Nicklaus Children's Performs Region's First Pediatric Total Hip Replacement Using Innovative Mixed Reality-assisted Surgical Guidance

Published on: 06/23/2026

Game-changing procedure for patients and surgeons

Nicklaus Children's Hospital Orthopedic, Sports Medicine, and Spine Institute clinicians made history once again in South Florida after successfully performing the region's first pediatric total hip replacement using mixed reality-assisted surgical guidance. The procedure was performed by Dr. Thomas J. Utset-Ward, a pediatric orthopedic oncologist and one of only 10 specialists in the nation focused entirely on treating bone tumors and complex orthopedic conditions in children and adolescents.

"At Nicklaus Children's Hospital, the drive and curiosity to constantly redefine what is possible is built into everything we do," said Dr. Utset-Ward. "As South Florida's nationally ranked, leading pediatric hospital, we are committed to pushing the boundaries of what medicine can offer the youngest and most vulnerable patients, and mixed reality allows us to plan and execute with a level of precision we simply did not have before. In Elienay's case, she couldn't walk for five years prior to her surgery, so this is about more than just replacing a hip, it's about restoring a childhood that was put on hold. She can now ride a bike, walk and run with her friends."

Elienay, 18, sustained slipped capital femoral epiphysis, or SCFE, five years before her surgery. This severe hip condition occurs in adolescents when the ball of the thigh bone slips off the neck of the hip. The injury caused severe deterioration in her hip, leaving her reliant on a crutch for mobility and only able to walk short distances. Total hip replacements are uncommon in pediatric patients because children continue to grow and develop. In cases involving SCFE, surgery is required, and postsurgical recovery is critical to long-term mobility.

A mixed reality guidance platform addresses the unique challenges of pediatric hip replacement surgery, where developing bone structure and long-term durability are critical concerns, by providing detailed 3D anatomical modeling, precise implant sizing and placement measurements, and predictive analysis designed to reduce surgical time and improve long-term outcomes.

"I never imagined I would have a future like most girls my age. I had a crutch and could barely walk, and for a long time that was my reality. Coming to Nicklaus Children's Hospital changed everything. I may have lost a few years of my childhood, but the future I only ever dreamed of is now within reach," Elienay said.

Elienay is now walking without support and is walking more confidently, riding bike and feeling confident to do normal day-to-day activities since her surgery.