Treatment Options for Hip Disorders

Treatments for hip disorders can be extremely complex. There is not one right method that works for every patient. Rather, our Hip Preservation team works together — and with you — to form a strategy that will be the most effective treatment for you or your child.

We address every patient’s unique needs when developing a treatment plan. To determine the best course of treatment, we carefully look at a number of factors, including the following:

• Age of onset
• Type and severity of the condition
• Location of the condition
• Activity level of the patient
• Patient expectations

We have a variety of promising treatments to choose from. Our team will help your family understand your options (surgical and non-surgical) and what might work best for your child.

Surgical Options

• Periacetabular osteotomy (PAO)
  This surgery is used to treat hip dysplasia and instability of the hip most commonly in patients ages 12-45. The goals of surgery are to reduce pain, and restore function and movement. This surgery often allows patients to live a healthy, pain-free life.
  
• Surgical hip dislocation
  This procedure is used to treat a number of conditions that cause hip pain. With a surgical dislocation of the hip, the surgeon carefully relocates the head of the femur (the ball) from where it normally rests in the hip socket. This allows an unmatched view of the joint for a very wide range of procedures to treat a variety of hip conditions.
  
• Labral repair
  This surgery is used to repair a torn labrum in the hip joint. The labrum is a ring of soft tissue within the hip joint that helps stabilize the hip and protects the cartilage of the hip socket.
• Femoral osteoplasty
  Osteoplasty is a surgery used to remove bony prominences sometimes called cams. In a femoral osteoplasty, surgeons remove these cams from the ball of the femur (thighbone) so the hip joint has better range of motion. This surgery is often used to treat hip pain caused by femoroacetabular impingement (FAI).
• Triple osteotomy
  This surgery is also commonly called a triple pelvic osteotomy (TPO). It is used in patients who have a hip socket that is too shallow, a condition known as developmental dysplasia of the hip. During the procedure, the surgeon repositions the hip socket for a better fit to relieve pain. This procedure is used specifically for those hips too young for PAO, often between 6 years of age and 12 years of age.
• Femoral osteotomy
  A femoral osteotomy is a surgery used to treat problems in the thighbone (femur) and hip joint. The femur is the long bone in the upper leg that joins the pelvis to the knee. During this surgery, surgeons cut the femur to treat problems with the femur, hip or both.
  
• Hip Athroscopy
  Sometimes called a “hip scope,” this minimally invasive procedure uses an arthroscope to examine the inside of the hip joint. We offer a full range of hip arthroscopy procedures by themselves or with other procedures such as femoral osteotomy or PAO. We use a postless traction to prevent nerve injuries that can be common and permanent in patients.
  
• Closed and open reduction
  These are treatments for hip dysplasia and developmental dysplasia of the hip (DDH). They are used in young children, typically ages 1-6, to put the hip back in the socket. A closed procedure is done without an incision; an open procedure requires an incision.
  
• Surgical treatment for dysplastic hip
  This surgery, often used to correct DDH, is typically performed when a child is about 18 months old.
• Arthrotomy
  During an arthrotomy, the surgeon explores the hip joint, looking closely at the cartilage, interior structures, and ligaments. This surgery is used to diagnose a condition or for surgical repairs.

Recovery from a hip procedure can be lengthy and requires significant participation of families and the patient depending on age. We are dedicated to helping our patients have healthy recoveries. Our goal is to get you back to a normal activity level while still focusing on long-term hip preservation and follow-up care. We developed a specific pain management protocol for our patients that we use for most procedures. This protocol has not only led to the decreased use of narcotics and improved pain scores, but has also led to reduced hospital stays. 

Non-Surgical Options

• Observation. Your care team may choose to closely observe you or your child for a period of time if an intervention is not yet necessary.
• Activity restrictions. Limiting certain activities, such as high-impact sports, is often necessary during the healing process.
• Medications. Anti-inflammatory medicines are commonly used to treat hip pain that is mild to moderate.
• Physical therapy. Physical therapy is an important part of managing hip pain. It is used to strengthen muscles, maintain range of motion, increase flexibility, and reduce inflammation of the hip joint.
• Steroid injections. These are sometimes prescribed to help relieve pain.
• Bracing/casting. These methods are used primarily for treating developmental dysplasia of the hip.
• Pavlik harness. This brace is most often used for babies who have hip dysplasia. The harness keeps the hips and knees bent and thighs spread apart, to help allow the hips to grow properly.