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There is often a question of how long it’s safe to postpone PAO surgery during the early stages of hip dysplasia in adolescents and adults. Sometimes there’s a labral tear that is tempting to repair with arthroscopy in the hopes of postponing PAO surgery. However, arthroscopic repair does not correct the shallow socket that caused the labral tear in the first place. (click here to view the IHDI  arthroscopy statement). PAO surgery is a pretty big surgery that is currently the best way to re-shape the socket and support the hip better. Mild pain from hip dysplasia can often be tolerated or managed instead of proceeding directly to major surgery like the PAO, but waiting too long may increase the chances of needing a total hip replacement. Now, there’s some new research that sheds some light on waiting or not.

A study about waiting or proceeding with PAO surgery was published in a May 2019, issue of the prestigious Journal of Bone and Joint Surgery. https://www.ncbi.nlm.nih.gov/pubmed/31094985 This study was unique because it looked at all stages of arthritis caused by hip dysplasia and compared the patients who had PAO surgery to those who had not undergone PAO surgery. The period of follow-up was as long as 20 years for both groups.

It’s not too surprising that the PAO surgery performed earlier made the biggest difference in avoiding total hip replacement. However, there were some interesting details. The benefits of PAO surgery were less pronounced when there was only dysplasia without any thinning of the cartilage space and no signs of early arthritis on x-ray. However, as soon as the earliest signs of arthritis showed up – mild thinning of the joint space, or small bone spurs – then PAO surgery had the greatest benefit. This was stage 1 of arthritis by the Tönnis classification. Patients who avoided surgery at this stage had more than twice the risk of total hip replacement within ten years. The benefit of PAO surgery was present for Stage 2 of arthritis – moderate joint space thinning, presence of cysts, and moderate loss of roundness of the hip. However, approximately half of these people needed total hip replacement within 10 years compared to three fourths of people who had not undergone PAO surgery. Advanced arthritis in the presence of hip dysplasia only helped for a short period of time and by ten years, 93% of PAO patients had a total hip replacement compared to all the patients who avoided PAO surgery.

What this seems to say is that it may be OK to wait at first if there’s no sign of any arthritis on the x-ray, but as soon as the first sign of arthritis is visible on x-ray, then the PAO surgery has the most benefit. After the arthritis has gotten a little worse, then PAO surgery can help but not as much as when it’s performed during the early stage of arthritis. The people who can safely consider postponing PAO surgery for a little while are those who are discovered to have a shallow socket when they don’t have much pain, and there is no visible arthritis on regular x-rays.

The post Should you wait to have a PAO until your arthritis gets worse? appeared first on International Hip Dysplasia Institute.

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A blog post by Nancy Muir

The diagnosis of hip dysplasia can elicit a gamut of emotions. There may be feelings of shock or disbelief. There may be confusion, frustration, anger, or fear. There may be relief or validation. And maybe even hope. These emotions may be experienced singularly, or they may hit in a variable, collective flood.

When it comes down to it, there are two things you need to know:

  1. Each person with hip dysplasia experiences it in their own way. This is YOUR journey, and there is no right or wrong way for it to be experienced.
  2. You’re not alone. There are 1000s of other adolescents and adults out there who are going through their own hip dysplasia journeys. Whether you choose to seek out this community or not, know that there are others out there who “get it.”

A hip dysplasia diagnosis, the treatment options, surge of emotions, and terminology can all be overwhelming and very frightening.

So where does someone who was just diagnosed with hip dysplasia even begin?

