Multicenter Prospective Cohort Study on Current Treatments of Legg-Calvé-Perthes Disease

NCT ID: NCT02040714

Last Updated: 2025-05-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ENROLLING_BY_INVITATION

Total Enrollment

1500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2012-08-31

Study Completion Date

2032-09-30

Brief Summary

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Legg-Calvé-Perthes disease is a childhood hip disorder which is common enough to be a significant public health problem (affects 1 in 740 boys between ages 0-14), but uncommon enough to have a sufficient number of patients from a single institution to perform a definitive prospective study comparing the results of current treatments. The present study will establish a database of prospectively identified patients with Legg-Calvé-Perthes (LCP) Disease and collect information regarding their presentation, treatment, and outcomes in the course of receiving currently available treatments.

This study seeks to compare the outcomes of current treatments in the management of different age groups (ages 1-6, 6-8, 8-11, \>11) of patients with Perthes disease at two- and five-year followup and at skeletal maturity. For each age group, two to three common treatment regimens currently used by practicing pediatric orthopaedic surgeons will be compared. The intervention a patient receives is determined through physician treatment expertise, and is not pre-determined by the study.

Detailed Description

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Approximately 50 pediatric orthopaedic surgeons from pediatric centers in the US and other countries have agreed to participate in this database as members of the International Perthes Study Group (IPSG). TSRH will be the lead center. Sites who agree to participate will seek IRB approval from their own institutions. Data will be collected prospectively and entered into REDCap (Research Electronic Data Capture), a browser-based research database.

1-6 Cohort: For the 1-6 age patient group, patients involved in any treatment will be asked to participate in the study.

6-8 Cohort: For the 6-8 age patient group, patients presenting in an early stage of the disease (stage I or IIa), the surgeons who treat their patients with one of the following three treatment regimens currently used in practice will be asked to participate in the study :

1. Non-operative management (i.e., no osteotomy but can include soft tissue release);
2. Operative containment treatment (femoral or pelvic osteotomy or Shelf acetabuloplasty).

8-11 Cohort: For the 8-11 patient age group, patients presenting in an early stage of the disease (stage I or IIa), the surgeons who treat their patients with one of the following treatment regiments currently used in practice will be asked to participate in the study:

1. Non-operative management (i.e., no osteotomy);
2. Operative containment treatment (femoral or pelvic osteotomy or Shelf acetabuloplasty) followed by 6 weeks of postoperative non-weight bearing; and,
3. Operative containment treatment (femoral or pelvic osteotomy or Shelf acetabuloplasty) followed by 6 months of postoperative non-weight bearing.

\>11 Cohort Registry: For the \>11 patient age group, we will collect prospective data from surgeons who are currently treating their patients with any treatment regimens.

Patients who present to an IPSG member or their group during the late stages of the disease (stage IIb or stage III) will also be arranged into four separate age cohorts, identical to the list above. We will collect prospective data for these cases, as well.

Regardless of the patient's stage at enrollment, the patient's age at diagnosis or assigned cohort, the following data will be collected: information regarding patient characteristics at presentation, physical exam findings, responses to Perthes patient and/or outcomes questionnaires, and results of radiographic and MR imaging.

Participants will be assigned a unique study number. A secure web application, REDCap, will be used to capture and store research information including radiographic and MR images, clinical information, and de-identified outcomes questionnaire responses. Data will be transmitted and stored on a secure and dedicated server for the purpose of this study.

Conditions

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Legg Calve Perthes Disease

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Nonoperative management between ages 6-8 in early stage

The choice of non-osteotomy management without containment or surgical containment would be solely governed by the current practice of the participating surgeons (i.e. the current practice of the individual surgeon would be followed within the broad framework of the study).

Nonoperative Observation

Intervention Type PROCEDURE

Group will not undergo any surgical or invasive procedures during course of treatment.

Operative management between age 6-8 in early stage

Operative containment treatment (femoral or pelvic osteotomy or Shelf acetabuloplasty) rendered in the early stage of the disease process

Osteotomy + Long Term Non-Weight Bearing

Intervention Type PROCEDURE

Surgical procedure that improves femoral head containment, plus a post-operative protocol that requires patient to maintain non-weight bearing for 6 months.

