Christopher J. DeFrancesco, MD, has joined the Orthopedic Center at Children’s Hospital of Philadelphia (CHOP) as an attending pediatric orthopedic surgeon. Dr. DeFrancesco returns to CHOP after additional training and brings expertise in pediatric hip care.
Dr. DeFrancesco explained his path to specializing in pediatric orthopedic hip care: “I grew up playing sports, and my undergraduate studies were in mechanical and biomedical engineering. These factors pushed me toward orthopedics as I went into medical school. I figured I would specialize more in sports medicine or hand surgery early in medical school, but then I spent a year doing research with the orthopedic team at CHOP (The Ben Fox Fellowship). This was a pivotal year in my training, showing me the interesting breadth and impact of pediatric orthopedic surgery. That is really when I got interested in pediatric orthopedics, and my interest in hip surgery grew from there as I worked with people like Dr. Wudbhav ‘Woody’ Sankar here at CHOP and Dr. Yi-Meng Yen at Boston Children’s.”
Discussing his decision to return to CHOP for fellowship and now as faculty, he said: “Coming to CHOP for fellowship was a bit of a homecoming. I am a Pennsylvania kid at heart. And I always felt like I belonged around the folks at CHOP. This division is really a special place that feels like a family.
But the decision to come back for a fellowship was more than that. As I researched training programs, it was clear that CHOP is the top pediatric orthopedic fellowship in the country. The volume, variety and complexity of cases is unmatched.
Returning as a faculty member is very exciting as well, because I am now on the other side of the line. Mentors have become partners, and now I have the chance (and challenge) to mentor students, residents and fellows. I look forward to the opportunity to carry on the great work of past and current leaders in our division.”
Dr. DeFrancesco treats various hip conditions including shallow hip sockets (dysplasia), femoroacetabular impingement, avascular necrosis, and developmental dysplasia of the hip (DDH) in babies.
He emphasized his approach when explaining advanced procedures such as hip arthroscopy or total hip replacement: “I spend a fair amount of time explaining conditions and procedures using analogies and drawing pictures, both on paper and on the computer. I hope this helps families understand what they are facing and the procedures they may undergo.”
CHOP offers total hip replacement for young patients when necessary after exhausting preservation options: “For the lion’s share of patients that we treat, hip preservation (avoiding hip replacement) is the preferred route.
For the small proportion of our patients who have exhausted reasonable hip preservation procedures, total hip replacement is the next reasonable option. The conversation with these families – who have commonly seen several other providers and had various previous procedures – requires time and patience. Part of my job is to offer continuity of care within the supportive environment here at CHOP.”
Describing patient care at CHOP involving multidisciplinary teams he stated: “You excel at what you do repeatedly, and taking care of kids is what we do day in and day out. All members of our team are used to taking care of our patients, along with all the related challenges that can crop up.”
On first visits with families he noted: “I really like to understand each patient’s history and expectations when I meet them. How many people have they seen before me? What sports and activities are important to them? Even if I don’t have an answer for them on the first visit, I hope that families walk out knowing that I care.”
When addressing surgical needs for children or teens he explained: “Many of our patients have been through a lot, and I think a team approach helps maximize outcomes for them. I like to get to know the patient and their family, and I’ll commonly ask them to see another specialist from our hip team, like Naomi Brown, MD, or Tom Swaffield, MD, who can do ultrasound evaluations and ultrasound-guided injections.
We really try to be systematic and objective in our evaluations, and this commonly includes diagnostic/therapeutic injections, as well as advanced imaging (such as MRI and CT scan). Most patients who sign up for a hip surgery end up seeing me at least twice before we decide to proceed with an operation.”
Rehabilitation plays an essential role after surgery according to Dr. DeFrancesco: “Rehabilitation is paramount after surgery. I will sometimes tell patients that most of my work was done on the day of the operation, and after that, the ball is mostly in their court. I turn into a cheerleader and coach after surgery. And just like in sports, sometimes you need your coach to be soft and supportive; sometimes you need some tough love.” He added about working with young people: “The personalities we see in kids are always so interesting… It really is a blast to help them through what can seem like tough times.”
Looking ahead at advances in his field he said: “I really look forward to better metrics for conditions where…the ball at the top of thigh bone moves more than it should inside…the socket…as well as more objective indications for surgery…These are some difficult surgical decisions…and we—as surgeons—have a way to go…”
He expressed optimism about future developments under leadership within CHOP’s program: “We pride ourselves on being a comprehensive center for hip care…Under leadership by Dr Sankar we are positioned for continued success…”
Outside work Dr DeFrancesco values family life most highly while also enjoying exercise and watching football.
