Hip Dysplasia Surgery

What is hip dysplasia surgery?

Hip dysplasia is a condition in which the hip socket (called the acetabulum) is too shallow or angled in a way that does not fully cover the ball at the top of the thigh bone (the femoral head). Because the ball is not held securely, the joint can be loose, unstable, or, in more severe cases, partly or completely out of the socket. Over time, this poor fit can wear down the smooth cartilage that lines the joint and lead to pain and early arthritis.

Hip dysplasia surgery is a group of operations that aim to place the ball more deeply and securely inside the socket, improve the way the joint carries weight, and protect the cartilage. The specific operation depends mainly on the patient’s age and how severe the problem is. In babies and young children, the condition is usually called developmental dysplasia of the hip (DDH), and DDH surgery may involve repositioning the joint and holding it in place with a cast. In teenagers and adults, the most common procedure is a periacetabular osteotomy (PAO), in which the socket is cut free from the surrounding pelvis and rotated into a better position. Surgery is generally considered when non-surgical treatments such as bracing or physical therapy have not been successful or are not appropriate.

Who is a candidate

Your orthopedic surgeon will consider your age, symptoms, x-rays, and often additional imaging such as an MRI or CT scan before recommending an operation. In general, hip dysplasia surgery may be considered in the following situations:

• Babies and young children with DDH whose hip remains unstable or dislocated after a trial of a soft brace (often a Pavlik harness), or whose dysplasia was found after the age when bracing is usually effective.
• Older children whose socket has not developed normally despite earlier treatment, or in whom the diagnosis was made late.
• Teenagers and adults with hip or groin pain caused by dysplasia, especially when the joint still has reasonably healthy cartilage. This is the typical group considered for periacetabular osteotomy.

Surgery is usually NOT considered suitable when:

• The hip already has advanced arthritis, meaning the cartilage is largely worn away. In this case, an osteotomy is unlikely to help, and hip replacement may be discussed instead.
• The condition is mild and causing no symptoms; many people with mild dysplasia are simply monitored.
• Other health problems make a long operation and recovery unsafe.
• In infants, a brace is still working and the hip is developing normally on follow-up scans.

The decision is individual. A specialist weighs the likely benefit of protecting the joint against the demands of surgery and recovery.

How the procedure works

Hip dysplasia surgery is performed under general anesthesia, meaning you or your child are fully asleep. The steps below describe the most common approaches in plain language.

Before the operation. Imaging is reviewed to plan exactly how much the socket needs to be repositioned. Blood tests and a general health check are completed. Adults may have blood drawn and stored in advance in some hospitals because osteotomy can involve significant bleeding. Babies are examined to confirm the hip is still dislocated or unstable.

During the operation in babies and young children (DDH surgery). The surgeon may first try a closed reduction, gently guiding the ball back into the socket without an incision, often using a dye injection and x-ray to confirm the position. If the hip cannot be safely placed this way, an open reduction is done through an incision in the groin or hip, removing any tissue that is blocking the socket and tightening loose ligaments. In older children, the surgeon may also reshape the thigh bone (a femoral osteotomy) or the pelvis (a pelvic osteotomy) so that the ball stays covered. Afterward, the child is placed in a spica cast, a body cast that holds the hips still while the joint heals.

During a periacetabular osteotomy in teenagers and adults. Through an incision at the front of the hip, the surgeon makes a series of carefully planned cuts in the pelvic bone around the socket (“osteotomy” simply means cutting bone). The freed socket is then rotated so it covers the ball more completely and sits at a better angle. It is fixed in its new position with several screws. Some surgeons combine this with a hip arthroscopy, a keyhole procedure using a small camera, to repair a torn labrum (the rim of cartilage around the socket) at the same time. The operation typically takes a few hours.

After the operation. Patients wake up in a recovery area and are monitored for pain, bleeding, and nerve function. Adults usually begin gentle movement and walking with crutches within a day or two, with strict limits on how much weight the operated leg may bear. Children in a spica cast are taught how to be positioned and cared for at home before discharge.

