Ehlers-Danlos Syndrome (EDS)

Ehlers-Danlos Patients may have hip conditions that can be treated with hip preservation arthroscopy

What is Ehlers-Danlos Syndrome (Hip problems)?

Ehlers–Danlos Syndrome (EDS) is a group of inherited connective tissue disorders that affect collagen, the protein that gives tissues strength and elasticity. From a hip perspective, EDS can cause a range of problems because the hip joint depends heavily on strong ligaments, tendons, and joint capsule stability.

What are the Symptoms of Ehlers–Danlos Syndrome (Hip problems)?

From a hip perspective, symptoms of Ehlers–Danlos Syndrome (EDS) may include the following:

• Hip pain (groin, buttock, or outer hip)
• Sensation of instability or hip “slipping out”
• Frequent subluxations or dislocations
• Clicking or clunking in the hip joint
• Muscle fatigue, spasms, or overuse pain
• Stiffness after activity despite hypermobility
• Difficulty walking long distances or standing for long periods
• Secondary pain in the knees, back, or pelvis from altered gait

How Does Ehlers-Danlos Syndrome Affect Hips?

Ehlers–Danlos Syndrome (EDS) affects the hips mainly through joint instability and tissue fragility. Because collagen is weak or abnormal, the ligaments and joint capsule that normally stabilize the hip are too loose, and the cartilage may wear down more quickly. EDS can specifically affect the hip in the following ways:

• Hypermobility: The hip joint can move beyond its normal range, which increases the risk of overuse and injury.
• Subluxations & Dislocations: The hip may partially slip (sublux) or completely dislocate, sometimes with simple movements like standing, turning, or getting up.
• Chronic Hip Pain: Instability and repeated micro-injuries irritate surrounding tissues, leading to persistent pain.
• Labral Tears & Cartilage Damage: Because the femoral head isn’t well stabilized, it places abnormal pressure on the labrum and cartilage, causing tears and accelerating joint wear.
• Early Osteoarthritis: Unstable mechanics speed up degenerative changes, leading to arthritis earlier than usual.
• Muscle Strain & Fatigue: Muscles around the hip (glutes, hip flexors, hamstrings) must work harder to hold the joint in place, leading to overuse pain and fatigue.
• Impact on Walking & Posture: Hip instability may cause limping, pelvic tilt, or compensation in the knees and spine, which can trigger secondary pain.
• Surgical Risks: If surgery is required (e.g., labral repair, hip replacement), fragile tissues and poor healing increase complications and risk of recurrence.

In summary, EDS makes hips unstable, painful, and prone to early degeneration, with both mechanical (joint instability) and tissue-related (healing, fragility) challenges.

How is Ehlers-Danlos Syndrome (Hip Problems) Diagnosed?

Ehlers–Danlos Syndrome (EDS) related to hip problems is diagnosed mainly through a detailed clinical assessment. Doctors begin by taking a history of recurrent hip pain, instability, or frequent subluxations and dislocations. A physical examination is performed to assess joint hypermobility, often using the Beighton score, and to check for excessive hip range of motion or signs of labral injury. Imaging, such as X-rays or MRI, may be used to look for labral tears, early cartilage wear, or subtle instability, although these may appear normal between episodes. In some cases, genetic testing is recommended to confirm specific EDS subtypes and to rule out other connective tissue disorders.

How is Ehlers-Danlos Syndrome (Hip Problems) Treated?

Ehlers–Danlos Syndrome (EDS) hip problems are treated mainly with conservative measures to reduce pain and improve stability. Physical therapy plays a key role, focusing on strengthening the hip and core muscles to support the joint. Activity modification, braces, and lifestyle adjustments help prevent dislocations and overuse injuries. Pain can be managed with medications, heat/ice, or targeted injections when needed. Surgery, such as labral repair or hip replacement, is considered only in severe cases of instability or arthritis, but outcomes can be challenging due to fragile tissues and a higher risk of complications. Overall, treatment aims to protect the hip, manage symptoms, and maintain mobility.