Developmental Dysplasia of the Hip in Adults: An Overview

Due to not treated in the early life for some reasons, developmental dysplasia and dislocation of the hip (DDH/CDH) remain a problem in the adults and contain a wide range of deformities from a symptomless dysplasia to a complete dislocation with severe anatomic anomaly. Crowe’s or Hartofilakidis’ classifications are commonly applied for grading the deformities of adult DDH/CDH. Conservative treatment includes observation for the hip without intolerable pain and shoe lift for the shorter limb. For young patients, periacetabular osteotomy can be applied for a dysplastic but relatively congruent hip, and salvage pelvic osteotomies with or without a proximal femoral osteotomy can be considered for an incongruent hip. For a patient over age of 40 with degenerative arthritis, replacement arthroplasty can be considered. Although total hip is the main trend, surface replacement conserves more bone stock and has good results if the patient and prosthesis are well-selected and the surgery done with a meticulously technique.