Hip pain in the young adult: diagnosis and treatment of disorders of the acetabular labrum and acetabular dysplasia

Abstract

Hip pain in the young adult patient (ages, 17-35 years) is a diagnostic and therapeutic challenge for the orthopedic surgeon. The diagnostic and treatment algorithm for many causes of hip pain in the young adult-such as tumors and tumoral conditions, rheumatoid and degenerative arthritis, osseous necrosis, and the sequelae of congenital problems such as slipped capital femoral epiphysis and Legg-Calve Perthes--are well described and established. However, the diagnosis and treatment algorithm for disease processes, such as disorders of the acetabular labrum and dysplasia of the hip, are less clear. Advances in diagnostic radiology, particularly magnetic resonance arthrography, and advances in therapy, including the successful use of the Bernese periacetabular osteotomy and hip arthroscopy, have allowed for both timely diagnosis and appropriate treatment of these sources of hip pain in the young adult. The purpose of this review is to outline the diagnostic and treatment decision-making protocol for young adult patients with hip pain, and specifically to discuss the treatment of acetabular labral tears and dysplasia of the hip.