  1. First, take a deep breath and try to relax. It’s going to be a long journey, but you can do this.
  2. If you haven’t already, find a surgeon who specializes in hip preservation surgeries. He or she can help you learn more about your individual hip structure and function, can order additional images and tests such as MRIs, CT scans, and X-rays, and can work with you to determine what your treatment options are, and which one might be the best for you. There are some resources for finding surgeons who specialize in hip preservation and lists of questions you can ask during your consultation on the IHDI website. It is important to find a surgeon who you trust and who works with you to make sure that you are comfortable with your treatment decisions.
  3. Regardless of whether you decide to manage your hip dysplasia conservatively or surgically, talk to your surgeon or primary care physician about whether physical therapy would be beneficial for you. A physical therapist who is knowledgeable in treating complex hip disorders can help with conservative or pre-operative symptom management through strengthening, pain management techniques, and movement re-education. Establishing care with a physical therapist will also be important if you pursue surgery and he or she can work with you to help you return to your home, work, family, and sports activities.
  4. How are you doing mentally and emotionally? Many patients report struggling with mental health concerns around their hip dysplasia diagnosis. Many experience anxiety, depression, difficulty sleeping, feelings of anger or frustration, loss of identity and loneliness. If you are struggling with any of these, consider seeking a support group, formal mental health support from a licensed therapist, or even discussing medical treatment with your surgeon or primary care physician. Mental health has been associated with long-term outcomes in some patients following hip preservation surgery, so identifying these issues and investing in support for them early may improve your outcomes.
  5. Consider seeking support from other hip dysplasia patients. Many adolescent and adult hip dysplasia patients express difficulty sharing their thoughts and concerns about their hip dysplasia diagnosis with friends and families. Many patients report that they benefit from peer support either in the form of mentorship from another hip dysplasia patient or from an online or in-person support group. If you are interested in peer support, search for online groups or ask your surgeon if he or she is aware of any local patient support groups or former patients who might be willing to provide some mentorship through this process. Keep in mind that every patient with hip dysplasia is different and each individual journey is unique. Try not to compare yourself to others. Trust your gut, trust your body, and trust your medical providers when it comes to your individual hip dysplasia journey. Don’t feel that what is right for other patients has to be right for you but do know that there are many wonderful and knowledgeable patients out there who want to support you if you need it.
  6. Finally, take a deep breath and try to relax. It’s going to be a long journey. But you CAN do this.

The post So. You’ve just been diagnosed with hip dysplasia. Now what? appeared first on International Hip Dysplasia Institute.

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International Hip Dysplasia Institute by Andrew.younger@orlandohealth.com - 3w ago

Hip Dysplasia Books and Resources

Betsy Miller
IHDI Advisory Committee
Author of The Parents’ Guide to Hip Dysplasia
betsy.miller@hipdysplasia.org

Hi everyone! In the last IHDI newsletter I covered a couple of books about hip dysplasia for babies and children (Hope the Hip Hippo). This time, I’m reviewing two books about adult hip dysplasia. Adults can have hip dysplasia if they weren’t diagnosed and treated in childhood, or if they were treated and still have residual hip dysplasia.

The first book I’m reviewing today is Anatomy Riot, which was written by Emily Running, a dancer and aerialist whose hip dysplasia wasn’t diagnosed  and treated until adulthood.

Anatomy Riot
by Emily Annette Running

In Anatomy Riot, Emily Running shares her personal experience as a dancer and aerialist who discovers that she has hip dysplasia and needs major hip surgery—a  PAO, also called periacetabular osteotomy. Emily takes the reader through the devastating diagnosis and the aftermath, which was compounded by the fact that all of her income depended on her ability to dance, teach yoga and Pilates, and so on. This memoir goes beyond the physical aspects and shares the emotional and social impact of diagnosis, treatment, and recovery. Anatomy Riot is easy to read and not at all depressing. Emily Running’s resilient personality and interesting occupation make this an engaging read.

This book is available through most online booksellers, and you can order a copy at many brick and mortar bookstores.

Amazon: https://www.amazon.com/Anatomy-Riot-Emily-Annette-Running/dp/1494278391

Contact Emily Running: https://www.movementinspired.com/

The next book I’m reviewing is A Guide for Adults with Hip Dysplasia by Denise Sutherland and Dr. Sophie West who both have adult hip dysplasia.

A Guide for Adults with Hip Dysplasia
by Denise Sutherland and Dr. Sophie West

A Guide for Adults with Hip Dysplasia is an incredibly complete resource about hip dysplasia and its treatment in adulthood. Not only does this illustrated book clearly explain hip anatomy and surgical treatments, it goes beyond the medical context to offer practical advice and emotional support for patients before, during, and after surgery. The authors’ friendly tone and the many quotes they’ve included from patients who have been through treatment really bring this book to life. Thank you Denise and Dr. Sophie for writing this wonderful book. It’s a welcome addition to my bookshelf.

