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Hip Dysplasia
When the Hip Socket Falls Short
Hip dysplasia is a structural issue that causes the hip joint to become unstable, painful, and prone to damage. Though often present from birth, symptoms can appear much later—especially in active teens and adults. The good news? With early diagnosis and the right treatment, it’s possible to preserve your natural hip and stay active for years to come.
Learn how hip dysplasia is diagnosed, when surgery is needed, and how innovative treatments like PAO surgery offer long-term relief.
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What Is Hip Dysplasia
Hip dysplasia is a structural condition where the hip socket (acetabulum) is too shallow or misaligned, preventing it from fully covering the ball of the upper thigh bone (femoral head). This leads to joint instability, uneven load distribution, and progressive wear on the cartilage and labrum. If left untreated, hip dysplasia can result in chronic pain, reduced mobility, and early-onset osteoarthritis.
In many cases, the condition is present at birth or develops in early childhood—a form known as developmental dysplasia of the hip (DDH). However, some individuals don't experience symptoms until adolescence or adulthood, when physical activity or growth triggers pain or mechanical symptoms.
In a healthy hip, the rounded femoral head fits snugly into the cup-shaped socket of the pelvis, allowing for smooth and stable movement. In dysplasia, this fit is compromised, often leading to labral tears, joint inflammation, and eventual damage to the protective cartilage lining.
Key Takeaways:
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Hip dysplasia affects the shape and fit of the hip joint
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It may be present from birth (DDH) or appear later in life
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Symptoms often develop gradually and worsen over time
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Early diagnosis is critical to preserving joint function
At HipPreservation.org, we specialize in diagnosing and treating hip dysplasia in teens, young adults, and active individuals seeking long-term joint health.
🕒 Why Early Diagnosis Matters
Catching hip dysplasia early can make all the difference in long-term joint health and mobility.
Learn why timing is critical in our blog: The Importance of Early Diagnosis for Hip Dysplasia ›
How the Hip Joint Works
The hip is one of the largest and most important joints in the human body. It’s a ball-and-socket joint, meaning the rounded head of the femur (thighbone) fits into the acetabulum, a curved socket in the pelvis. This design allows the hip to support your body’s weight and move smoothly in multiple directions—walking, running, squatting, and rotating.
For the hip joint to function properly, three elements must be in alignment:
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Bony structure: The femoral head must sit securely inside the socket.
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Soft tissues: The labrum (a ring of cartilage around the socket) and other cartilage help cushion and stabilize the joint.
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Muscles and ligaments: These support the joint during movement and protect it from dislocation or wear.
When any part of this system is compromised—especially the bony alignment—it can cause increased friction, instability, and damage over time.
In individuals with hip dysplasia, the socket is often too shallow or rotated incorrectly. This leads to poor coverage of the femoral head, reducing joint stability and increasing strain on the labrum and cartilage.
Why This Matters:
Understanding normal hip function helps explain why hip dysplasia leads to:
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Pain with movement
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Cartilage breakdown
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Early arthritis
🦴 By restoring proper alignment of the hip joint through surgery like PAO, we aim to recreate that natural stability and protect the joint for the long haul.
What Causes Hip Dysplasia?
Hip dysplasia typically develops during early growth and development, either in the womb, at birth, or during early childhood. In some cases, it can go undetected until adolescence or adulthood—especially if symptoms don’t appear until the joint is under physical stress.
The underlying issue is a mismatch between the ball of the femur and the socket of the pelvis. This can result from structural underdevelopment, abnormal rotation, or looseness in the soft tissues supporting the joint.
Common Causes and Contributing Factors
🧬 Developmental Factors
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Shallow or misshapen hip socket (acetabulum) that does not fully support the femoral head
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Increased femoral anteversion (twisting of the thigh bone)
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General joint laxity (loose ligaments), which allows the hip to shift too freely
👶 Perinatal and Infant Factors
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Breech birth (baby’s bottom or feet come out first)
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First-born status (tight uterus can restrict movement)
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Being swaddled tightly with legs extended, limiting natural hip movement
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Family history of DDH or connective tissue disorders
🧍 Adolescent and Adult Risk Factors
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Hypermobile joints or Ehlers-Danlos syndrome
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Female sex (hip dysplasia is more common in females)
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Repetitive hip motion from sports or dance (which can reveal underlying dysplasia)
👩⚕️ Even if hip dysplasia wasn’t diagnosed in childhood, these risk factors may lead to symptoms later in life—especially for active individuals.
