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 |  | With Health Insurance: Copay + 10%-50% Coinsurance |  | Without Health Insurance: $26-$38,000+ |
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Developmental dysplasia of the hip (DDH) includes a range of congenital abnormalities that cause the ball at the top of the thighbone to become partly or completely dislodged from its socket. According to the American Academy of Orthopaedic Surgeons[1] , DDH can usually be corrected if detected early. Left unchecked, DDH can lead to difficulty walking, pain and osteoarthritis.
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%.
Related articles: X-Ray, Physical Therapy, Well Baby Doctor Visit, Health Insurance
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What should be included: | - 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.
Additional costs: | - 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.
Discounts: | - 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.
Shopping for hip dysplasia treatment: | - 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.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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External Resources: | - orthoinfo.aaos.org/topic.cfm?topic=A00347
- www.cincinnatichildrens.org/health/p/pavlik-harness/
- www.sportsbraces.com/procare-pediatric-pavlik-harness.htm
- www.hap.org/internet/bam/policy/provider/18_845HIPORTHOSI_P_3.htm
- www.healio.com/orthopedics/hip/journals/ORTHO/{4415B79D-B12F-44DA-A8A9-3DB0D0353A45}/Th...
- hcupnet.ahrq.gov/HCUPnet.jsp
- www.healio.com/orthopedics/hip/journals/ORTHO/{4415B79D-B12F-44DA-A8A9-3DB0D0353A45}/Th...
- kff.org/health-costs/report/employer-health-benefits-2012-annual-survey/
- orthoinfo.aaos.org/topic.cfm?topic=A00347
- www.hss.edu/conditions_developmental-pediatric-hip-dysplasia-overview.asp
- www.hss.edu/conditions_developmental-pediatric-hip-dysplasia-overview.asp
- www.shrinershospitalsforchildren.org/
- www.insurekidsnow.gov/chip/index.html
- www.insurekidsnow.gov/medicaid/index.html
- www.hipdysplasia.org/developmental-dysplasia-of-the-hip/tips-for-parents/questions-for-...
- www7.aaos.org/member/directory/directory.aspx
- www.brennerchildrens.org/uploadedFiles/Brenner/Families_and_Visitors/Getting_Your_Child...
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