A combination of hip impingement and dysplasia, often related to acetabular retroversion. Accurate diagnosis is essential as treatment differs significantly from straightforward impingement or dysplasia alone.
(03) 9573 9659
Some patients present with a combination of hip impingement and dysplasia, often related to acetabular retroversion. This combination is clinically important because treatment differs significantly from straightforward impingement or dysplasia alone. Treating impingement surgically without recognising and accounting for the dysplasia component can produce poor outcomes.
In a normal hip, the acetabulum faces slightly forward. In acetabular retroversion, the socket faces slightly backwards. This altered orientation causes impingement at the front of the joint during hip flexion, because the rim of the socket makes contact with the femoral neck earlier than it should, while simultaneously leaving the back of the femoral head relatively uncovered.
The result is a hip that impinges and is also relatively unstable. The condition is sometimes misdiagnosed as straightforward impingement if the retroversion component is not identified on imaging.
Mr Balakumar uses a combination of clinical assessment, standardised X-ray views, CT scanning and MRI to evaluate the hip in three dimensions and identify the specific pattern of pathology. Recognising the retroversion component and quantifying its contribution to the patient’s symptoms is essential before any treatment decision is made.
Treatment is individualised based on the degree of each component, the patient’s age, activity level and joint health. Options may include hip arthroscopy to address the impingement component, periacetabular osteotomy to correct the acetabular orientation, femoral osteotomy to address any contributing femoral deformity, or a combination of procedures. In some patients a staged approach is most appropriate.
Mr Balakumar explains the complexity of these cases clearly at the consultation so that patients fully understand the reasoning behind the recommended approach before any decision is made.
(03) 9573 9659
Mr Balakumar is one of a small number of surgeons in Australia with formal training in both paediatric and adult hip surgery. His fellowship at Harvard’s Children’s Hospital in Boston, under some of the world’s leading specialists in hip preservation, gives him a depth of expertise that is difficult to find in a single practice.
His approach is the same whether the patient is 6 months or 65 years old – thorough assessment, honest options, and no pressure toward surgery until the clinical picture clearly supports it.
(03) 9573 9659
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Melbourne Orthopaedic Group is home to a team of experienced orthopaedic surgeons, providing comprehensive care for sports injuries and orthopaedic conditions. Whether it’s joint replacement or sports injuries, our specialists provide comprehensive orthopaedic care.