This book is available through most online booksellers, and you can order a copy at many brick and mortar bookstores.

Amazon: https://www.amazon.com/Guide-Adults-Hip-Dysplasia/dp/0987215205/ref=cm_cr_arp_d_product_top?ie=UTF8

Contact Denise Sutherland: https://sutherland-studios.com.au/about.php

Contact Dr. Sophie West: https://hipdysplasia.org/about/international-advisory-board/sophie-west/

The post Book Review V2 appeared first on International Hip Dysplasia Institute.

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International Hip Dysplasia Institute by Andrew.younger@orlandohealth.com - 3w ago

Contrary to popular belief, this W-sitting posture is normal for many children, and should be allowed even though children who can sit like this often walk with their feet turned in – called pigeon toed walking. The medical term that allows W-sitting is called Internal Femoral Torsion because the thigh bone has an increased twist in some people.

Treatments for this common variation were debunked more than twenty years ago, but myths still persist about the best way to stop this way of sitting and walking. This way of sitting and walking is often noticed around the age of three years while the child is very flexible. During further growth, the bone twist goes away naturally in 99% of children without intervention. When this goes away, parents and doctors often credit whatever they did to “help” it go away. Studies have shown that W-sitting does not cause any harm to the developing hips, and does not contribute to hip dysplasia. The Seattle Children’s Hospital has a short brochure for those who want to learn more about this common variation of normal. https://www.seattlechildrens.org/pdf/pe245.pdf

Each of us have differences in body shapes and abilities, which explains why some people are gymnasts or sprinters and others are basketball players or swimmers. These are variations of normal. Internal Femoral Torsion is one of those variations like being left-handed or having reddish hair except that Internal Femoral Torsion decreases with age. Research studies show that adolescents who could W-sit during childhood have athletic abilities that are just as good in those who did not W-sit during childhood. [https://www.ncbi.nlm.nih.gov/pubmed/608277] Some doctors have noticed that these children may engage in different sports than those who did not W-sit with sports such as swimming and gymnastics being preferred.

There has been concern that increased Femoral Torsion can cause hip dysplasia, but this is not the case. While increased femoral torsion is more common in older children with a dislocated hip, this is because the twist does not improve spontaneously when the hip is out of the socket. Early treatment to get the hip back into the socket can allow the hip to develop naturally and this is another reason why early treatment is important for hip dysplasia. Pediatric orthopedic surgeons who treat older children for a dislocated hip are aware that these older children may need correction of internal femoral torsion when surgery is performed. The surgeons can evaluate this during surgery and adjust as needed. Stopping W-sitting has no influence on femoral torsion whether the hip is in or out of the socket.

The post W-Sitting and Hip Development appeared first on International Hip Dysplasia Institute.

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A blog post by Nancy Muir

The diagnosis of hip dysplasia can elicit a gamut of emotions. There may be feelings of shock or disbelief. There may be confusion, frustration, anger, or fear. There may be relief or validation. And maybe even hope. These emotions may be experienced singularly, or they may hit in a variable, collective flood.

When it comes down to it, there are two things you need to know:

  1. Each person with hip dysplasia experiences it in their own way. This is YOUR journey, and there is no right or wrong way for it to be experienced.
  2. You’re not alone. There are 1000s of other adolescents and adults out there who are going through their own hip dysplasia journeys. Whether you choose to seek out this community or not, know that there are others out there who “get it.”

Treatment for hip dysplasia can be broken down into two main categories: non-operative/conservative or operative/surgical.

Conservative Management

Most doctors and surgeons will recommend that patients start with conservative management. This may be a simple as modifying your activities, taking over the counter pain medication, or doing physical therapy to strengthen your core and hips and re-train your movement patterns. Some people argue that hip dysplasia is a structural issue and that conservative management cannot “fix” the structural issue. This is true. But hip dysplasia pain is also poorly understood, and a course of conservative management can help determine what pain is related to the actual structure (primary) and what is secondary. Sometimes activity modification, reducing pain and inflammation, and strength, posture, and movement education is enough to relieve symptoms and allow people with healthy joint tissue to continue to lead active lives with only occasional monitoring of their hips. For others, the risk of arthritic progression is high or conservative management is not effective and quality of life remains decreased. In these cases, surgery may be a good option.

