Hip Preservation

Care from nationally recognized experts in hip dysplasia and acetabular impingement

Learn more about our pediatric orthopedic services


Some babies are born with unstable hips (hip instability). Adolescents, especially athletes and children with cerebral palsy, can develop hip issues. If these difficulties affect your child, expert care is closer than you think.

Joe DiMaggio Children’s Hospital is one of South Florida’s only pediatric orthopedic programs with hip preservation services. 

We deliver specialized therapies that stabilize hip joints, preventing abnormal wear and tear. Our services help many children avoid early onset arthritis and the need for a hip replacement later in life. Patients consistently achieve outstanding outcomes, returning to their daily routines and favorite activities without pain.

Why is Hip Preservation Necessary?

In a healthy hip, the thigh bone’s top end (ball) fits snugly into a ridge in the pelvis (socket). This keeps the joint stable and ensures smooth movement. With hip instability, the ball (femur head) is loose in the socket. 
There can be:
  • Hip dysplasia: The socket is too shallow to secure the ball. This allows the femur head to move in ways it shouldn’t. 
  • Acetabular impingement: Irregularities with the ball or socket cause bones to rub together. Impingement wears out the hip joint’s protective lining leading to pain that worsens over time. 

Nonsurgical Hip Preservation Treatments

Some children get better with nonsurgical treatments and avoid hip preservation surgery. 

Nonsurgical Hip Preservation Care may include:

Pavlik Harness or Spica Cast

Babies with hip dysplasia may benefit from a Pavlik harness. This soft splint holds the legs in a bent, outward-facing position.

Older children may need a Spica cast. It’s a hard plaster cast that holds the legs in a similar position. This aligns the femur head in the socket at the correct angle. Over time, connective tissue near the ball and socket tightens, stabilizing the joint.

Physical Therapy

Physical therapy is often necessary after Pavlik harness or Spica cast removal. Pediatric physical therapists guide your child through exercises to improve muscle strength and flexibility.

We also help your child achieve tasks like rolling over or standing that might not have been possible with a harness or cast. 

Ultrasound-Guided Injections

We relieve hip pain with steroid injections, which quiet inflammation. Experts use ultrasound imaging technology to deliver injections to the precise location they’re needed.

These treatments are available in many pediatric orthopedic clinic locations.

Hip Preservation Surgery

Multiple specialists come together to deliver seamless, personalized care if surgery is right for your child. The hip preservation specialist works alongside radiologists, physical medicine doctors (rehab specialists) and physical therapists. We manage the small details of your child’s procedure so you can focus on helping them feel better.

Types of hip preservation surgery we offer include:

Periacetabular Osteotomy

The surgeon starts by making a series of cuts in the socket part of the hip. This makes it possible to shift a section of bone, creating a more stable foundation for the femur head. They then adjust hip alignment to reduce wear and tear. Surgical screws secure bones in their new position. 

Surgical Hip Dislocation

The surgeon removes the femur head from the ridge of the hip socket. Doing so enables assessing joint structure and motion in ways that are not otherwise possible. We may remove excess bone tissue or malformations affecting hip function.

Our depth of experience enables us to protect delicate muscle tissue and blood vessels near the hip.

Learn more about our pediatric orthopedic services


Hip Preservation at Joe DiMaggio Children’s Hospital: Why Choose Us?

Our team includes pediatric orthopedic experts with advanced (fellowship) training in surgical hip preservation. This rare skill set can improve your child’s current and future quality of life significantly. Our surgeons learned from the world’s leading authorities in joint-preserving hip surgery, so you can count on us for safe, effective care. Meet our team.

Highlights of our program include:

  • High-volume specialty: We see hundreds of children with hip instability each year — more than any other specialist in the region. This experience helps us anticipate your child’s needs and determine the best ways to address them.
  • Hip preservation surgery: Severe cases of hip instability often require surgery. We offer sophisticated procedures like surgical hip dislocation and periacetabular osteotomy you won’t find elsewhere in South Florida. 
  • Family-centered approach: Hip instability treatments often take time, with months of appointments, imaging and special exercises. Our experts set realistic expectations and provide helpful tips for supporting your child throughout the process.

Learn more about our pediatric orthopedic services

Cardiac patient Deacon surrounded by his family, Svetlana Shugh, MD and Maryanne Chrisant, MD

Patient- and Family-Centered Care