Problems arising in the adolescent and young adult hip and pelvis can present real problems for those who experience them, and can present diagnosis and treatment challenges for the orthopedic team they come to for help. Successfully managing these problems takes a spectrum of expertise that focuses on the patient’s individual history, goals and lifestyle. Relying on decades of orthopedic experience with this patient population, the pediatric hip preservation program at Gillette Children’s takes a comprehensive approach to care.
An Expert Team
The pediatric orthopedic team at Gillette is the largest in the region and has added a new hip preservation specialist to the roster. Alison Dittmer, MD, recently joined Gillette after completing fellowship training in Pediatric Orthopedics and Hip Preservation. She joins long-time Gillette orthopedic surgeons Mike Healy, MD, Gregory Hildebrand, MD, Tom Novacheck, MD, and Amy Jo Beebe, CNP, in formalizing the decades-long expertise in pediatric hip preservation care at Gillette. We look forward to welcoming Natalie Stork, MD, when she joins the team in April.
Drs. Alison Dittmer joined Mike Healy and others on the joint preservation team to expand this team-based orthopedic service.
Diagnosis Starts the Journey
The Gillette team diagnoses hip issues after obtaining a detailed history and physical examination, in conjunction with diagnostic tests, which can include radiographs, EOS low-dose imaging, instrumented gait analysis, CT, MRI, and in-office diagnostic/therapeutic ultrasound-guided hip injections.
“Diagnosing and treating hip and pelvic conditions in pediatric patients means navigating various diagnostic techniques and both surgical and nonsurgical management,” Dittmer says. “We’re able to provide all of these options at Gillette, which is extremely exciting. By relying on the expertise of our highly trained team, families can be certain their children are receiving the right care for their hip issues.”
Mike Healy, MD, adds, “It’s very satisfying to know we have assembled a team with the expertise to treat a wide range of structural hip abnormalities. In one day, we can help patients with anomalies ranging from the more common, such as developmental dysplasia of the hip or femoroacetabular impingement to the complex sequelae, from pediatric hip conditions such as slipped capital femoral epiphysis, avascular necrosis, Legg-Calvé-Perthes disease and hip fractures.”
The Ins and Outs of Treatment
After diagnosis, the hip preservation team relies on discussion with the patient to align their treatment recommendations with the patient’s personal goals and expectations. “When I first meet a patient in the hip preservation clinic, my primary intent is to get a sense of who they are as a person, and what their personal goals are in regard to their hip and desired activities,” Dittmer says. “This can range anywhere from being able to compete in athletics at a collegiate level to simply not thinking about their hip daily.”
The Gillette hip preservation team has the breadth of surgical experience to provide arthroscopic surgery for impingement and labral tears, as well as new and complex open surgical techniques such as periacetabular osteotomies, surgical hip dislocations, femoral subcapital realignment, and various femoral osteotomies including femoral head reduction, reshaping and cartilage grafts. Gillette also offers a unique pre-operative psychology screening to young hip patients.
This evaluation takes place before any surgical treatment and helps patients surmount the mental and emotional hurdles that come with anticipating a surgical procedure. Hip preservation literature and the experienced team of hip preservation specialists at Gillette report optimized surgical outcomes for patients who participate in this perioperative screening.
As for nonsurgical treatment, Gillette is a one-stop shop, offering a renowned pediatric physical medicine and rehabilitation program as well as comprehensive physical therapy options tailored to a patient’s individual needs and timeline for treatment.
The Gillette Difference
A highly collaborative team and comprehensive approach to pediatric care sets the Gillette hip preservation program apart from others. Many adolescent and young adult hip conditions are complex and multifactorial: these are the cases that truly benefit from the collaborative review of hip preservation specialists with different training and experience.
Dittmer recounts a recent case illustrating the collaborative culture that makes the Gillette team stand out. “I recently began treating a top-level gymnast with anterior groin pain. She had exam features and imaging consistent with a mixed picture of both dysplasia and femoroacetabular impingement. I was able to discuss the complex presentation with my partners on the hip preservation team at Gillette. After advanced imaging and case discussion, I met with the gymnast and her mother to discuss her treatment options. Keeping in mind her current level of function and personal goals for her sports career, we recommended a combined open and arthroscopic approach to address her complex hip pathology.”
To refer a patient to the hip preservation program at Gillette, call 651-325-2200 or use our online referral form.