Genetic vs. Environmental Influences
While hip dysplasia can run in families, environmental factors such as how a baby is positioned in the womb or how they’re swaddled after birth also play a significant role. That’s why early screening and physical exams in newborns are so important.
🧠 Did You Know?
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Up to 10% of adults under 50 with hip pain may have undiagnosed hip dysplasia.
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80% of hip dysplasia cases occur in females.
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Breech birth increases the risk of DDH by up to 10 times.
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Many people with hip dysplasia are misdiagnosed for years as having "tight hips," "labral tears," or "hip impingement."
Understanding the root cause of hip pain is the first step toward preserving your joint and preventing arthritis.
Who Is at Risk for Hip Dysplasia?
Hip dysplasia affects people across all age groups, but certain individuals are more likely to develop symptoms due to genetic, structural, or lifestyle factors. Some people are diagnosed shortly after birth, while others remain undiagnosed until their teens or adult years—often after pain or instability appears during sports, dance, or everyday movement.
👶 Infants and Children
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Breech birth (feet or buttocks first)
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First-born children (less room in the uterus)
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Family history of hip dysplasia or joint disorders
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Girls are significantly more likely to be affected than boys
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Improper swaddling that restricts natural hip movement
Developmental dysplasia of the hip (DDH) is the term used when hip dysplasia is diagnosed in infancy or early childhood.
🧍♀️ Teens and Young Adults
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Female athletes and dancers are at higher risk due to repetitive hip motion
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Individuals with loose joints or connective tissue disorders (e.g., Ehlers-Danlos syndrome)
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Those with labral tears, frequent hip impingement, or chronic groin pain
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Young adults with no prior diagnosis but increasing pain during activity or limited range of motion
Many patients don't realize they have hip dysplasia until pain limits their ability to stay active. These stories are more common than you might think.
👉 Read real patient stories from athletes, dancers, and young adults who found answers—and relief—through accurate diagnosis and advanced treatment.
🧠 Why Symptoms Often Appear Later
Many patients with undiagnosed dysplasia compensate well during early life. But as physical demands increase—or as joint wear accumulates—symptoms begin to surface. Often, these individuals are first misdiagnosed with:
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Muscle strains
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Generalized hip tightness
👩⚕️ If you’ve been treated for a hip injury but continue to experience symptoms, it may be time to explore whether hip dysplasia is the root cause.
Signs & Symptoms of Hip Dysplasia
Hip dysplasia symptoms can vary widely depending on a person’s age, activity level, and the severity of the structural abnormality. While some individuals are diagnosed as infants due to physical screening, others may not notice symptoms until adolescence or early adulthood—especially during sports, dance, or after an injury.
For many patients, the earliest signs are subtle and can mimic other hip problems like impingement or overuse injuries.
🧍♀️ Common Symptoms in Teens and Adults
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Pain in the front of the hip or groin, especially with activity
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A catching, clicking, or popping sensation during movement
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Hip instability or feeling like the joint is slipping
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Decreased hip range of motion or stiffness
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Pain when sitting for long periods
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Limping or difficulty bearing weight after activity
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A feeling of tightness deep in the hip or lower back
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Symptoms that flare after exercise or long walks
Parents of young athletes can watch for early warning signs of hip dysplasia — see our parent’s checklist here.
👶 Signs of Hip Dysplasia in Infants
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Uneven leg lengths
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Asymmetrical skin folds on the thighs or buttocks
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Limited movement or stiffness in one leg
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A clicking or popping sound during diaper changes
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Delayed walking or abnormal gait
👉 Learn more about the Impact of Hip Dysplasia on Children vs. Adults
Early diagnosis and bracing can often correct the problem in infants. In teens and adults, advanced imaging is typically required for accurate diagnosis.
🔄 Often Misdiagnosed As:
Because the symptoms overlap with other conditions, hip dysplasia is commonly mistaken for:
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Hip flexor or groin strains
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Chronic “tight hips”
💡 If you’ve been treated for one of these conditions but still experience pain or instability, it may be time to explore hip dysplasia as the underlying cause.
❓ Think You Might Have Hip Dysplasia?
