This is an advanced ICL designed for the pediatric orthopaedic surgeon and senior delegates. We will provide the attendee with information on the natural history of subluxated femoral heads in Perthes disease that cannot be adequately contained in the acetebulum. Current treatment options to obtain containment and improve femoral head sphericity will then be discussed. These are techniques that have the capacity to alter the natural history of the non-containable hip. Case based discussion by the faculty will follow to illustrate decision making and results in specific cases.