Nick Fletcher sits down with Pablo Castaneda, Chief of International Surgery at Texas Children's Hospital in Houston and hip surgeon extraordinaire to talk about his transitions from Mexico City where he performed over 1000 surgeries for DDH, to NYU where he led a team as they grew a department within a new freestanding pediatric hospital in NYC, and back to Houston where he recently started a new venture helping grow the international footprint of TCH. Other highlights include discussions about early vs late reconstruction of developmentally dislocated hips, PAO's with or without arthroscopy, and how to manage complex deformity in older patients with Perthes.