Straight From The Hip

pablocastaneda
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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. 1D AGO · BONUS

    What Every Parent Should Know About Baby Hips!

    This is a special video episode of the podcast meant as a public service announcement to help parents understand what matters for baby hips!

    31 min

  2. 3D AGO

    Betsy Miller & the lived and shared experience

    On this podcast, I've explore developmental dysplasia of the hip from every angle: the science, the evolution of treatment, the lived experience, and how patients and families make sense of a diagnosis that can follow them across decades. Today’s episode is a wide-ranging conversation with Betsy Miller, author of The Parents’ Guide to Hip Dysplasia, (https://betsymillerbooks.weebly.com), a book she published nearly twenty years ago, around the same time the International Hip Dysplasia Institute was founded. Betsy wrote that book not as a physician, but as someone who had been treated for hip dysplasia as an infant and later realized how little practical, accessible information existed for parents facing a brace, a cast, or surgery. With a background in technical writing, she set out to create the resource she wished had existed. Although she did well for many years, she was later told she had residual dysplasia, something that came as a surprise. We discuss how hip dysplasia can remain silent for decades, why some people do not realize they have it, and how the field of hip preservation emerged in response to these late presentations. We also talk about how people get their information in 2026, whether books still matter, the challenges of nonprofit education, and what happens when hip preservation is no longer enough. Betsy ultimately underwent bilateral hip replacements and is now writing a new book, Hip Replacement at Any Age, aimed at younger patients who often feel alone in a space dominated by older adults. It is a thoughtful conversation about information, identity, and how a diagnosis in infancy can echo throughout a lifetime.

    39 min

  3. FEB 25

    Maurizio De Pellegrin: Mythbusting and decoding hip dysplasia

    Today I’m joined by Maurizio De Pellegrin from Parma, Italy, and we’re going to do something I enjoy: highlight a set of practical contributions, then stress-test what the data really support.  We start with a question parents ask all the time—often more urgently than they ask about the hip itself: Will treatment delay my child’s milestones? De Pellegrin’s recent work examines walking age and motor development in severe DDH, and it helps us speak to families with greater precision about timing, severity, and what happens when treatment begins early. From there, we tackle a classic piece of folk remedy: double diapering. It’s common advice, it sounds plausible, and it persists. We’ll review what happens when you actually measure hip position with and without it, and what that should mean for pediatric counseling. Then we shift to ultrasound biology, what the labrum looks like, and how it changes in dysplastic and dislocated hips during stabilization. I’m especially interested in echogenicity: whether it’s a risk marker, a response marker, or both. Finally, we’ll go beyond typical DDH and discuss hip ultrasound in Hurler syndrome (MPS I) after hematopoietic stem cell gene therapy, what ultrasound can still tell us when anatomy is atypical, and what the next outcome questions should be.

    1 hr

  4. 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

  5. 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

  6. 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
  7. 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

  8. 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
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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
    54
  • Rating
    Clean
  • Copyright
    © pablocastaneda
  • Show Website
    Straight From The Hip

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