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Femoral Anteversion

  • Most children don't need treatment for femoral anteversion, since the condition usually resolves on it own. For kids who need surgery for severe forms of the condition, the outlook is excellent. The surgeries are quite safe. And in kids, the bones heal quite reliably, so they should do very well.

    If your child has been diagnosed with femoral anteversion, you’ll have concerns and questions about her health, treatment, recovery and other issues. It may comfort you to know that Boston Children's Hospital is a world leader in pediatric orthopedics, and we have a wealth of experience helping children with this fairly common and treatable hip condition. We specialize in innovative, family-centered care that supports your child and family every step of the way.

    About femoral anteversion

    • Femoral anteversion is an inward twisting of the thigh bone (called the femur—the bone located between the hip and knee).
    • Femoral anteversion causes a child's knees and feet to turn inward and have a "pigeon-toed" appearance.
    • It usually shows up when a child is between 2 and 4 years old (the time period when inward rotation from the hip tends to increase), and is most obvious at age 5 to 6.
    • The condition is somewhat more common in girls than boys.
    • It often, but not always, occurs symmetrically in both thigh bones.
    • As your child’s knees and feet turn in, her legs look bowed. This bowed leg stance actually gives your child a more stable balance when she stands.

    In femoral anteversion, your child’s balance is fairly unsteady when she tries to walk normally with her feet close together or turned out. The unsteadiness may cause her to trip and fall more often than is usual.

    The condition usually normalizes by itself by the time a child is 8 or 9 years old, or by the time she reaches adolescence.

    How Boston Children's Hospital approaches femoral anteversion and other developmental hip conditions

    Doctors at Boston Children's work to make sure that your child's legs can straighten themselves naturally, as happens with most children. Only the most severe cases need surgery.

    Whatever treatment your child’s hip problem requires, you can have peace of mind knowing that, as a national and international orthopedics referral center, our Orthopedic Center has vast experience treating children with every kind of hip condition, some of which few other pediatric hospitals have ever encountered. As a result, we can provide expert diagnosis, treatment and care for every level of complexity and severity of femoral anteversion.

    Unique expertise in treating adolescents with hip problems. Many adolescents and young adults with hip problems need diagnostic and surgical techniques that differ significantly from what’s indicated for younger children. Boston Children’s Child and Adult Hip Preservation Program is the only such program of its kind. We offer the extensive experience and the most advanced techniques, with clinicians and researchers who are dedicated to finding better ways to care for adolescents and young adults with hip problems.

    One of the first programs. Our Orthopedic Center is one of the world’s first comprehensive pediatric orthopedic programs, and is now the largest pediatric orthopedic surgery center in the United States, performing more 5,000 procedures each year. Our program, consistently ranked among the top in the country by U.S.News & World Report, is the nation’s preeminent care center for children and young adults with developmental, congenital, post-traumatic and neuromuscular problems of the musculoskeletal system.

    Femoral anteversion: Reviewed by Young-Jo Kim, MD, PhD

    © Boston Children's Hospital, 2011

    The world's most extensive pediatric research enterprise

    At Boston Children’s, we’re known for our innovative treatments and a research-driven approach. We’re home to the world’s most extensive pediatric research enterprise, and we partner with elite health care and biotech organizations around the globe. But as specialists in family-centered care, our physicians never forget that your child is precious, and not just a patient.

    Orthopedic care in lots of places

    Boston Children’s physicians provides orthopedic care at locations in Lexington, Peabody, Weymouth and Waltham, as well as at our main campus in Boston.

    Orthopedic Center
    Boston Children's Hospital

    300 Longwood Avenue
    Fegan 2
    Boston, MA 02115
    617-355-6021

  • Right now, you probably have lots of questions: How serious is femoral anteversion? Does my child need treatment? What do we do next? We’ve provided some answers to your questions on this site, and our experts at Boston Children’s Hospital can explain your child’s condition in detail when you meet with us.

