Athletes with hip dysplasia: current understanding, management and future directions

Hip dysplasia is a developmental condition that can be congenital or occur throughout childhood and increases the risk of hip osteoarthritis. It is associated with pain and impairments in young adults and can be career-ending for professional athletes. Rehabilitation often involves high-level goals and expectations, and there is no guarantee that interventions (both surgical and non-surgical) can always achieve these. Existing research in adults with hip dysplasia has focused on non-athletes undergoing surgery, with minimal studies in athletes. To guide future research, it is important to appreciate current knowledge and recognise gaps in the literature. The aim of this editorial is to outline what is known about athletes with hip dysplasia and offer considerations for management and future studies. ### Hip dysplasia prevalence Hip dysplasia is a condition of insufficient acetabular coverage of the femoral head. The prevalence of hip dysplasia among athletes has a large variation in the reported data, potentially due to differences in diagnostic criteria. In elite ballet dancers, dysplasia rates of up to 89% have been reported1 with different imaging methods used across studies. The lateral centre-edge angle (LCEA) indicates lateral coverage of the femoral head by the acetabulum and is the traditional radiographic measure used to diagnose hip dysplasia. In a cohort of female football players, hip dysplasia was identified in 16% when using an LCEA cut-off of <20°; this increased to 66% when using an LCEA of <25°.2 More uniform diagnostic …