Hip Preservation | Conditions We Treat

Treatment for Congenital, Developmental and Post-Traumatic Hip Disorders

Our Hip Preservation Program team evaluates and treats the full spectrum of hip disorders, including congenital, developmental, and post-traumatic. A unique feature of our program is that we treat these conditions not only in newborns, children and teens, but also in adults up to age 45.

The labrum is a band of soft tissue (cartilage) that lines the hip socket. It protects the surface of the joint and provides stability to the hip bones. A tear in the labrum can occur because of a sudden injury, or can be due to wear and tear over time. Some labral tears may do well with conservative treatment, while selected cases might require surgery.

Primary acetabular (hip) dysplasia in adolescents and young adults causes pain, instability, decreased hip function, and damage to the hip cartilage (labrum). Without treatment, it often worsens throughout the late teen years and into adulthood, commonly affecting active patients. A hip preservation surgery called periacetabular osteotomy (PAO) offers good long-term results. Our team has specialized training in this procedure and routinely performs PAOs in patients of all appropriate ages.

Articular cartilage is a smooth tissue that covers the ends of the hip bones where they meet at the joint. They allow the bones to move freely with little friction. Damage can occur to the cartilage due to injury or normal wear and tear. Several treatments—both surgical and non-surgical—are available for an articular cartilage injury.

Avascular necrosis occurs when there is a loss of blood flow to the bone, which causes irreversible bone loss. AVN can result in the collapse of bone and cartilage and leads to significant disability in weight bearing joints such as the hip. Treatment ranges from simple injections and decompressions of the bone to osteotomies or even total joint replacement in severe cases.

We use a special technique to treat AVN, using either tissue from the patient’s own body (autograft) or tissue from an organ donor (allograft). We are leaders in research using these regenerative approaches.

Chondrolysis is associated with slipped capital femoral epiphysis (SCFE). It occurs when joint cartilage on both the femur and the hip socket break down. Chondrolysis may occur at any time as a result of the SCFE or for unknown reasons.

In this deformity of the hip, the angle formed between the head and neck of the femur (thigh bone) and its shaft is decreased, which affects limb length. Coxa vara increases the likelihood for bone fractures and for earlier osteoarthritis (OA). Possible treatment options range from epiphysiodesis (which allows the bone to grow into a more natural shape) to osteotomy of the femur (cutting the bone to correct the angulation).

Developmental dysplasia of the hip, or hip dysplasia, is the abnormal development of the hip joint. It occurs when the hip ball and socket are not properly shaped and connected. Symptoms include limping and pain. Treatment varies depending on how severe the condition is.

Femoroacetabular impingement (FAI) is the result of the hip ball socket not fitting together properly. Without treatment, FAI causes repetitive injury to the hip socket. This repetitive injury leads to pain, breakdown of cartilage, decreased function and the development of osteoarthritis (OA). Treatment can include arthroscopic or open surgery.

Femoral anteversion occurs when the femur (thigh bone) twists inward. This causes a child’s feet and knees to turn in, which is sometimes referred to as being “pigeon-toed.” This condition typically clears up on its own. Severe cases affecting function may require surgery.

Hip cartilage injuries can occur after trauma or due to a more chronic condition. We use a special technique to reconstruct the cartilage, using either tissue from the patient’s own body (autograft) or tissue from an organ donor (allograft). We are leaders in research using regenerative approaches like this for cartilage repair.

A hip fracture occurs when there is a break in the upper portion of the femur (thigh bone). Fractures can range from mild to severe. We look at the patient’s overall health and medical condition when determining treatment for a hip fracture. Treatment can include both surgical and non-surgical options.

Legg-Calvé-Perthes disease is a disease of the hip that occurs when the hip joint does not get enough blood. With this disease, the head of the femur (thigh bone) that sits in the hip joint breaks down. It can cause pain and limping. LCP is temporary and will resolve over time. Treatment can include both surgical and non-surgical options.

After trauma to the hip, such as a fracture or dislocation, related problems can appear, including post-traumatic arthritis. This causes pain and swelling in the joint. Treatments vary depending on the cause and how severe the condition is.

Slipped capital femoral epiphysis occurs when a portion of the hip ball separates from the rest of the femur (thigh bone) and occurs through the growth plate. Symptoms may include pain, limping, and the inability to walk or bear weight on the leg. Treatment includes both arthroscopic and open surgery.

Septic arthritis is an infection of the joint. It generally causes a significant amount of pain. Treatment includes a combination of medication and draining the joint to remove the infected fluid (usually through surgery).

A hip stress fracture occurs because of overuse. People of any age can experience a hip stress fracture. Treatment typically involves rest from the activity that caused the stress fracture. If left untreated or unresponsive to non-operative treatment, surgery may eventually be needed.

This is a common cause of hip pain in kids ages 3-8. It is also sometimes called toxic synovitis. With TS, the hip becomes inflamed, and can cause limping and pain in the hip and leg. It typically clears up on its own and doesn’t cause any known, long-term problems.

Hip Preservation in Young Adults

Hip conditions are not uncommon in young adults ages 15 and up. Often, they have chronic pain that affects their daily living. Treatment from the right healthcare team can make all the difference.

At Cincinnati Children’s, our Hip Preservation Program offers care for patients ranging from newborns up to age 45. We treat all hip conditions, whether it’s something you were born with or developed later in life. For young adults, we offer a wide range of advanced procedures that we customize for your specific needs. These procedures are designed to relieve pain and delay or prevent the need for future hip replacement.

If you’re a young adult looking for a solution to your hip pain, we would be happy to talk with you. We regularly perform consultations on patients ranging in age from newborn to 45 years old.

Three sisters smiling, one on crutches.

Associated Conditions

Children with cerebral palsy and spina bifida often can develop hip problems related to these conditions. These patients should be evaluated in their respective multidisciplinary clinics.

Second Opinion?

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Our Hip Preservation team offers second opinions for the full spectrum of hip disorders, including congenital, developmental and post-traumatic.

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