Ongoing groin pain, hip instability, or failed treatments could be signs of an underlying structural problem.
👉 Book a consultation with our team to get clarity and start a path toward recovery.
Not sure if surgery is right for you?
👉 Take our surgical candidate quiz › to see if you're a good fit for advanced hip preservation procedures.
How Is Hip Dysplasia Diagnosed?
Diagnosing hip dysplasia involves more than just an X-ray. Because symptoms often mimic other hip conditions—like labral tears or impingement—it’s essential to look at both the structure of the joint and how it’s functioning.
At HipPreservation.org, we use a combination of detailed medical history, physical exams, and advanced imaging to make a precise diagnosis and tailor treatment plans accordingly.
🔍 Diagnostic Process
🩺 1. Patient History & Symptom Review
We start by listening. You’ll discuss:
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When your symptoms began and what makes them worse
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Any previous injuries or diagnoses (like impingement or labral tears)
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Family history of joint issues or dysplasia
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How your symptoms affect movement, sports, or daily life
🧘 2. Physical Examination
Your orthopedic specialist will assess:
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Hip range of motion
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Joint stability
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Pain with specific movements
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Signs of impingement or muscle imbalances
🖼️ 3. Medical Imaging
Proper imaging is key to confirming hip dysplasia and ruling out other causes. This may include:
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X-rays: To assess how well the femoral head is covered by the socket (look for shallow acetabulum or abnormal angles)
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MRI: To evaluate soft tissues like the labrum and cartilage
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CT scan (in some cases): For detailed 3D analysis of bone alignment
🧠 What We Look For:
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Shallow or misshapen hip sockets
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Poor coverage of the femoral head
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Labral tears or cartilage damage
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Increased femoral anteversion or retroversion (twisting of the thigh bone)
🩻 Advanced imaging ensures that no underlying issues are missed—especially in patients who’ve been misdiagnosed with other hip problems.
⚖️ Not All Hip Pain Is the Same
Some patients are told they have “tight hips,” “tendonitis,” or even arthritis, when in reality, the root cause is structural. Accurate diagnosis of hip dysplasia makes all the difference in choosing the right treatment—especially if you're a candidate for joint-preserving surgery like PAO.
Treatment Options for Hip Dysplasia
Not every patient with hip dysplasia needs surgery. The right treatment depends on your age, symptoms, activity level, degree of joint damage, and how well your hip socket covers the femoral head.
At HipPreservation.org, we tailor every treatment plan to your goals—whether you're a young athlete hoping to stay active, or an adult looking to avoid joint replacement later in life.
🧘♀️ Non-Surgical Options
Mild cases of hip dysplasia or early symptoms may be managed conservatively at first.
💡 Common non-surgical strategies:
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Activity modification (avoiding movements that aggravate pain)
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Anti-inflammatory medications to reduce swelling and discomfort
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Physical therapy to strengthen surrounding muscles and improve joint stability
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Injections (e.g., corticosteroids or Platelet-Rich Plasma Injections PRP) for short-term relief of inflammation
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Close monitoring with repeat imaging if symptoms progress
⚠️ Non-surgical treatments may provide relief but cannot correct the structural misalignment of the joint.
🛠️ Surgical Treatment Options
When symptoms persist or imaging reveals joint damage, surgery may be recommended to preserve the hip and delay or prevent arthritis.
1. Hip Arthroscopy
A minimally invasive procedure used to:
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Repair labral tears
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Remove inflamed tissue or bone spurs
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Improve joint mechanics
Best for:
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Patients with mild dysplasia and labral damage
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Those needing joint clean-up before or after realignment surgery
2. Periacetabular Osteotomy (PAO)
A highly specialized, joint-preserving surgery that repositions the hip socket to better cover the femoral head. It addresses the root cause of dysplasia by correcting bony alignment.
Benefits of PAO:
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Improves joint stability
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Preserves your natural hip
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Prevents further cartilage and labral damage
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Ideal for young, active individuals
In some borderline cases, families ask whether hip arthroscopy or PAO is better. Here’s our comparison guide.
3. Combined Approach: Arthroscopy + PAO
For complex cases involving both structural dysplasia and labral/cartilage damage, surgeons may recommend a staged or combined procedure:
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Hip arthroscopy to address internal damage
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PAO surgery to realign the joint
This comprehensive plan offers the best chance of pain relief and long-term joint preservation.