Preparation for hip dysplasia surgery

Good preparation helps reduce complications and makes recovery smoother. Your care team will give instructions specific to your situation, but the following points are common:

• Medical review. Tell the team about all medications, supplements, allergies, and past reactions to anesthesia. Blood thinners, some anti-inflammatory drugs, and certain supplements may need to be paused, but only on your doctor’s advice.
• Fasting. You will be told when to stop eating and drinking before the anesthetic. For babies, feeding instructions are especially important and should be followed exactly.
• Home setup for adults. Arrange a bed or sleeping area that is easy to reach, remove trip hazards, and consider a raised toilet seat and shower chair. Practice using crutches if possible, since you will rely on them for weeks.
• Home setup for a child in a spica cast. Ask about car seats that accommodate a cast, how to keep the cast clean during diaper changes, and how to carry and position your child safely.
• Support. Adults should plan for someone to drive them home and help with daily tasks for the first weeks.
• Smoking. Stopping smoking before surgery is advised because smoking slows bone healing.

In many hospital groups, including Acibadem, this care is managed by the orthopedics department. You can read more about the Orthopedics & Joint Center.

Recovery and aftercare

Hip dysplasia surgery recovery is measured in weeks and months rather than days, because bone needs time to heal in its new position. Timelines vary with age, the type of surgery, and overall health.

Recovery after periacetabular osteotomy in adults.

• Hospital stay: typically several nights.
• Weeks 1 to 6: walking with crutches, usually putting only partial weight on the operated leg. Pain medication, blood-thinning medication or compression stockings to reduce clot risk, and gentle exercises are common. Many patients need help with shopping, cooking, and driving during this period.
• Weeks 6 to 12: x-rays are checked to confirm healing. If the bone is uniting well, weight bearing is gradually increased and formal physical therapy focuses on strength and walking pattern. Many people return to desk work in this window.
• Months 3 to 6: most patients are walking without crutches and returning to low-impact activities. Muscle strength continues to improve.
• Months 6 to 12: return to more demanding activities is often discussed at this stage. Full recovery, including the last of the muscle strength and endurance, can take up to a year.

Recovery after DDH surgery in babies and children.

• The spica cast typically stays on for several weeks to a few months, sometimes with a cast change under anesthesia in between.
• Parents learn to keep the cast dry and clean, check the skin at the cast edges, and watch that toes stay warm and pink.
• After the cast is removed, a brace may be used for a period, and children often need a little time to regain movement and confidence before walking or crawling normally.
• Regular follow-up x-rays continue through childhood to make sure the socket keeps developing properly as the child grows.

Keeping follow-up appointments is an important part of aftercare at every age, since the surgeon needs to confirm that bone is healing and the joint is staying in position.

Risks and side effects

All surgery carries some risk, and hip dysplasia surgery is a significant operation. Your surgeon will discuss the risks that apply to your specific procedure. Commonly discussed risks include:

• Bleeding during or after the operation, which occasionally requires a blood transfusion, particularly with osteotomy.
• Infection of the wound or, less commonly, deep around the bone or screws.
• Blood clots in the leg veins (deep vein thrombosis) that can travel to the lungs; preventive measures are routinely used in adults.
• Nerve irritation or injury, most often numbness on the outer thigh, which may be temporary or, less often, lasting.
• Delayed healing or non-union, where the cut bone is slow to join or does not join, sometimes needing further surgery.
• Screw or implant problems, including irritation that leads to later removal.
• Over- or under-correction of the socket position, which may affect how the hip functions.
• Avascular necrosis, a loss of blood supply to the femoral head that can damage the joint; this is a recognized concern in children treated for DDH.
• Re-dislocation in children after cast removal, requiring additional treatment.
• Anesthesia-related risks, which are generally low but are higher in people with other health problems.
• Persistent pain or stiffness, since surgery cannot restore cartilage that is already damaged.

Side effects that are expected rather than complications include pain, swelling, bruising, fatigue, and a period of reduced mobility.

Results and outlook

For babies with DDH, treatment that achieves and maintains a well-positioned hip generally allows the socket to develop more normally as the child grows. Earlier treatment is usually associated with simpler procedures and better long-term joint development, which is why screening and early referral are emphasized. Some children need more than one procedure, and follow-up continues until the skeleton matures.

For teenagers and adults, periacetabular osteotomy is considered a joint-preserving operation. The evidence generally shows that, when performed in a hip with relatively healthy cartilage, it can reduce pain, improve function, and delay or potentially avoid the need for a hip replacement for many years. Results tend to be less favorable when arthritis is already advanced, which is why patient selection matters so much. Recovery is long and requires commitment to rehabilitation. Some patients will still eventually need hip replacement later in life, and the surgeon will explain how your particular findings affect the likely outcome.

