobility

Many people with hip dysplasia also have generalised joint hypermobility. Their muscles work harder to stabilise the joint, which can cause fatigue and tightness around the hip. Strength and control exercises are more helpful than stretching for these people.

Daily life tips

Avoid sitting in very low chairs, crossing legs for long periods and standing on one leg with the hip pushed out. Sleeping with a pillow between the knees, spreading activity across the day and using a stick in the opposite hand during flare-ups reduce load on the joint.

When to seek assessment

Persistent groin pain in a young adult.
Clicking or locking with pain.
A limp or worsening walking.
A family history of hip dysplasia with hip pain.
Night pain or pain at rest.

Key points to remember

Hip dysplasia is a shallow hip socket, often present from birth.
In adults it causes groin pain, clicking and instability.
Physiotherapy strengthens and stabilises the hip.
PAO can protect the joint; hip replacement treats advanced arthritis.

Questions about hip dysplasia in adults

These answers are general information and do not replace an examination or individual medical advice.

Can you develop hip dysplasia as an adult?

It is usually present from birth but may not cause symptoms until adulthood.

What does hip dysplasia feel like?

Groin pain, clicking and a feeling of instability, often with activity.

Can physiotherapy fix hip dysplasia?

It cannot change the bone shape but can reduce symptoms.

What is a PAO?

Surgery that reorients the hip socket to improve coverage.

Does hip dysplasia cause arthritis?

It increases the risk of early osteoarthritis.

Is walking good for hip dysplasia?

Usually yes, within comfort.

Should I stretch with hip dysplasia?

Focus on strength and stability; avoid extreme stretches.

Is hip dysplasia genetic?

It often runs in families.

How is adult hip dysplasia diagnosed?

By examination and standing X-rays, with CT or MRI if needed.

Can hip dysplasia cause back pain?

Yes, altered movement can lead to pain in the lower back or pelvis.

Sources

This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.