Hip Dysplasia Treatment Cost

Typical costs:

• Babies 6 months or younger will be typically be fitted with a Pavlik harness^[2] , a soft positioning device, which typically costs $26-$73. For example, Sportsbraces.com charges $40 for the ProCare Pediatric Pavlik Harness^[3] . Health insurers usually pay for the Pavlik harness once DDH has been diagnosed, but may have restrictions. For example, under the Health Alliance Plan^[4] , the harness is covered, but must be purchased from an affiliated or contracted provider.
• If the harness doesn't work, or the child is between 6 months and 2 years old, doctors may perform a non-surgical procedure called a closed reduction and set the hip in a body cast. According to a 2008 study^[5] published in the journal Orthopedics, the average total cost for X-rays, closed reduction, and casting is $7,133. According to the Agency for Healthcare Research and Quality^[6] , the average cost of treatment for hip dislocation is $6,764 in children younger than one and $7,367 for children younger than four.
• If the child is older, or closed reduction failed, he or she may need open surgery to correct hip formation. The Orthopedics study^[7] found the average cost for open surgery to be $18,201, but that figure can be as high as $38,000 when bone cutting or reshaping is needed.
• For insured patients, out-of-pocket costs typically consist of a specialist copay, possibly a hospital copay of $100 or more, and coinsurance of 10%-50% for the procedure, which could reach the yearly out-of-pocket maximum. According to the Kaiser Family Foundation^[8] , the average hospital copay for outpatient surgery is $132 and for inpatient surgery is $232.The average coinsurance rate is 17%-18%.

• According to the American Academy of Orthopaedic Surgeons^[9] , a pediatrician will do a physical examination to check for DDH in newborns, which includes manipulating the hip and listening for a popping sound. For older infants and children, imaging tests may be used.
• A Pavlik harness is typically the first line of treatment for babies under 6 months, though a brace, splint or body cast may be used instead. Worn for 1-2 months, the harness keeps the hips and knees bent and thighs spread apart to help the hip grow normally.
• If the harness doesn't work, or the child is between 6 months and 2 years old, pediatricians may do a procedure called a closed reduction where the hip is manually pushed back into place while the child is under anesthesia. The hip is then set into a cast for 12 weeks.
• If the child is older, or closed reduction failed, he or she may need open surgery. According to the Hospital for Special Surgery^[10] in New York, a surgeon will make an incision and re-position the thighbone.

• An older child may require physical therapy following surgery. For insured patients out-of-pocket costs typically consist of a copay of $10-$75 per session or coinsurance of 10%-50% or more. For uninsured patients it typically costs $50-$350 or more per session.
• According to the Hospital for Special Surgery^[11] , children who are treated for hip dysplasia will need to be examined on regular intervals until they are skeletally mature.

• Shriners Hospitals for Children^[12] , a network of nearly two dozen hospitals, provides no-cost orthopedic care to children under 18.
• In most states, uninsured children 18 years old and younger whose family incomes are up to $45,000 per year (for a family of four) can qualify for the Children's Health Insurance Program (CHIP)^[13] or Medicaid^[14] , which provide free or low-cost health coverage.

• The International Hip Dysplasia Institute offers a list of questions^[15] for parents to evaluate possible surgeons for their child's procedure.
• The American Academy of Orthopaedic Surgeons features an orthopedic surgeon finder^[16] .
• Brenner Children's Hospital in Winston-Salem, NC, offers a list of reminders^[17] for parents of small children headed for surgery, such as remembering to bring a child's favorite stuffed animal, blanket or toy.

1.  orthoinfo.aaos.org/topic.cfm?topic=A00347
2.  www.cincinnatichildrens.org/health/p/pavlik-harness/
3.  www.sportsbraces.com/procare-pediatric-pavlik-harness.htm
4.  www.hap.org/internet/bam/policy/provider/18_845HIPORTHOSI_P_3.htm
5.  www.healio.com/orthopedics/hip/journals/ORTHO/{4415B79D-B12F-44DA-A8A9-3DB0D0353A45}/Th...
6.  hcupnet.ahrq.gov/HCUPnet.jsp
7.  www.healio.com/orthopedics/hip/journals/ORTHO/{4415B79D-B12F-44DA-A8A9-3DB0D0353A45}/Th...
8.  kff.org/health-costs/report/employer-health-benefits-2012-annual-survey/
9.  orthoinfo.aaos.org/topic.cfm?topic=A00347
10.  www.hss.edu/conditions_developmental-pediatric-hip-dysplasia-overview.asp
11.  www.hss.edu/conditions_developmental-pediatric-hip-dysplasia-overview.asp
12.  www.shrinershospitalsforchildren.org/
13.  www.insurekidsnow.gov/chip/index.html
14.  www.insurekidsnow.gov/medicaid/index.html
15.  www.hipdysplasia.org/developmental-dysplasia-of-the-hip/tips-for-parents/questions-for-...
16.  www7.aaos.org/member/directory/directory.aspx
17.  www.brennerchildrens.org/uploadedFiles/Brenner/Families_and_Visitors/Getting_Your_Child...

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