Deep Dive in DDH is a three-part limited series where experts in the field of DDH have been invited to discuss the controversies in the management of hip dysplasia. Episode 1 was published in August and discussed management of DDH in infants under 6 months of age. In Episode 2, we are joined by Eduardo Novais at Nemour Children’s Health in Jacksonville and Salil Upasani of Rady Children’s Hospital and discuss the controversies in the management of developmental hip dislocations in the operating room including the process to decide between closed and open reduction, the use of concomitant osteotomies, adjunctive imaging, and casting protocols.

Hosted by Will Morris (Scottish Rite for Children). Music by A. A. Aalto.

Referenced Publications:

1. Novais EN, Hill MK, Carry PM, Heyn PC. Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis. Clin Orthop Relat Res. 2016 May;474(5):1166-77. doi: 10.1007/s11999-015-4590-5. PMID: 26472583; PMCID: PMC4814411.
2. Schmaranzer F, Justo P, Kallini JR, Ferrer MG, Miller P, Bixby SD, Novais EN. Hip Morphology on Post-Reduction MRI Predicts Residual Dysplasia 10 Years After Open or Closed Reduction. J Bone Joint Surg Am. 2024 Jan 17;106(2):110-119. doi: 10.2106/JBJS.23.00333. Epub 2023 Nov 22. PMID: 37992184; PMCID: PMC12205695.
3. Morris WZ, Chilakapati S, Hinds SA, Herring JA, Kim HKW. The Clinical Significance of Infolded Limbus on Postreduction Arthrogram in Developmental Dysplasia of the Hip. J Pediatr Orthop. 2022 Apr 1;42(4):e309-e314. doi: 10.1097/BPO.0000000000002070. PMID: 35132011.
4. Morris WZ, Hinds S, Worrall H, Jo CH, Kim HKW. Secondary Surgery and Residual Dysplasia Following Late Closed or Open Reduction of Developmental Dysplasia of the Hip. J Bone Joint Surg Am. 2021 Feb 3;103(3):235-242. doi: 10.2106/JBJS.20.00562. PMID: 33252590.
5. Gans I, Sankar WN. The medial dye pool revisited: correlation between arthrography and MRI In closed reductions for DDH. J Pediatr Orthop. 2014 Dec;34(8):787-90. doi: 10.1097/BPO.0000000000000187. PMID: 24787303.
6. Novais EN, Hollnagel KF, Bixby SD, Ferrer MG, Williams DN, Kim YJ, Schmaranzer F. Predictive value of post-reduction gadolinium-enhanced magnetic resonance imaging in detecting avascular necrosis after closed and open reduction for developmental dysplasia: A minimum 5-year follow-up study. J Child Orthop. 2025 Jul 6;19(4):329-338. doi: 10.1177/18632521251350524. PMID: 40630930; PMCID: PMC12230044.
7. Paez C, Badrinath R, Holt J, Bomar JD, Mubarak SJ, Upasani VV, Wenger DR. Ligamentum Teres Transfer During Medial Open Reduction in Patients with Developmental Dysplasia of the Hip. Iowa Orthop J. 2021;41(1):47-53. PMID: 34552403; PMCID: PMC8259203.

Dr. Daniel Hoernschemeyer from the University of Missouri joins the show to discuss his recent research on vertebral body tethering as well as the past, present, and future of this new treatment. Your hosts are Josh Holt from the University of Iowa, Stephanie Logterman from Arnold Palmer Hospital for Children, Craig Louer from Vanderbilt, and Tyler McDonald from the University of South Alabama. Produced by Josh Holt and Carter Clement (Manning Family Children’s). Music by A.A. Aalto.

References:

“Growth modulation increases clinical success in vertebral body Tethering.” Hoernschemeyer et al. Spine Deformity 2025.

“Anterior Vertebral Body Tethering: A Single-Center Cohort with 4.3 to 7.4 Years of Follow-up.” Hoernschemeyer et al. JBJS 2024.

“Effect of Vertebral Body Tether Tensioning on Vertebral Body Growth Modulation.” Jackson et al. with PSSG. JOR Spine 2025.

“Growth modulation response in vertebral body tethering depends primarily on magnitude of concave vertebral body growth.” Louer et al. with PSSG. Spine Deformity 2024.

“Multicenter validation of a surgical planning tool for lumbar vertebral body tethering simulating growth modulation over 2 years.” Cobetto et al. Spine Deformity 2025.

Drs. Stephanie Logterman from Arnold Palmer Hospital for Children and Tyler McDonald from the University of South Alabama bring you this year's IPOS® 2025 episode. We highlight some of the exciting programming from this year's meeting delve into a few interesting topics in pediatric orthopedics. Special guests include Drs. Rachel Thompson, Michael Vitale, Jennifer Beck, Alex Arkader, Brian Kaufman, Lindley Wall, Jaysson Brooks, Henry Ellis, Wood Sankar, and Derek Kelly. This episode is produced by Tyler McDonald. Music by A.A. Aalto.