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A prevalent form of damage in DDH is labral tears caused by abnormal loading at the shallow acetabular edge. Although the majority of reported DDH\u2010related labral tears occur in the antero\u2010superior acetabulum, posterior labral tears are prevalent in individuals whose lifestyle involves frequent high hip flexion tasks such as squatting. To better understand region\u2010specific risks for chondrolabral damage during high hip flexion, we used image\u2010based musculoskeletal models to compare acetabular edge loading (AEL) during double\u2010legged squat between hips with symptomatic DDH (<jats:italic>n<\/jats:italic>\u2009=\u200910) and healthy controls (<jats:italic>n<\/jats:italic>\u2009=\u200910). Compared to controls, hips with DDH had higher instantaneous posterior AEL at the lowest point of squat (2.6 vs. 1.8\u2009\u00d7BW, <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.04), and higher accumulative loading across the duration of the squatting motion (2.6 vs. 1.9\u2009\u00d7BW*s, <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.04). Elevated posterior AEL coincided with increased net hip extension moments and posterior joint reaction forces, and was correlated with the severity of DDH acetabular deformity. Our findings suggest that posterior AEL is elevated in hips with symptomatic DDH during double\u2010legged squat, which may contribute to chondrolabral damage in individuals who often perform such high hip flexion tasks. Clinical evaluation of DDH should consider patient\u2010specific anatomy and lifestyle factors when establishing diagnoses and planning personalized treatment.<\/jats:p>","DOI":"10.1002\/jor.25249","type":"journal-article","created":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T18:36:14Z","timestamp":1641926174000},"page":"2147-2155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Elevated loading at the posterior acetabular edge of dysplastic hips during double\u2010legged squat"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8987-2523","authenticated-orcid":false,"given":"Ke","family":"Song","sequence":"first","affiliation":[{"name":"Movement Science Research Center, Program in Physical Therapy Washington University in St. Louis School of Medicine St. Louis Missouri USA"},{"name":"Department of Mechanical Engineering and Materials Science Washington University in St. 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