    Background: the normal hip joint

    The hip joint is one of the body's most reliable structures, providing movement and support without pain or problems in most people for a lifetime. The hip’s simple ball-and-socket anatomy—with the ball-shaped femoral head rotating inside a cup-shaped socket called the acetabulum—usually works well with amazingly little friction, and little or no wear.In toddlers and young children, walking with pigeon-toes is a normal part of your baby's hip and walking development, even when it’s caused by femoral anteversion. The anteversion usually straightens itself out as a baby learns to walk.

    What is femoral anteversion?

    Femoral anteversion is an inward twisting of the thigh bone (called the femur—the bone located between the hip and the knee). The condition causes your child's knees and feet to turn inward and have a "pigeon-toed" appearance.

    Because your child’s knees and feet turn in, her legs look like they’re bowed. This bowed leg stance actually helps her achieve greater balance as she stands. Her balance is unsteady when she tries to stand and walk with her feet close together or with her feet turned out, so she may trip and fall quite a lot.

    When does femoral anteversion usually become obvious?

    Femoral anteversion usually shows up when a child is between 2 to 4 years old, since inward rotation from the hip tends to increase during that time. The condition is at its most obvious when a child is age 5 to 6 years old.

    What causes femoral anteversion?

    Femoral anteversion is usually considered to be a developmental variant, and the reasons for excessive femoral anteversion in some are unknown. The majority of patients are normal.

    What are the signs and symptoms of femoral anteversion?

    • Some signs and symptoms can include:
    • pigeon-toed walking—the child is unable to walk with her feet close together and legs straight
    • running with legs swinging out
    • tripping and falling often
    • sitting in a “W”-shaped position, with the child’s knees bent and her legs splayed out behind her

    How common is femoral anteversion?

    As the most common cause of kids walking with toes pointing inward (in-toeing) after age 3, femoral anteversion occurs in up to 10 percent of children.

    Is my child in pain?

    No, femoral anteversion doesn’t usually cause a child any pain.

    How serious is femoral anteversion?

    For the vast majority of children with femoral anteversion (some experts estimate as high as 99 percent), the condition usually self-corrects and normalizes by adolescence. Very few cases are severe enough to need surgery.

    Do splints, braces or special shoes help correct femoral anteversion?

    No, studies show that these devices don’t usually lead to faster improvement of this condition.

    Who’s at risk for developing femoral anteversion?

    • Most cases of femoral anteversion are sporadic (by chance) with no clear reason.
    • There’s some evidence that femoral anteversion may be more common in girls than boys.
    • Rarely some babies may be born with femoral anteversion (congenital).

    How does a doctor diagnose femoral anteversion?

    Tools for diagnosing femoral anteversion may include:

    • a complete medical history and physical exam, including several measurements for the degree of in-toeing
    • CT (CAT) scan—the chief imaging test for confirming a diagnosis of femoral anteversion (faster than MRI, more detailed than x-rays)
    • MRI (magnetic resonance imaging) 
    • x-rays

    How does Boston Children’s treat femoral anteversion?

    Specific treatment for femoral anteversion is determined by your child’s doctor based on:

    • her age, overall health and medical history
    • the degree of her in-toeing

    Doctors treat most children who have femoral anteversion with close observation over the course of several years, since the twisting-in of the thigh bone usually corrects by itself with time. As a child grows, normal or near-normal walking patterns typically resume by 8 to 10 years of age, or by the time the child becomes a teen.

    In a very few cases, the twisting-in may be severe and may not self-correct. For children with severe, unresolved femoral anteversion, doctors may perform surgery to reposition the femur at a more normal angle.

    Should I be concerned with my baby's progress in walking?

    Walking with pigeon-toes is a normal part of your baby's walking progress, even when caused by femoral anteversion, which should straighten itself out as your baby learns to walk. If it doesn't by the time she’s about 4 years old, consult your baby's doctor.

    Will my child be OK?

