Conservative and Post-Operative Rehabilitation Protocols for Hip Dysplasia in Adolescents to Adulthood: A Literature Review

Background and Purpose Developmental dysplasia of the hip (DDH) is a spectrum of structural abnormalities associated with insufficient acetabular coverage, predisposing adults to labral pathology, chondral wear, and early-onset osteoarthritis. Despite a range of conservative and post-operative management options, key aspects of physiotherapy rehabilitation remain poorly defined, including intervention timing, progressive loading criteria and exercise selection in those with DDH. The purpose of this review is to examine conservative and post-operative rehabilitation protocols and associated functional outcomes in adolescents and adults aged 13–50 years with DDH. Methods A structured electronic search of MEDLINE (PubMed) and Web of Science Core Collection was used to identify English-language, peer-reviewed literature addressing physiotherapy rehabilitation for DDH. Twelve sources met inclusion criteria, comprising randomized controlled trials, Delphi consensus studies, a retrospective case series, and observational designs. Data were extracted regarding intervention type, progression criteria, patient-reported outcome measures, and return to sport measures. Results and Discussion Twelve sources were included, comprising adolescent and adult cohorts aged 13–50 years, with one source exclusively including an adolescent population aged 5–17 years.1 Conservative rehabilitation commonly emphasised hip abductor, extensor and hip external rotator strengthening combined with lumbopelvic stability and movement pattern retraining. Post-operative protocols applied phased, criterion-based progressions guided by pain-free range of motion, ≥80% hip abductor strength symmetry, and functional stability testing. The overall evidence base was limited by methodological heterogeneity, small sample sizes, reliance on expert consensus, with no high-quality comparative trials identified. Conclusion Current evidence tentatively supports physiotherapy as a central component of both conservative and post-operative rehabilitation for adolescents and adults with DDH, with multimodal, criterion-based approaches incorporating progressive strengthening and neuromuscular retraining most consistently described across included sources. Standardized rehabilitation frameworks and validated progression criteria are needed to optimize functional outcomes in this population. Level of Evidence 5