Developmental Dysplasia of the Hip | Research and Innovations

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For more than a century, orthopedic surgeons and investigators at Boston Children's Hospital have played a vital role in the field of musculoskeletal research—with breakthrough treatments and major advances for conditions such as developmental hip dysplasia, scoliosis, polio, tuberculosis and traumas to the hand and upper extremities.

Our pioneering research helps answer the most pressing questions in pediatric orthopedics today—to provide children with the most innovative care available.

In Boston Children’s Orthopedic Center and Child and Young Adult Hip Preservation Program, we take great pride in our basic science and clinical research leaders, who are recognized throughout the world for their achievements. Our orthopedic research team includes:

•    full-time basic scientists
•    more than 37 clinical investigators
•    a team of research coordinators and statisticians

Studies of developmental hip conditions

Some developmental hip conditions can lead to premature arthritis in young adults, with resulting pain and disability. Our research focuses on understanding the pathomechanics (mechanical forces that adversely change the body's structure and function) of these conditions. With better understanding, we can improve existing therapies and develop new therapies for these conditions. 

Current and recent studies include the following:

A large number of ongoing studies to follow patients who’ve had various treatments for SCFE and hip dysplasia.

Our studies use outcomes measures, custom questionnaires and special methods for measuring results—both prospectively (before treatment) and retrospectively.

For example, a very common hip condition called femoral acetabular impingement (FAI) is a research topic that Boston Children’s is working on extensively. FAI is a frequent cause of osteoarthritis of the hip. FAI is a jamming that occurs in some hips, resulting in damage to the cartilage.

The most common cause of FAI is a “bump” on the neck of the femur that remains as a result of SCFE. The impingement can be small (causing minor damage) or larger, resulting in arthritis. In a long-term study, our researchers are investigating the effectiveness of removing the bump at the time of surgery.

Long-term outcomes after Bernese periacetabular osteotomy (Bernese PAO) for hip dysplasia

Since 1991, Children's has performed more than 1,400 Bernese periacetabular osteotomies to correct hip dysplasia in teens and adults, whose hip sockets have finished growing. This large volume makes Boston Children’s the most experienced center in the United States for this procedure—and the second-most experienced in the world.

PAO is our standard treatment for a hip socket that’s too shallow in a patient whose socket has finished growing—typically teens ages 13 and older—and whose hip is still viable enough to be repaired rather than replaced. The procedure rotates the hip socket into a more stable position and is the most complex and powerful procedure for positioning the hip socket.

We’re constantly obtaining and analyzing radiographic and clinical long-term follow-up data on sub-groups of our PAO patient population as it ages, to determine the effectiveness of the procedure for halting or preventing the development of osteoarthritis of the hip. 

The use of delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) to assess early osteoarthritis in dysplastic hips

In early osteoarthritis, the charge of the extracellular matrix is degraded and lost. The delayed gadolinium-enhanced MRI of cartilage technique is designed to indirectly measure the early loss of charge density in cartilage. 

Perfusion MRI as a predictor for developing avascular necrosis after closed reduction of dislocated hips

Our retrospective analysis is looking at predictive values of contrast-enhanced MRI after closed reduction for avascular necrosis (cellular death due to interrupted blood supply) in people with developmental dysplasia of the hip. 

Academic Network of Conservational Hip Outcomes Research (ANCHOR)

Boston Children’s is a founding member of the Academic Network of Conservational Hip Outcomes Research (ANCHOR), a collaboration of researchers dedicated to following patients with developmental hip disease. The group now comprises 10 centers in the United States and one in Europe, and enrolls more than 500 patients each year in various studies.

Orthopedic basic science laboratories

Working in Boston Children’s labs are some of the leading musculoskeletal researchers in the nation. Our labs include:

   •    Orthopedic basic science research
   •    Center for the study of genetic skeletal disorders
   •    Sports Medicine research laboratory
   •    Matthew Harris laboratory

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

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