Hip Fracture | Research & Innovations

For more than a century, orthopedic surgeons and investigators at Children’s Hospital Boston 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 20 clinical investigators
  • a team of research coordinators and statisticians

New trauma/ER database

Under the direction of Travis Matheney, MD, Boston Children’s database of orthopedic ER trauma cases — implemented in July 2010 — has begun outcomes research, in which we track/compile orthopedic trauma data, such as:

  • type and location of a fracture
  • outcome (quality improvement)
  • whether the injury required admission to the hospital
  • how was the injury initially treated

The information gathered from this ongoing tracking study will further influence how specialists in Boston Children’s Orthopedic Trauma Program care for children by providing accurate, comprehensive tracking, and outcomes data.

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.

Clinical Effectiveness Research Center

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

Major areas of focus for the CERC include:

Ongoing laboratory studies include:

  • basic science studies
  • biomechanical/instrumentation studies

Orthopedic basic science laboratories

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