Straight From The Hip

pablocastaneda
  • 5.0 (1)
  • MEDICINE
  • UPDATED WEEKLY

This podcast is for anyone who wants to learn more about pediatric hip problems, including developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), and other conditions. I’ll be interviewing experts in the field to get their insights on the latest treatments and research. I aim to empower physicians, providers, and parents with the knowledge they need to make the best decisions.

  1. FEB 4

    Tom Youm: Borderline hip dysplasia and femoroacetabular impingement

    Today’s guest is Dr. Thomas Youm from NYU Langone Health a high-volume hip arthroscopist. The focus of the conversation is a niche but common clinical scenario: femoroacetabular impingement syndrome in the setting of borderline hip dysplasia—typically defined by a lateral center-edge angle between 20 and 25 degrees. We use several recent papers from Dr. Youm’s group as the starting point, but the discussion stays practical: when a hip lives near that borderline zone, where undercoverage and potential instability may coexist with impingement morphology, who truly benefits from arthroscopy, who should be screened out, and what long-term outcome studies can—and cannot—claim. We talk about definitions that drive everything: how “borderline dysplasia” is operationalized beyond a single angle, how FAIS is defined and selected for surgery, and how labral and capsular management can shift a hip toward stability or toward symptoms. We talk about imaging as decision-making, not just documentation: what plain radiographs miss, how MRI can (and should) classify the labrum and cartilage more meaningfully, when CT adds value for combined femoral and acetabular version, and how those parameters change counseling and surgical indications. We talk about dynamic assessment—especially the role of ultrasound to evaluate motion-dependent instability in select patients—and how that complements static imaging when the story and exam do not match the radiographs. We also spend time on endpoints. We talk about what “survivorship” means when studies use revision arthroscopy and conversion to total hip arthroplasty, and how that aligns—or fails to align—with the outcomes that matter most to patients: pain, function, athletic participation, and the possibility that some hips may later need a reorientation procedure rather than another arthroscopic intervention.

    53 min

  2. 12/24/2025

    Recap & Ask me anything December 2025

    This 50th-episode recap of Straight from the Hip brings together some of the most important themes we’ve covered over the past block of conversations: how we share knowledge, how we generate and question evidence, and how we safely push the field forward. I revisit episodes with Nick Fletcher on podcasting as a serious medium for medical education; Simon Thomas and Emily Dodwell on long-term outcomes, fragile statistics, and what that means for counseling families; Perry and Jon Schoenecker on the tension and harmony between clinical experience and basic science; and Valerie Parrish on what IHDI 2.0 is actually doing for real babies and families right now. We then move into innovation and leadership with Dror Paley, Michael Vitale, and Dan Sucato, touching on moral ambition, safety culture, robotics, FHRO, and the real value (and limits) of rankings. It’s a chance to zoom out, connect the dots, and respond to some of your questions about where hip preservation is going next.

    35 min

  3. 12/02/2025

    Dan Sucato: Femoral Head Reduction Osteotomy & Leadership

    Today I’m joined by Dan Sucato, Chief of Staff at Texas Scottish Rite for Children, an institution that currently sits at the top of the U.S. News & World Report rankings for pediatric orthopedics. We start with Perthes, specifically, one of the most complex reconstructions we have for the post-Perthes deformity: femoral head reduction osteotomy. Dr. Sucato is one of the few surgeons worldwide to have published on this procedure. I was able to pick his brain about when he considers it, how he executes it, whether it can realistically be taught, and how to think about adolescents and young adults with painful, misshapen femoral heads who are still “too young” for arthroplasty. We dig into what problem FHRO is really trying to solve, how he selects patients, what he tells families about risk and recovery, and where he draws the line between attempting salvage and accepting that a hip is no longer reconstructable. From there, we shift into leadership. I asked him what it actually means to lead a program that everyone else sees as “number one”: what metrics he trusts more than USNWR, how he balances volume, access, and complexity, and how he protects trainees and staff from chasing rankings instead of chasing better care. We talk about culture, humility, and how to build a place where people can speak up, disagree, and still move in the same direction. It was a grounded, honest conversation about hard hips and real leadership.

    50 min
  4. Mike Vitale & Safety in Surgery

    11/19/2025

    Mike Vitale & Safety in Surgery

    Michael Vitale, Chief of Pediatric Spine Surgery at Columbia, joins me to talk about one thing: how to make surgery safer. We walk through why he became obsessed with safety, and how high-stakes spine surgery forced a rethink of teams, errors, and systems under pressure. We break down core principles: planning, standardization, human factors, checklists that actually work, and psychological safety in the OR. We talk innovation: navigation, robotics, AR—how to adopt new tech without creating new failure modes. Finally, we discuss metrics, outcomes, and performance measures, and why the future of quality in orthopedics depends on transparency, benchmarking, and shared learning.

