Skeletally mature acetabular dysplasia: Anatomy, pathomorphology, pathomechanics, clinical presentation, and imaging studies

Abstract

Acetabular dysplasia is a developmental disorder that affects approximately 4 % of the population and can lead to hip pain in the young adult. Over the last decade, the field of hip preservation has evolved with an increased understanding of the underlying pathomorphology and biomechanics of dysplasia. Significant advancements have also been made in the surgical treatment. The treating physician should be well versed in the clinical exam findings and pertinent history to accurately make a diagnosis. There is often significant delay in patient presentation to final diagnosis. Plain radiographs provide significant information and can confirm the diagnosis of dysplasia. Advanced imaging may provide additional information about intra-articular processes and can be useful for preoperative planning. Goals of the surgical treatment of acetabular dysplasia include improving acetabular coverage, medializing the center of rotation, decreasing the joint reactive forces at the hip, and improving overall joint congruity. Left untreated, acetabular dysplasia and associated deformities may be precursors for hip joint arthrosis, early hip pain, and the need for hip arthroplasty in the young active patient.