Child Orthopedics

Frequently Asked Questions

We've been told our child will need surgery for a chronic hip problem called dysplasia. When's the best time to do this surgery? He starts school next year. Should we do it before school starts and risk delaying entry? Or wait until the summer after his first year?

Studies suggest earlier may not be better for this type of problem. Surgery too early before major bone growth occurs can disrupt the surgery done. Surgery too late may not be able to change the muscular imbalances that have formed.

The best results seem to occur on children operated on between the ages of seven and twelve. They seem to get the best motion back. They also have the best correction of the leg length difference from side to side. X-rays show fewer arthritic changes later in life.

Surgery for this problem in children between three and six often requires another operation later. Waiting until the child is older than 12 can lead to worse outcomes. It's likely that at the older ages the bone is less able to adapt and remodel.

Your surgeon will be able to advise you given your child's case. Let him or her know your concerns about the timing in relation to school and see what's suggested.

Oldrich Cech, MD, DSc, et al. Management of Ischemic Deformity After the Treatment of Developmental Dysplasia of the Hip. In Journal of Pediatric Orthopaedics. Vol. 25. No. 5. Pp. 687-694.

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