The Hip-Spine Relationship in Developmental Dysplasia of the Hip: A Contemporary Review for the Spinal Deformity Surgeon

Dr. Nishant

Abstract: Background: Developmental dysplasia of the hip (DDH) is traditionally managed within pediatric orthopaedics and adult reconstruction, but a growing body of literature demonstrates that the dysplastic hip and the spine are mechanically and clinically interdependent. Uncorrected acetabular and femoral deformity alters pelvic incidence, pelvic tilt, and pelvic obliquity, and can precipitate or mask coexisting spinal deformity, while spinal malalignment in turn reshapes the biomechanical demands placed on a dysplastic hip. Purpose: To synthesize recent advances (predominantly 2019-2026) in the diagnosis, pathophysiology, and treatment of DDH that carry direct relevance for spinal deformity surgeons managing patients with combined hip-spine pathology. Methods: A narrative review of the PubMed, Embase, and Cochrane literature was performed using combinations of the terms "developmental dysplasia of the hip", "hip-spine syndrome", "spinopelvic alignment", "pelvic incidence", "pelvic obliquity", "periacetabular osteotomy", and "total hip arthroplasty", prioritizing studies published within the last five years. Results: Recent work has clarified that pelvic incidence in DDH is not uniformly elevated but rises early in mild dysplasia before a compensatory ceiling is reached in advanced (Crowe III-IV) disease; that pelvic obliquity is disproportionately represented among adolescents with combined idiopathic scoliosis and hip dysplasia; that periacetabular osteotomy reliably corrects acetabular version and coverage without materially changing pelvic tilt; that total hip arthroplasty in unilateral high-grade DDH meaningfully improves low back pain while symmetric or low-grade dysplasia benefits less; and that deep-learning-assisted ultrasound and expanding genome-wide association data are reshaping early screening and risk stratification. Emerging robotic and augmented-reality navigation platforms are improving the precision of acetabular correction, with early but still limited evidence of downstream spinopelvic benefit. Conclusions: DDH should be considered a spinopelvic, not purely femoroacetabular, disorder. Spinal deformity surgeons evaluating patients with scoliosis, pelvic obliquity, or sagittal imbalance should screen for coexisting hip dysplasia, and hip surgeons planning periacetabular osteotomy or arthroplasty in DDH should account for spinal alignment when sequencing care. Prospective, spinopelvic-parameter-driven studies are needed to define optimal surgical sequencing in patients requiring both hip and spine correction.

Keywords: developmental dysplasia of the hip, hip-spine syndrome, spinopelvic alignment, pelvic incidence, pelvic obliquity, periacetabular osteotomy, total hip arthroplasty, scoliosis

How to Cite?: Dr. Nishant, "The Hip-Spine Relationship in Developmental Dysplasia of the Hip: A Contemporary Review for the Spinal Deformity Surgeon", Volume 15 Issue 8, August 2026, International Journal of Science and Research (IJSR), Pages: 1759-1764, https://www.ijsr.net/getabstract.php?paperid=SR26826081455, DOI: https://dx.doi.org/10.21275/SR26826081455

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