How Do You Know Which Treatment Is Right?
It all starts with an accurate diagnosis. From there, your surgeon will help you weigh:
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Your symptoms and activity level
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Degree of joint damage
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Age and lifestyle goals
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MRI/X-ray findings
✨ The goal is always the same: relieve pain, restore function, and preserve your natural hip for as long as possible.
What Is PAO Surgery?
(Periacetabular Osteotomy)
Periacetabular osteotomy (PAO) is a specialized surgical procedure used to treat moderate to severe hip dysplasia by repositioning the hip socket (acetabulum) to better cover the femoral head. This correction restores joint stability, reduces pain, and preserves the natural hip—delaying or even preventing the need for hip replacement.
The goal of PAO is to fix the underlying bone alignment problem rather than just treating symptoms. When successful, it can allow patients—especially young and active individuals—to return to sports, work, and daily life without chronic pain.
🦴 How PAO Works
During the procedure:
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Several precision cuts are made around the acetabulum (the cup of the pelvis).
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The socket is rotated into a more optimal position over the femoral head.
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The bone is secured in place with screws to allow healing in the corrected alignment.
This technique improves load distribution across the joint, reduces stress on the labrum, and protects cartilage over the long term.
🎥 Watch: How PAO Surgery Works
Want to see how the procedure is performed?
👉 Watch our animated video on PAO surgery
This short, educational video breaks down each step of the procedure and explains how PAO restores stability to the hip joint by correcting alignment.
Understanding the surgical plan is a key part of feeling confident in your care.
👩⚕️ Who Is a Candidate for PAO?
PAO surgery may be right for you if:
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You’ve been diagnosed with hip dysplasia
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You’re experiencing pain and instability that affects your daily life
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You’re between the ages of 14–45 with minimal to no arthritis
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You want to preserve your natural hip instead of replacing it
Not sure if you’re a surgical candidate?
👉 Take our quick quiz ›
What to Expect from PAO Surgery
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Surgical time: ~2–3 hours
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Hospital stay: Typically 2–4 days
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Weight-bearing restrictions: Crutches for 6–12 weeks
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Physical therapy: Begins once bone healing is confirmed via imaging
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Full recovery: Most patients return to normal activities in 6–12 months
Outcomes of PAO
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Significant reduction in hip pain
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Improved joint function and stability
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Preservation of the native hip joint
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High satisfaction rates in young, active patients
At HipPreservation.org, PAO is one of our signature procedures. Our team has extensive experience helping patients achieve life-changing outcomes with this advanced, anatomy-correcting approach.
Recovery Timeline After Hip Dysplasia Surgery
Recovering from periacetabular osteotomy (PAO) or a combined procedure with arthroscopy is a gradual, structured process. It’s not a quick fix—but for many, it’s a life-changing solution that preserves their natural hip and restores mobility for years to come.
Here’s what to expect after surgery:
🏥 Hospital Stay (Days 0–4)
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Most patients stay 2–4 days for pain control and monitoring.
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Pain is managed with a combination of medications, ice therapy, and early mobilization.
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Physical therapy begins in the hospital—you’ll learn to move safely, use crutches, and manage daily activities.
🩼 Weeks 1–6: Protection & Healing
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You’ll use crutches with limited or non-weight bearing (often 6 weeks).
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X-rays confirm bone healing before increasing activity.
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Focus is on gentle mobility, blood clot prevention, and wound care.
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You’ll likely need assistance at home during the first few weeks.
🧘 Weeks 6–12: Transition Phase
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Gradual increase in weight-bearing, based on X-ray findings.
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Start structured outpatient physical therapy focused on:
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Range of motion
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Core and glute activation
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Gait training
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This is when patients often begin to notice a reduction in pain and more confidence in movement.
💪 Months 3–6: Strength & Stability
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You’ll begin more advanced strengthening and neuromuscular control.
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Return to light cardio (bike, elliptical) under guidance.
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Most people return to office work by 6–8 weeks, and school or light activities around this time.
🏃 Months 6–12: Return to Full Activity
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Continue building endurance, balance, and strength.
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Gradual return to higher-impact activities, if cleared by your surgeon.
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Full recovery timelines vary by individual, but many patients resume recreational sports and active lifestyles within a year.
🔄 What Affects Recovery Speed?