Surgical Management

There are several surgical treatments for adolescent and adult hip dysplasia, including operations to change the alignment of the hip bones (osteotomies); minimally-invasive operations to reshape the bones or address the soft tissue structures inside or around the joint like the labrum, cartilage, or joint capsule (arthroscopies or “hip scopes”); and total hip replacement (arthroplasty).

Osteotomy Procedures: Pelvis

Osteotomy procedures are considered to be a type of “joint preservation surgery” since the goal is to improve the function of the person’s natural hip. Osteotomies involve cutting bones and moving them to improve alignment. Since hip dysplasia is characterized by a shallow hip socket (acetabulum) that doesn’t fully cover the top of the thigh bone (head of the femur), the most commonly performed osteotomy surgery for hip dysplasia is a pelvic osteotomy called the periacetabular osteotomy or “PAO.” PAO surgery involves performing a series of bone cuts (osteotomies) around (peri) the hip socket (acetabulum). The acetabulum can then be moved to improve coverage of the head of the femur to improve weight bearing stresses and decrease pain.

Osteotomy Procedures: Femur

Some people with hip dysplasia also have abnormally-shaped femurs. In these cases, the femur may be described as being anteverted (top of the femur is turned forward significantly more than the bottom), retroverted (top of the femur is turned back significantly more than the bottom), valgus (increased angle between the long bone and the top of the femur), or varus (decreased angle between the long bone and the top of the femur). If your doctor feels that the shape of your femur is contributing to your symptoms, he may decide to do a “femoral osteotomy” (surgery that involves cutting the femur and reorienting it to improve the alignment). Depending on the patient, this may be performed as a stand-alone procedure or it may be before, during, or after a pelvic osteotomy.

Hip Arthroscopy (“scopes”)

Some patients with hip dysplasia benefit from a less invasive surgery called hip arthroscopy (often referred to as a “scope”). During arthroscopy, the surgeon makes several small incisions and can insert a special camera into the joint and surrounding areas. He then can use special instruments to address “intraarticular” issues (problems inside the joint such as repairing the labrum or cartilage) and “extra-articular” issues (problems outside the joint such as shaving down bone of the thigh bone or pelvis to improve alignment).

Often times, arthroscopy, alone, is not appropriate for people with hip dysplasia. This is because it cannot address the underlying issue, which is a shallow hip socket that doesn’t fully cover the head of the femur.

When the surgeon feels that intraarticular or extra-articular issues are causing pain and may continue to be problems even after osteotomy procedures, he may recommend doing hip arthroscopy either before, during, or after an osteotomy. If the damage in the joint is mild and the surgeon feels that improving the alignment of the joint with an osteotomy surgery will take the load off of the inside structures of the joint and improve overall alignment and joint function, he may decide to do the osteotomy, alone.

In some cases of very mild or borderline hip dysplasia or when symptoms are felt to be more due to impingement and not instability from dysplasia, a surgeon may decide to do hip arthroscopy, alone. Some patients choose this option knowing that they may still have to have an osteotomy at a later point, but they may want to try a less invasive surgery first. In select patients, arthroscopy, alone, may be enough to improve symptoms and function and prevent the need for an additional hip surgery. This is still an area of debate in the hip preservation world.

When hip arthroscopy is an option in a patient with dysplasia, patients should have a detailed conversation with their surgeon to understand why this might be an appropriate surgery and what the goals and expectations of it should be.

Hip Arthroplasty (“hip replacement”)

Patients who are older and/or who already have significant cartilage damage or arthritis in their hip joint may not be candidates for osteotomy or arthroscopy surgeries. Patients who are having pain and decreased function may decide to have arthroplasty surgery (a total hip replacement (“THA”). THA involves replacing the socket and the head of the femur with implant made out of a variety of materials including plastic, metal, and ceramic. In some patients, resurfacing may be an option. Historically THA has not been recommended for younger or more active patients since the parts can wear down and need to be replaced multiple times in a lifetime. Research and technology in this field is improving though. Implants are starting to last for longer periods of time and changes in surgical techniques allow some patients to continue to be highly active after surgery.