    Femoral anteversion has a very good prognosis. Most cases correct themselves as a child grows, reaching normalcy or near-normalcy by the time the child is 8 or 9 years old, or by the time she reaches adolescence.

    What new research is Boston Children’s doing regarding lower extremity and developmental hip conditions?

    The clinical and basic science researchers in Boston Children’s Orthopedic Center are recognized throughout the world for their achievements in the field. Our breakthroughs mean that we can provide your child with the most innovative care available.

    Some developmental hip conditions, such as hip impingement, slipped capital femoral epiphysis, hip dysplasia and Legg-Calve-Perthes disease, can lead to premature arthritis in young adults, with resulting pain and disability. Children’s many research studies focus on understanding the mechanical forces (pathomechanics) that adversely change the hip’s structure and function. With better understanding, we can improve existing therapies and develop new therapies for these conditions.

    FAQ

    Q: What is femoral anteversion?

    A: Femoral anteversion is an inward twisting of the thigh bone (femur), which causes your child's knees and feet to turn inward and present a "pigeon-toed" appearance.

    Q: If my child has femoral anteversion, will she be OK?

    A: The prognosis for femoral anteversion is very positive. Most cases correct themselves during a child’s growth years, reaching normalcy or near-normalcy by the time the child is 8 or 9 years old, or by the time she reaches adolescence.

    Q: How does Boston Children’s treat femoral anteversion?

    A: Treatment for femoral anteversion includes:

    • close observation for most cases
    • surgery for severe cases that don’t resolve on their own

    Q: If my child has femoral anteversion, what should I ask my Children’s doctor?

    A: Some of the questions you may want to ask include:

    • Could you describe what’s wrong with my child’s leg(s)?
    • Are other tests needed to confirm this diagnosis?
    • Is there, or could there be, damage to her tissues or blood vessels?
    • Does my child need treatment? Does she need surgery?
    • Will femoral anteversion affect her growth plate or the normal growth of her leg?
    • Could there be long-term effects? Pain? Arthritis?
    • Could this condition affect my child’s ability to walk, run or play sports?
    • How long should my child be followed by her care team?

    Q: How is femoral anteversion usually diagnosed?

    A: Besides a complete medical history and physical exam with measurements for the degree of in-toeing, tests for femoral anteversion may include:

    • CT (CAT) scan—the chief imaging test for confirming a diagnosis of femoral anteversion (faster than MRI, more detailed than x-rays)
    • MRI (magnetic resonance imaging)
    • x-rays

    Q: If my child has femoral anteversion in one femur, can she develop it on the other side, too?

    A: Femoral anteversion often develops symmetrically in both thigh bones, although it can develop on just one side.

    Q: If my child has femoral anteversion, is she at risk for early arthritis?

    A: No, femoral anteversion typically does not lead to arthritis or any other future health problems.

    Q: What are the causes and risk factors for femoral anteversion?

    A: Femoral anteversion is usually considered to be a developmental variant, and the reasons for excessive femoral anteversion in some are unknown. The majority of patients are normal. There’s some evidence that femoral anteversion may be more common in girls than boys. Some babies may be born with femoral anteversion (congenital).

    Q: What’s the long-term outlook for a child who has femoral anteversion?

    A: The long-term outlook for femoral anteversion is very positive. Most of the time, the condition corrects itself during a child’s growth years, reaching normalcy or near-normalcy by the time the child is 8 or 9 years old, or by the time she reaches adolescence.

    Q: What is Children’s experience treating hip problems in children and teens?

    A: At Boston Children’s, we’re known for our clinical innovations, breakthrough research and leadership in treatment for hip impingement and other hip problems. Orthopedic Center offers the most advanced diagnostics and treatments—several of which were pioneered and developed by Boston Children’s own researchers and clinicians.

    Teens and young adults with hip problems usually need unique diagnostic and surgical techniques different from what’s indicated for younger children. As the only program of its kind in the world, our Child and Adult Hip Preservation Program offers the extensive experience and advanced techniques of clinicians and researchers dedicated to finding better ways to care for adolescents and young adults with hip problems.