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Age and overall health
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Type of surgery (PAO alone vs. combined procedure)
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Pre-surgical strength and conditioning
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Consistency with physical therapy
💬 Recovery from hip dysplasia surgery is a journey. At HipPreservation.org, we’re with you every step of the way—from day one to your return to doing what you love.
Real Recovery in Action
Want to know what recovery from hip dysplasia surgery really looks like?
Read our blog: Patient Stories: Overcoming Hip Dysplasia ›
Hear directly from patients who’ve returned to sports, dance, and active lifestyles after diagnosis and treatment.
Outcomes & Long-Term Joint Health
For many patients, treating hip dysplasia isn’t just about getting out of pain—it’s about preserving the ability to live, move, and stay active for decades to come. With the right diagnosis and timely treatment, hip preservation surgery like PAO can provide outstanding long-term results.
📈 What Are the Outcomes of Hip Dysplasia Surgery?
Most patients experience:
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Significant pain relief
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Improved joint function and stability
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Return to desired activities like walking, sports, or daily exercise
Studies show that PAO surgery:
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Has a 90–95% survival rate at 10–15 years post-op in well-selected patients
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Can delay or eliminate the need for hip replacement in many young adults
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Leads to high satisfaction rates, especially when performed before advanced arthritis develops
🧠 Why Timing Matters
Early intervention is key. Surgery before cartilage breakdown or arthritis sets in leads to:
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Better outcomes
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Easier recovery
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Longer-lasting joint health
Even if you’ve been managing symptoms conservatively, progressive pain or imaging changes may signal it’s time to consider surgery.
🛡️ The Goal: Preserve Your Natural Hip for Life
Our team’s mission is to help you:
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Avoid joint replacement surgery for as long as possible
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Keep your natural hip functioning well into middle age (and beyond)
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Get back to doing what you love—with confidence
“I waited too long to get diagnosed” is one of the most common things we hear. Our goal is to make sure that’s not your story.
Frequently Asked Questions
❓ What age is hip dysplasia usually diagnosed?
Hip dysplasia is often diagnosed in infants, but it can also be identified in teens and adults who develop symptoms later. Developmental dysplasia of the hip (DDH) may go undetected until adolescence or early adulthood, especially in active individuals.
❓ Can adults have hip dysplasia?
Yes. Many adults are diagnosed later in life, especially if symptoms like groin pain, instability, or labral tears appear during activity. Adult hip dysplasia is often misdiagnosed as impingement or muscle strain.
❓ What is PAO surgery?
Periacetabular osteotomy (PAO) is a hip preservation surgery that realigns the hip socket to better support the femoral head. It helps correct instability caused by dysplasia and can prevent or delay arthritis.
👉 Watch our animated video on PAO surgery
❓ What’s the difference between PAO and hip arthroscopy?
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PAO addresses the bony structure by repositioning the hip socket.
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Hip arthroscopy is a minimally invasive procedure that repairs soft tissues like the labrum or cartilage.
In some cases, both procedures are combined to treat all aspects of hip dysfunction.
❓ How long is the recovery after PAO?
Recovery typically takes 6 to 12 months:
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Non-weight bearing for the first 6 weeks
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Physical therapy begins after imaging confirms bone healing
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Gradual return to sports or high-impact activities around 6–12 months
❓ Will I need a hip replacement someday?
The goal of hip preservation surgery is to delay or prevent hip replacement. Many patients who undergo PAO early enough maintain their natural joint for decades.
❓ How do I know if I’m a candidate for surgery?
If you’ve been diagnosed with hip dysplasia, have persistent pain, or have failed conservative treatment, you may be a candidate. Age, degree of joint damage, and activity goals all factor in.
👉 Take our surgical candidate quiz ›
Take the Next Step Toward Hip Relief
You don’t have to keep living with uncertainty, pain, or limitations. Whether you’ve just discovered hip dysplasia or have been struggling with symptoms for years, you deserve clarity—and options.
At HipPreservation.org, our mission is simple:
🎯 Diagnose early. Treat thoughtfully. Preserve your natural hip whenever possible.
We’ve helped countless patients avoid misdiagnosis, reduce pain, and return to the activities they love—with a customized treatment plan that fits their goals.
💬 You’ve made it this far—take the next step. We’re here to help you move forward with clarity and confidence.