Teens between the ages of 14 to 18 who have hip pain are more likely to experience hip dysplasia, according to a new study.
Teens More Likely to Experience Hip Dysplasia Than Adults
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“Hip dysplasia is a common source of hip pain and a known cause of early osteoarthritis of the hip,” the researchers of “Incidence of Hip Dysplasia Diagnosis in Young Patients With Hip Pain: A Geographic Population Cohort Analysis” wrote. The study was published on March 5, 2021 in Orthopaedic Journal of Sports Medicine.
“Previous studies have estimated the prevalence of hip dysplasia in asymptomatic patients to be between 3.6% and 12.8%, depending on the radiographic indexes used. However, no study has analyzed the incidence of hip dysplasia in a large population of patients with hip pain,” they added.
Using a geographic epidemiological database, the research team analyzed patient medical records of 1,893 patients aged 14 to 50 years with hip pain between the years 2000 and 2016.
Overall, 156 patients (196 hips) had a diagnosis of hip dysplasia. The incidence rate among those with hip pain was 12.7 per 100,000 person-years. Patients with dysplasia had a mean age of 26.7 ± 9.8 years, but the highest age-adjusted incidence occurred at age 14 to 18 years in both male and female patients. However, female patients had twice the incidence than male patients (cases per 100,000 person-years: 16.8 [95% CI, 13.9-19.7] vs. 8.7 [95% CI, 6.6-10.8]; p < .01).
The patients were treated with physical therapy (67%), intra-articular steroid injection (29%), hip arthroscopy (10%), and periacetabular osteotomy (9%). The use of hip arthroscopy significantly increased over time (p < .01) but use of steroid injection and periacetabular osteotomy did not.
“The incidence of hip dysplasia diagnosis in patients presenting with hip pain was 12.7 per 100,000 person-years. Female patients had twice the age-adjusted incidence occurred in the age range of 14 to 18 years in both sexes. The use of hip arthroscopy to treat patients with hip dysplasia significantly increased over time,” the researchers wrote.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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