    50 min

  5. 10/26/2025

    Valerie Parrish & the IHDI 2.0 Symposium

    If you’ve listened to this show in the past or our sister show (Hip & Happening), you already know today’s guest: Valerie Parrish, the Director of Patient Advocacy and Engagement at the IHDI. This episode was recorded right after our IHDI 2.0 symposium in New York, In this conversation: We talk about baby positioning and baby-wearing. We get into early detection and why we still miss hips — and how that might change with smarter imaging and motion tools. We discuss improving brace treatment We explain why kids are not just “small adults” how we are helping build pediatric shape libraries and patient-specific modeling We talk about surgical precision in theory vs reality: and where augmented reality may fit in the future. And we end with a big idea: “normal” is not universal. Which matters for screening, labeling, and deciding who needs an operation.

    46 min

  6. 08/26/2025

    Perry & Jon Schoenecker: Wisdom, innovation & the hip

    Today’s episode is a real privilege. I had the chance to sit down with Perry and Jon Schoenecker, a father and son who represent two distinct but complementary approaches to orthopedics. Perry is a giant in clinical orthopedics, with decades of work shaping how we think about hip dysplasia, hip preservation, and surgical decision-making. Jon, meanwhile, brings a different perspective, grounded in basic science and biomechanics, with a focus on the biology of bone and cartilage and how those insights can drive the future of our field. In this conversation, we talked about how each of them found their way into orthopedics and what drew them to the hip in particular. We revisited the evolution of hip dysplasia care, what has been learned across generations, and what still challenges us today. We explored Legg–Calvé–Perthes, not just from a clinical standpoint but also through the lens of biology and healing mechanisms. We also discussed biomechanics, the role of cartilage in joint preservation, and how an understanding of basic science can inform and sometimes challenge established surgical approaches. Together, Perry’s wisdom from decades of clinical experience and Jon’s innovative, science-driven lens make for a fascinating dialogue about where the field has been and where it’s going. Finally, we looked ahead to the future of orthopedics, what the next generation of surgeons and scientists should focus on, and how we can balance tried-and-true clinical experience with the possibilities offered by new discoveries in biology and technology. It was a rich, wide-ranging discussion that blended experience and innovation in a way that few conversations can; for me it was a truly special experience and I hope you enjoy listening to it as much as I did recording.

    1h 7m

  7. 08/06/2025

    Nick Fletcher and the future of sharing orthopedic knowledge

    Today’s episode is a bit meta, in the best way. We’re talking about podcasting as a medical medium: not just a way to pass time on a commute, but a tool to reshape how we communicate, teach, and share orthopedic knowledge. My guest is Dr. Nick Fletcher from Atlanta. He’s a Professor of Orthopaedic Surgery at Emory, the Medical Director of the Spine Program at Children’s Healthcare of Atlanta, and the host of Interview with a PediPod, the official podcast of The Pediatric Orthopedic Society of North America. He’s published more than 70 peer-reviewed papers and served in leadership roles across POSNA and SRS. But today, we’re not talking about any of that directly. We’re asking: what does it mean to teach without a podium? What are the risks and rewards of creating content that’s accessible but unfiltered? And in a field that values precision and peer review, where does a medium like podcasting fit? We get into the ethics of self-promotion versus service, the technical choices behind producing a credible medical podcast, and why audio might just be the most human way to talk about medicine. And of course, we discuss how podcasting can help people and especially doctors, become better listeners, thinkers, and communicators. This was a thoughtful, practical, and energizing conversation with someone who’s not only advancing spine and hip care, but also rethinking how we share what we learn.

    51 min

  8. 07/14/2025

    Dror Paley: Innovation, Moral Ambition, and the Future of Orthopedic Surgery

    On this episode I have a candid conversation with: Dror Paley, the founder of the Paley Orthopedic & Spine Institute in Florida, the Paley European Institute in Poland, and the Paley Institute Middle East in Abu Dhabi. He’s a pioneer in deformity correction and one of the surgeons who introduced the Ilizarov method to North America. In hip surgery, he developed the SUPER Hip procedure, along with more than a hundred other techniques. But this episode isn’t about applause. It’s about ambition, controversy, and what it means to innovate in a field that often resists disruption. We talked about the cost of leadership: how innovation can be mistaken for ego, how financial success can attract criticism, and how doing what’s right isn’t always what’s expected. We explored brand building, the moral imperative behind patient care, and the obligation to advance the field itself. We discussed the challenges of being a disruptor and the complicated path to peer recognition. On the clinical side, we covered complex hip reconstructions including the SUPER Hip, femoral head reduction osteotomy, and the so-called “extreme PAO.” I asked him some hard questions: Where’s the line between surgical creativity and overreach? What scares him more: stagnation or automation? We also talked about the future of limb reconstruction, the promise of regenerative medicine, and the potential of integrating what’s increasingly referred to as “One Medicine.” This was a wide-ranging conversation with someone who’s changed the field and taken a few hits for it. I hope you find it as provocative and inspiring as I did.

    1h 8m
See All (51)

About

This podcast is for anyone who wants to learn more about pediatric hip problems, including developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), and other conditions. I’ll be interviewing experts in the field to get their insights on the latest treatments and research. I aim to empower physicians, providers, and parents with the knowledge they need to make the best decisions.

Information

  • Creator
    pablocastaneda
  • Years Active
    2024 - 2026
  • Episodes
    51
  • Rating
    Clean
  • Copyright
    © pablocastaneda
  • Show Website
    Straight From The Hip