    Causes

    Femoral anteversion is usually considered to be a developmental variant, with the reasons for excessive femoral anteversion in some unknown. Most patients are normal.

    • Most occurrences of femoral anteversion are sporadic (by chance) with no clear reason.
    • The condition may be more prevalent in girls than boys.
    • Some babies may be born with femoral anteversion (congenital).

    Signs and symptoms

    Some signs and symptoms can include:

    • pigeon-toed walking—the child is unable to walk with her feet close together and legs straight
    • running with legs swinging out
    • tripping and falling often
    • sitting in a “W”-shaped position, with the child’s knees bent and her legs splayed out behind her

    When to seek medical advice

    Contact your child’s doctor if she:

    • walks with a pigeon-toed gait
    • can’t walk with her feet close together and legs straight
    • runs with her legs swinging out
    • trips and falls more often than her peers
    • likes to sit in a “W”-shaped position, with her knees bent and her legs flung out behind her

    Questions to ask your doctor

    If your teen or child is diagnosed with femoral anteversion, you may feel a bit overwhelmed. It can be easy to lose track of the questions that occur to you. Lots of parents find it helpful to jot down questions as they arise—that way, when you talk to your child’s doctors, you can be sure that all your concerns get addressed.

    Some of the questions you may want to ask include:

    • Could you describe what’s wrong with my child’s leg(s)?
    • Are other tests needed to confirm this diagnosis?
    • Is there, or could there be, damage to her tissues or blood vessels?
    • Does my child need treatment? Does she need surgery?
    • Will femoral anteversion affect her growth plate or the normal growth of her leg?
    • Could there be long-term effects? Pain? Arthritis?
    • How long should my child be followed by her care team?

    Who’s at risk

    • Most cases of femoral anteversion occur sporadically (by chance) with no clear reason.
    • Femoral anteversion may be more common in girls than boys.

    Some babies may be born with femoral anteversion (congenital).Complications

    Complications

    Surgery for femoral anteversion is uncommon because most of the time it goes away on its own. But if it’s needed for severe cases, the vast majority of surgeries for femoral anteversion at Children’s are successful and occur without major complications. After surgery, patients are at a very small risk for infection, bleeding or poor bone healing (malunion).

    Long-term outlook

    The long-term outlook for this condition is very positive. Most cases of femoral anteversion correct themselves during a child’s growth years, achieving normalcy or near-normalcy by the time the child is 8 or 9 years old, or by the time she becomes a teen.

    Femoral anteversion glossary

    • acetabulum: hip socket; a part of the pelvis
    • arthritis (osteoarthritis): joint inflammation and damage, resulting in pain, swelling, stiffness and limited movement. Arthritis can occur when a joint’s cushioning cartilage wears away. Femoral anteversion doesn’t typically lead to arthritis.
    • The Center for Families at  Boston Children’s: dedicated to helping families find the information, services and resources they need to understand their child’s medical condition and take part in their care
    • cartilage:smooth, rubbery tissue that cushions the bones of a joint and other areas; allows the bones to move easily without pain
    • congenital: present at birth
    • CT scan: a diagnostic imaging test that uses x-ray equipment and powerful computers to create detailed, cross-sectional images of your child's body
    • diagnosis, diagnostics: identifying disease or injury through examination, testing and observation
    • femoral anteversion: an inward twisting of the thigh bone, causing a “pigeon-toed” gait
    • femoral derotation osteotomy:a surgical procedure for severe cases of femoral anteversion, in which the surgeon cuts the femur, rotates the ball of the femur in the hip socket to a normal position, and reattaches the bone.
    • femoral head:round-headed top of the thigh bone (femur)
    • <><>the thigh bone, the longest and strongest of your child’s bones. The rounded top of the femur (femoral head) joins the hip socket (acetabulum) to form the hip joint<>
    • in-toeing:walking with toes pointing inward; femoral anteversion is a the most common cause of a child’s in-toeing beyond the age of 3
    • MRI (magnetic resonance imaging):a diagnostic imaging test that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body
    • onset (of signs or symptoms): the first appearance of signs or symptoms
    • open reduction surgery: a procedure in which the doctor repositions the thigh bone through an incision into the patient’s body
    • orthopedic surgeon, orthopedist: a doctor who specializes in surgical and non-surgical treatment of the skeletal system, spine and associated muscles, joints and ligaments
    • orthopedics: the medical specialty concerned with diagnosing, treating, rehabilitating and preventing disorders and injuries to the spine, skeletal system and associated muscles, joints and ligaments
    • sporadic:by chance
    • W" shaped sitting position:child sits with knees bent and legs spread out behind her; sitting position often adopted by children with femoral anteversion
    • x-raysa diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film

