Developmental Dysplasia of the Hip 2: Adult

The most characteristic feature of DDH is a decreased acetabular lateral coverage of the femoral head. Many patients are symptom-free but it has been shown that moderate and severe dysplasia lead to premature OA. Surgery is to be considered when the patients have persistent symptoms which restrict everyday activities. Today the Bernese periacetabular rotational osteotomy is a common procedure to recreate relatively normal anatomy. To establish the diagnosis of DDH plain radiographs and measurements of the CE and AA angles are sufficient. However, to choose the right patients for surgical correction more sophisticated radiographic and CT measurements are needed in order to obtain a thorough visualisation and knowledge of the underlying abnormalities, as well as the magnitude of malpositions and malalignments so that reconstruction of a deficient acetabular roof and malrotated femur can be planned and performed appropriately. A radiological follow up after surgery makes it possible to determine performed coverage corrections, possible complications and a possible progression of degenerative joint disease.