Cost considerations

The cost of hip dysplasia surgery varies widely between countries, hospitals, and individual cases. Rather than quoting figures, it is more useful to understand what drives the price:

• Type of procedure. A closed reduction with casting in an infant involves less operating time and fewer materials than an open reduction with pelvic and femoral osteotomy, or a periacetabular osteotomy in an adult.
• Length of hospital stay. Osteotomy patients usually stay several nights, which adds nursing, room, and monitoring costs.
• Implants and devices. Screws, plates, casts, braces, and crutches are billed items, and their number and type vary.
• Anesthesia and surgical team time. Longer and more complex operations cost more.
• Imaging and testing. CT or MRI planning scans, blood tests, and repeated follow-up x-rays over months or years.
• Rehabilitation. Physical therapy sessions after adult surgery can continue for months.
• Possible additional procedures. Cast changes under anesthesia in children, or later screw removal in adults.

Insurance coverage and referral pathways also affect what a patient pays. A detailed written estimate from the treating hospital is the only reliable way to understand the expected cost in your case.

Frequently asked questions

What is a periacetabular osteotomy and how is it different from a hip replacement?

A periacetabular osteotomy keeps your natural hip joint. The surgeon cuts the pelvic bone around the socket, rotates the socket to cover the ball more fully, and fixes it with screws. A hip replacement removes the damaged ball and socket and replaces them with artificial parts. Osteotomy is usually offered to younger patients whose cartilage is still in reasonable condition, with the aim of protecting the joint for as long as possible.

How long does hip dysplasia surgery recovery take for an adult?

After a periacetabular osteotomy, many patients use crutches for roughly six weeks or more, gradually increase weight bearing as x-rays show healing, and walk without aids at around three to six months. Returning to more demanding sports or physical work is often a later milestone, and regaining full strength can take up to a year. Your surgeon and physical therapist will adjust the pace to how your bone is healing.

What does hip dysplasia surgery in babies involve?

If a brace has not held the hip in place, a surgeon may perform a closed reduction, guiding the hip into the socket without an incision, or an open reduction through a small cut if tissue is blocking the socket. The child is then placed in a spica body cast for several weeks to months. Older children may also need bone reshaping of the thigh or pelvis. Follow-up continues through childhood to check the socket is developing normally.

Is DDH surgery always necessary if my baby has hip dysplasia?

No. Many babies with DDH are treated successfully with a soft brace alone when the condition is found early, and some mild cases resolve as the hip matures under observation. Surgery is generally reserved for hips that stay unstable or dislocated despite bracing, or for children diagnosed after the age when bracing usually works. Your pediatric orthopedic specialist will base the recommendation on examination and ultrasound or x-ray findings.

Will I be able to have children or run after a periacetabular osteotomy?

In general, a healed periacetabular osteotomy is not considered a barrier to pregnancy or vaginal delivery, though you should discuss your history with your obstetrician. Many patients return to running and other higher-impact activities once healing and strength allow, often several months to a year after surgery, but the surgeon may advise limiting very high-impact loading if cartilage damage was present.

Does hip dysplasia surgery guarantee I will not need a hip replacement later?

No operation can guarantee that. Periacetabular osteotomy aims to slow cartilage wear by improving how the joint carries weight, and many patients keep their natural hip for many years afterward. However, if cartilage was already damaged before surgery, or if arthritis develops with age, a hip replacement may still be needed at some point. Your surgeon can explain how your imaging affects the likely long-term picture.

When to see a doctor

You should be assessed by a specialist if you or your child has any of the following:

• In a baby: a hip that clicks or feels loose during diaper changes, uneven skin folds on the thighs or buttocks, one leg that appears shorter, limited spread of one hip, or a family history of hip dysplasia. Late signs include a limp or waddling walk after the child starts walking.
• In a teenager or adult: groin or hip pain that builds with activity or standing, a catching or locking sensation, a feeling of the hip giving way, or pain that has not improved with rest and physical therapy.
• A previous diagnosis of dysplasia with new or worsening symptoms.

After hip dysplasia surgery, seek urgent medical attention if you notice:

• Fever, chills, or increasing redness, warmth, or discharge from the wound.
• Sudden severe pain, or pain that is worsening rather than improving.
• A swollen, painful, or warm calf, or sudden shortness of breath or chest pain, which can signal a blood clot.
• New numbness, weakness, or inability to move the foot or toes.
• In a child in a spica cast: toes that are cold, pale, blue, or swollen; a cast that has cracked or become soaked; persistent crying that does not settle; or a bad smell from inside the cast.
• A fall or injury to the operated hip, or a sudden change in how the leg looks or feels.

These situations may need prompt review, and your surgical team should be contacted through the emergency instructions you were given at discharge.