    See our extensive glossary of orthopedic terms.

    Unique expertise in problems of the adolescent hip. 

    Many adolescents and young adults with hip problems need diagnostic and surgical techniques that differ significantly from what’s indicated for younger children. Boston Children’s Child and Adult Preservation Program, led by Michael Millis, MD, and Young-Jo Kim, MD, is the only such program in the world. We offer the extensive experience and advanced techniques of clinicians and researchers dedicated to finding better ways to care for adolescents and young adults with hip problems.

    Our complete orthopedic team

    Boston Children’s is the primary pediatric teaching hospital of Harvard Medical School, where our physicians hold faculty appointments. We’re the largest pediatric orthopedic center in the nation, with 13 specialty clinics; an onsite brace shop; a plaster room; and a clinical team of orthopedic surgeons, orthopedic residents and fellows, certified physician assistants, nurse practitioners, registered nurses, physical/occupational therapists, brace technicians and cast technicians.

    Boston Children’s Teen Advisory Committee 

    To help teenagers take a more proactive role in their treatment and to have their needs recognized, Boston Children’s developed the Teen Advisory Committee. The group—made up of current Children’s patients, ages 14 to 21—serves as a team of peers who can listen to other patients’ needs, ensure their voices are heard. 

  • At Boston Children's Hospital, we know that the first step to treating your child’s hip impingement is to form a timely, complete and accurate diagnosis.

    To diagnose your child’s femoral anteversion, the doctor will conduct a physical exam. During the exam, the doctor will take your child’s complete prenatal, birth and family medical history.

    The physical exam includes measurements to determine the degree of your child’s in-toeing. These measurements can be obtained easily just by placing ink or chalk on the bottom of your child's feet and having her walk on paper to leave an impression.

    The doctor may use diagnostic tests to get detailed images of your child’s thigh bone and hip joint, including:

    • Computed Tomography (CT or CAT) Scan: uses x-ray equipment and powerful computers to create detailed, cross-sectional images of your child's body; CT scan is the chief imaging test for confirming a diagnosis of femoral anteversion (faster than MRI, more detailed than x-rays)
    • MRI (magnetic resonance imaging): uses magnets, radio frequencies and a computer to produce detailed images of organs and structures within your child’s body
    • x-rays: uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs

    Our Orthopedic Clinical Effectiveness Research Center (CERC)  

    Children’s Orthopedic Clinical Effectiveness Research Center (CERC) was established by the Orthopedic Center to improve the quality of life for children with musculoskeletal disorders. This collaborative clinical research program is unique in the nation and is playing an instrumental role in establishing, for the first time, evidence-based standards of care for pediatric orthopedic patients throughout the world. 

    If you come from far away, we can help 

    As an international pediatric orthopedics center, we care for young patients from all over the world. Our International Center assists families residing outside the United States: We facilitate the medical review of patient records; coordinate appointment scheduling; and help families with customs and immigration, transportation, hotel and housing accommodations. 