You might be thinking right now: “One word: overwhelmed.”

Yes, a hip dysplasia diagnosis, the treatment options, surge of emotions, and terminology can all be overwhelming and very frightening. So where does someone who was just diagnosed with hip dysplasia even begin?

  1. First, take a deep breath and try to relax. It’s going to be a long journey, but you can do this.
  2. If you haven’t already, find a surgeon who specializes in hip preservation surgeries. He or she can help you learn more about your individual hip structure and function, can order additional images and tests such as MRIs, CT scans, and X-rays, and can work with you to determine what your treatment options are and which one might be the best for you. Some resources for finding surgeons who specialize in hip preservation and learning what questions you should ask can be found on the IHDI website. It is important to find a surgeon who you trust and who works with you to make sure that you are comfortable with your treatment decisions.
  3. Regardless of whether you decide to manage your hip dysplasia conservatively or surgically, talk to your surgeon or primary care physician about whether physical therapy would be beneficial for you. A physical therapist who is knowledgeable in treating complex hip disorders can help with conservative or pre-operative symptom management through strengthening, pain management techniques, and movement re-education. Establishing care with a physical therapist will also be important if you pursue surgery and can work with you to help you return to your home, work, family, and sports activities.
  4. How are you doing mentally and emotionally? Many patients report struggling with mental health concerns around their hip dysplasia diagnosis. Many experience anxiety, depression, difficulty sleeping, feelings of anger or frustration, loss of identity and loneliness. If you are struggling with any of these, consider seeking a support group, formal mental health support from a licensed therapist, or even discussing medical treatment with your surgeon or primary care physician. Mental health has been associated with long-term outcomes in some patients following hip preservation surgery, so identifying these issues and investing in support for them early may improve your outcomes.
  5. Consider seeking support from other hip dysplasia patients. Many adolescent and adult hip dysplasia patients express difficulty sharing their thoughts and concerns about their hip dysplasia diagnosis with friends and families. Many patients report that they benefit from peer support either in the form of mentorship from another hip dysplasia patient or from an online or in-person support group. If you are interested in peer support, search for online groups or ask your surgeon if he or she is aware of any local patient support groups or former patients who might be willing to provide some mentorship through this process. Keep in mind that every patient with hip dysplasia is different and each individual journey is unique. Try not to compare yourself to others. Trust your gut, trust your body, and trust your medical providers when it comes to your individual hip dysplasia journey. Don’t feel that what is right for other patients has to be right for you, but do know that there are many wonderful and knowledgeable patients out there who want to support you if you need it.
  6. Finally, take a deep breath and try to relax. It’s going to be a long journey. But you CAN do this.

The post So. You’ve just been diagnosed with hip dysplasia. Now what? appeared first on International Hip Dysplasia Institute.

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International Hip Dysplasia Institute by Andrew.younger@orlandohealth.com - 1M ago

By Betsy Miller
IHDI Advisory Committee
Author of The Parents’ Guide to Hip Dysplasia

Hi, everyone. I’m so happy to have the opportunity to be a guest contributor to the International Hip Dysplasia Institute newsletter! I’m going to be writing about books and resources that are specifically about hip dysplasia.

I was treated for hip dysplasia myself as a baby. I don’t remember my cast or brace, but I do remember growing up without mobility problems. Last year at age 56, I had my left hip replaced. The surgery went very well, but I’m sure without treatment I would have needed the surgery decades ago. So you might say I have a long-term interest in hip health.

As some of you know, I wrote a book to help parents who are dealing with a child who has hip dysplasia. This ultimately led to me getting to know Dr. Charles T. Price from the IHDI medical board. When the IHDI was formed, I worked with Dr. Price to write many of the topics on the IHDI website www.hipdysplasia.org. There’s a lot of good information available concerning hip dysplasia in children and in adults. Of course, the IHDI is also involved in medical research for hip dysplasia. You can learn about those efforts on the IHDI website as well.

