Developmental Hip Research | Overview
Developmental hip conditions such as hip dysplasia, Legg-Calve-Perthes disease and slipped capital femoral epiphysis can lead to premature arthritis in young adults, resulting in 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 complex 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 hip dysplasia. Our studies use outcomes measures, custom questionnaires and special methods for measuring results – both prospectively (before treatment) and retrospectively.
- We’re studying long-term outcomes after Bernese periacetabular osteotomy (Bernese PAO) for hip dysplasia: Since 1991, Boston Children's has performed over 1,400 Bernese periacetabular osteotomies to correct dysplastic hips in teens and adults, whose hip sockets have finished growing. Our large volume makes us 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 ages 13 or 14 through adult – 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 developmental dysplasia of the hip.
- 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, andenrolls more than 500 patients each year in various studies.