  • Boston Children's Hospital's hip sub-specialists provide comprehensive treatment—including evaluation, diagnosis, consultation and follow-up care.

    Specific treatment for femoral anteversion is determined by your child's doctor based on:

    • her age, overall health and medical history
    • the degree of her in-toeing

    Doctors treat most children who have femoral anteversion with close observation over the course of several years, since the twisting-in of the thigh bone usually corrects by itself with time. As the child grows, she'll achieve normal or near-normal walking patterns by about 8 to 10 years of age, or by the time she becomes a teen.

    Braces, special shoes and exercises don't usually speed up or help the body's own mechanism for self-correcting femoral anteversion.

    If surgery is needed

    In a very few cases, the twisting-in may be severe and may not self-correct by the time a child is age 8 or 9. For children with severe, unresolved femoral anteversion at that age, doctors may perform surgery to reposition the femur at a more normal angle. In the procedure (called a 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.

    After surgery

    After surgery, your child will probably stay in the hospital for a couple of days, and be given pain medication. When she goes home, she'll need to limit her weight-bearing activities, and she might use crutches or a walker for a few weeks. Physical therapy will help her restore her muscle strength. She'll probably be able to resume full activities, including sports, after three or four months.

    Long-term outlook

    • Since femoral anteversion is self-correcting in up to 99 percent of cases, the long-term outlook is very positive for most children with the condition.
    • For children who need surgery for severe forms of the condition, the outlook is also excellent. The surgery itself is quite safe, with the added bonus that children's bones usually heal faster and more reliably than adults'.
    • Femoral anteversion doesn't typically lead to arthritis or any other future health problems.

    Coping and support

    At Boston Children's, we understand that a hospital visit can be difficult. So, we offer many amenities to make your child's—and your own—hospital experience as pleasant as possible. Visit the Center for Families for all you need to know about:

    • getting to Boston Children's
    • accommodations
    • navigating the hospital experience
    • resources that are available for your family

    In particular, we understand that you may have a lot of questions when your child is diagnosed with femoral anteversion. Will my child need surgery? How long will her recovery take? Will it affect her long term? Boston Children's can help you connect with extensive resources to help you and your family through this stressful time, including:

    • patient education: From doctor's appointments to treatment to follow-up, our nurses and physical therapists will be on hand to walk you through your child's diagnosis, surgery and recovery. And once your child is home, we'll help you coordinate and continue the care and support she received at Boston Children's.
    • parent-to-parent: Want to talk with someone whose child has been treated for femoral anteversion? Our Orthopedic Center can often put you in touch with other families who've been through the same experience that you and your child are facing.
    • faith-based support: If you're in need of spiritual support, we'll connect you with the Children's chaplaincy. Our program includes nearly a dozen clergy—representing Protestant, Jewish, Muslim, Catholic and other faith traditions—who will listen to you, pray with you and help you observe your own faith practices during your hospital experience.
    • social work: Our social workers and mental health clinicians have helped many other families in your situation. We can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness and dealing with financial issues.
  • For more than a century, orthopedic surgeons and investigators at Children’s Hospital Boston have played a vital role in advancing the field of musculoskeletal research. We’ve developed breakthrough treatments and major advances for lower limb and hip problems, as well as 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 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
    • 28 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:

    • We’re conducting 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.
    • We’re studying 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.
    • We’re studying 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. 
    • We’re studying 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. 
    • 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:

    Children speak about what it's like to be a medical research subject

    View a video of a day in the life of Children’s Clinical and Translational Study Unit, through the eyes of children who are “giving back” to science.

    Boston Children's Hip Program's unique insight and expertise

    Children’s Child and Adult Hip Preservation Program enjoys a special degree of effectiveness; not just because of our long tradition of excellence in pediatric hip care, but also because we follow our patients through adulthood. This gives us a unique perspective, insight and expertise—we can track how the hip works in each age group, how the problems evolve, and how the hip’s function changes over time in adult patients who’ve had treatment in childhood.

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