Dr. Price asked me to include my own book along with the others, which feels a little awkward, but it would be even more awkward to leave it out. So today’s books are: The Parents’ Guide to Hip Dysplasia and Hope, the Hip Hippo. Both of these books are resources for parents. I will be writing about more books, including books for adults with hip dysplasia, in future IHDI newsletters.

Happy reading!

The Parents’ Guide to Hip Dysplasia
by Betsy Miller

The Parents’ Guide to Hip Dysplasia is an easy-to-understand resource that explains what hip dysplasia is and guides parents through diagnosis and treatment for babies, children, and adolescents.

This book is available through most online booksellers, and you can order a copy at many brick and mortar bookstores.

Amazon:https://www.amazon.com/Parents-Guide-Hip-Dysplasia-ebook/dp/B00LMKZ58O/ref=tmm_kin_swatch_0?_encoding=UTF8&qid=&sr=

Indiebound: https://www.indiebound.org/book/9780897936460

To reach me please contact: Betsy.Miller@hipdysplasia.org

Hope the Hip Hippo
by Gina Jay & Julie Beattie
Illustrated by Cherie Turner

Hope the Hip Hippo is a children’s picture book with bright, animated art that follows Hope, a pink hippo who has hip dysplasia, through her treatment. Hope loves to run, play, and dance, but her hips hurt until she goes to Dr. Kindly to get them fixed.

The authors did a great job of keeping the story reassuring and simple enough for a child to understand. I love the little details, like the way Hope is smiling when she gets an x-ray because x-rays don’t hurt, and how she wakes up after surgery in a hip spica cast and says, “I’m stuck!” because she can’t move her legs. At the end of the story, Hope’s hips are better and she’s back to dancing.

I highly recommend this book to families with a young child who needs treatment involving a hip spica cast.

This book is available through most online booksellers, and you can order a copy at many brick and mortar bookstores.


Hope’s website: https://www.hopethehiphippo.com/

Amazon: https://www.amazon.com/Hope-Hip-Hippo-Dysplasia-Children/dp/1460200624

The post Book Review – Hope the Hip Hippo appeared first on International Hip Dysplasia Institute.

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International Hip Dysplasia Institute by Andrew.younger@orlandohealth.com - 2M ago

The hip spica cast – body cast – is often a necessary part of hip dysplasia treatment. Doctors and parents know this can be a difficult challenge at any age. A survey reported in a nursing journal in 2015 documented that the majority of parents experience emotional and care problems at some time when the hip spica cast was used for longer than three months. If you or someone you know is in distress because their child is in a hip spica cast, please seek help that may even include psychological counseling.

Some resources are available on this website to help understand management in a hip spica cast. Also, see our previous post about waterproof cast liners that can help decrease skin problems (See previous post here). There is also a website dedicated to supporting spica cast families (SpicaLife.com).

One new piece of information is that it may be possible to shorten the time in a body cast if a brace is worn after the cast is removed. It’s best to have the brace ready before the cast is removed so the child can be washed carefully and put into the brace without disturbing the hip position. In one study, the time in the cast was decreased to four weeks with this practice. [https://www.ncbi.nlm.nih.gov/pubmed/?term=emara+k+and+ddh] It’s best to discuss the cast in advance with your doctor to see if there are special circumstances. Also, before surgery is a good time to discuss and options for waterproof cast liners, length of time in the cast, and how you will manage your child.

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A body cast, or hip spica cast is used after closed reduction or surgery for hip dysplasia [https://hipdysplasia.org/developmental-dysplasia-of-the-hip/child-treatment-methods/hip-spica-cast/]

It may be helpful to ask your doctor about the cast itself in addition to reviewing tips for managing a child in a hip spica cast. [https://hipdysplasia.org/developmental-dysplasia-of-the-hip/tips-for-parents/spica-cast-tips/]

Two separate research studies have shown that a Goretex waterproof cast liner can decrease skin irritation and improve ease of care for infants in a cast for hip dysplasia.

