Child and Young Adult Hip Preservation Program | Treatment Options

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Contact the Child and Young Adult Hip Preservation Program

  • 617-355-6021
  • International: +1-617-355-5209
  • Locations

Non-Surgical Treatment and Consultative

Includes physical therapy (to strengthen muscles), activity restriction, weight loss, and/or pain medication.

Clinical consultation

Patient and family support group: Our support group consists of a network of patients and families with hip disorders. This resource provides patients and families with important supplemental educational information as well as emotional support.

Surgical Treatment

If an abnormality of the acetabulum is causing hip symptoms and leading the hip to wear out, and if surgery can correct the abnormality, then surgery should be considered. Since the wearing out of cartilage inside the hip joint becomes permanent, it is important to carefully discuss the appropriate timing of corrective surgery with your physician.

What are the surgical options for hip preservation?

Arthroscopy

An arthroscopy is a noninvasive technique for treating secondary problems inside the hip. An arthroscopy alone cannot correct the main problem of the abnormal orientation of the acetabular rim in dysplasia. Realignment operations such as the periacetabular osteotomy (PAO) can correct the important rim tilt problem.

Arthrotomy

An arthrotomy is a procedure in which the capsule surrounding the hip joint is opened to examine the articular cartilage. This type of procedure can fix some minor problems of the acetabular labrum and joint cartilage.

Closed reduction

A procedure performed to put the hip back into place manually.

Femoral Realignment Osteotomy

For some severe deformities, the femur is cut and realigned into proper alignment.

Femoral Derotation Osteotomy

The surgeon cuts the femur, rotates the ball of the femur in the hip socket to a normal position, and reattaches the bone.

Open Reduction

The surgeon inserts metal screws and pins (internal fixation) to hold bone fragments in place to allow alignment and healing

Periacetabular osteotomy

A periacetabular osteotomy or PAO is considered to be the preferred surgical correction of acetabular dysplasia. This procedure preserves and improves the function of the patient's own hip joint rather than replacing it with an artificial one. The goal of the PAO is to reduce or eliminate pain, restore function, and maximize the functional life of the dysplastic hip.

A PAO involves rotating the shallow dysplastic acetabulum by cutting it free enough from its attachments within the pelvis so that it can be repositioned into a more stable alignment on the top of the head of the femur. In this new alignment, excessive pressure from the femoral head is more evenly distributed away from the sensitive rim area.

Treatment options for:

•   Acetabular labral tears
•   Developmental dysplasia of the hip (DDH)
•   Femoral anteversion
•   Hip dysplasia in the adolescent and young adult
•   Hip fracture
•   Hip impingement
•   Legg-Calve-Perthes disease
•   Slipped Capital Femoral Epiphysis (SCFE)

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944

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