Incidence of Hip Dysplasia Diagnosis in Young Patients With Hip Pain: A Geographic Population Cohort Analysis.

Background: Hip dysplasia is a common source of hip pain and a known cause of early osteoarthritis of the hip.
Purpose: To (1) define the population-based incidence of hip dysplasia diagnosis in young patients presenting with hip pain in a large geographically defined cohort, (2) analyze trends regarding presentation and diagnosis of hip dysplasia, and (3) report the rate and type of surgical interventions used to treat this population.
Study Design: Cross-sectional study; Level of evidence, 3.
Methods: A geographic epidemiological database was queried to identify patients aged 14 to 50 years with hip pain between the years 2000 and 2016. Patient medical records were analyzed, and demographic, imaging, clinical, and treatment history were recorded. Incidence trends were examined by use of linear regression with confidence intervals for age and calendar year.
Results: Overall, 1893 patients were included. Of these, 156 patients (196 hips) had a diagnosis of hip dysplasia. The incidence of hip dysplasia diagnosis in patients who reported hip pain was 12.7 per 100,000 person-years. Patients with dysplasia had a mean age of 26.7 ± 9.8 years, while the highest age-adjusted incidence occurred at age 14 to 18 years in both male and female patients. Female patients had double the age-adjusted incidence of 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). Of the patients who underwent magnetic resonance imaging, 77% had imaging consistent with labral pathology. 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), whereas the use of steroid injection and periacetabular osteotomy did not ( P < .28 and P < .08, respectively).
Conclusion: 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 of male patients, and the highest 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.
Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: This study was partially funded by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases for the Musculoskeletal Research Training Program (T32AR56950). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. M.D.L. has a family member who has received consulting fees from Linvatec, Ossur, and Smith & Nephew and royalties from Arthrex, Smith & Nephew, and Thieme. R.J.S. has received consulting fees from Orthaligh and Zimmer and royalties from Zimmer. R.T.T. has received consulting fees from Medical Device Business Services and Medtronic and royalties from DePuy. B.A.L. has received research support from Biomet, Smith & Nephew, and Stryker; consulting fees from Smith & Nephew; speaking fees from Linvatec; and royalties from Arthrex. A.J.K. has received research support from Aesculap/B.Braun, Arthritis Foundation, Ceterix, Exactech, Gemini Medical, and Histogenics; consulting fees from Arthrex, DePuy, JRF Ortho, and Vericel; and royalties from Arthrex; has stock/stock options in Responsive Arthroscopy; and is a board or committee member for the Musculoskeletal Transplantation Foundation. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
(© The Author(s) 2021.)