Standard cotton-based cast liners can be cut to fit and are widely available compared to waterproof cast liners that come in different sizes. The Goretex hip spica liners need to be ordered in advance or the hospital needs to keep an inventory of different sizes so this influences availability of waterproof hip spica liners.

Most of the Top Children’s Orthopedic Hospitals recognized by US News and World Report use this liner, but it is somewhat expensive and may not be completely reimbursed by insurance companies. However, the waterproof liners have been shown to be cost-effective because fewer cast changes are needed for soiling or skin problems.

A waterproof liner is especially helpful for infants because they can’t control their bowel and bladder. It is difficult to clean a cast that has been soiled with urine or bowel movements and the urine may soften a cast made of plaster of Paris. For older children a standard cotton-based liner is often satisfactory because they can help keep their casts clean. You may want learn more [https://aquacastliner.com/products/hipster-liners/]  and discuss this option with your doctor if your child is scheduled for a spica cast application.

Some doctors use synthetic fiberglass materials to apply the spica cast while others prefer standard plaster of Paris. In general, the synthetic materials hold up better and allow better x-rays in the cast. However, plaster of Paris is sometimes easier to mold so the hip stays in place better. The techniques for applying each of these materials are slightly different. Both come in rolls like elastic bandages that are used to treat sprains and decrease swelling. However, casting tape is filled with plaster of Paris or fiberglass resin that is activated by dipping the material in water. The setting process occurs in about five minutes so the doctor and cast technicians have time to apply the cast materials.

The post Cast Liners and Synthetic Cast Materials appeared first on International Hip Dysplasia Institute.

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The strategic initiatives of the IHDI account for some of the most ambitious goals ever undertaken by the IHDI. To be successful, it will require the leadership and participation of the IHDI administration, IHDI Medical Advisory Panel, advocates and countless volunteers. In addition, because of the world-class nature of the Institute, it is imperative we have support and leadership from outside the orthopedic community. To this end, the International Advisory Committee (IAC) has been created.

Members of the IAC are from diverse backgrounds and geographies. They hail from 3 different countries located on 3 different continents giving us a diverse and comprehensive position.

We are honored by their commitment and humbled by their passion.

To learn more our IAC members, please click here.

The post The International Advisory Committee appeared first on International Hip Dysplasia Institute.

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International Hip Dysplasia Institute by Andrew.younger@orlandohealth.com - 2M ago

“Newborn Hip Checks Have Failed to Prevent Late Diagnosis”

This was a recent headline on BBC News in England. https://www.bbc.com/news/health-47735103 A research paper published by an IHDI Physician showed that the rate of late diagnosis has not changed in 35 years. This is in spite of a national health service and wide use of ultrasound for babies at higher risk for hip dysplasia; such as families with positive family history or breech births. During the period of the study approximately 30 children per year weren’t diagnosed until after the age of one year. That doesn’t count the children detected after six weeks of age when treatment is only half as successful as hip dislocations found before six weeks of age. An IHDI study published in 2016 showed one in four children with a dislocated hip wasn’t diagnosed until after the age of six weeks.

This recent report from England emphasizes that current methods of early diagnosis have clearly failed. Physical exam of the newborn, even by experienced physicians, is not as reliable as once thought. Professor Ortolani described the technique for newborn examination in 1948 and many pediatricians have learned to perform this examination skillfully. However, in Professor Ortolani’s book he stated that only mild hip dislocations that can be placed back into the socket can be detected. He specifically noted that the dislocation signs, “…in serious cases, they are seldom noticeable”. This is because the hip is trapped outside the socket so there is no sensation of the hip going into and out of the socket.

It is clear that improved methods of diagnosis are needed. Comprehensive ultrasound studies are expensive and time consuming to perform for every infant. However, IHDI is investigating newer technological advances that may assist the examiner by “listening” to the sounds of a normal or abnormal hip, or by using simpler ultrasound methods at the bedside with an APP for a hand-held mobile device.

You can help by supporting development of new technology and by being aware that all hip dislocations cannot be detected by physical examination alone.

The post Diagnosing newborns in the UK appeared first on International Hip Dysplasia Institute.

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