Osteotomy + Short Term Non-Weight Bearing

Intervention Type PROCEDURE

Surgical procedure that improves femoral head containment, plus a post-operative protocol that allows early return to function after 6 weeks of non-weight bearing.

Nonoperative management between age 8-11 in early stage

Patients who do not undergo some form of containment surgery because of medical, social, or other reasons will receive no surgical treatment.

Nonoperative Observation

Intervention Type PROCEDURE

Group will not undergo any surgical or invasive procedures during course of treatment.

Operative containment with short-term non-weightbearing in early stage

As per the current standard practice for patients between age 8-11 in developed countries, all patients will undergo some form of containment surgery (pelvic or femoral osteotomy) in order to better "contain" the femoral head underneath the acetabulum. Post-operative treatment will include 6 weeks of non-weight bearing on the operated leg.

Osteotomy + Short Term Non-Weight Bearing

Intervention Type PROCEDURE

Surgical procedure that improves femoral head containment, plus a post-operative protocol that allows early return to function after 6 weeks of non-weight bearing.

Operative containment with prolonged non-weightbearing in early stage

As per the current standard practice for patients between age 8-11, all patients will undergo some form of containment surgery (pelvic or femoral osteotomy) in order to better "contain" the femoral head underneath the acetabulum. Post-operative treatment will include 6 months of non-weight bearing on the operated leg.

Osteotomy + Long Term Non-Weight Bearing

Intervention Type PROCEDURE

Surgical procedure that improves femoral head containment, plus a post-operative protocol that requires patient to maintain non-weight bearing for 6 months.

Operative containment for over 11 age group

Patients presenting over age 11 may receive multiple drilling and be non weight bearing for up to 6 months according to the treating physician's preference. Patients with application of fixator (arthrodiastasis) will be studied in this cohort arm as well, which typically involved 3-4 months followed by 8-12 weeks of non-weight bearing after fixator removal. Other surgical techniques may be included, however these are the most common for this age group.

Osteotomy + Long Term Non-Weight Bearing

Intervention Type PROCEDURE

Surgical procedure that improves femoral head containment, plus a post-operative protocol that requires patient to maintain non-weight bearing for 6 months.

Osteotomy + Short Term Non-Weight Bearing

Intervention Type PROCEDURE

Surgical procedure that improves femoral head containment, plus a post-operative protocol that allows early return to function after 6 weeks of non-weight bearing.

Multiple Epiphyseal Drilling

Intervention Type PROCEDURE

Multiple epiphyseal drilling is a procedure that creates small holes in the femoral head growth plate to increase blood flow into the femoral head.

Nonoperative management in over 11 age group

Patients will be non-weight bearing and receive physical therapy according to the physician preferences.

Nonoperative Observation

Intervention Type PROCEDURE

Group will not undergo any surgical or invasive procedures during course of treatment.

Nonoperative management in 1-6 age group

The choice of non-osteotomy management without containment or surgical containment would be solely governed by the current practice of the participating surgeons (i.e. the current practice of the individual surgeon would be followed within the broad framework of the study).

Nonoperative Observation

Intervention Type PROCEDURE

Group will not undergo any surgical or invasive procedures during course of treatment.

Operative management in 1-6 age group

The choice of osteotomy management with containment would be solely governed by the current practice of the participating surgeons (i.e. the current practice of the individual surgeon would be followed within the broad framework of the study).

Osteotomy + Long Term Non-Weight Bearing

Intervention Type PROCEDURE

Surgical procedure that improves femoral head containment, plus a post-operative protocol that requires patient to maintain non-weight bearing for 6 months.

Osteotomy + Short Term Non-Weight Bearing

Intervention Type PROCEDURE

Surgical procedure that improves femoral head containment, plus a post-operative protocol that allows early return to function after 6 weeks of non-weight bearing.

Multiple Epiphyseal Drilling

Intervention Type PROCEDURE

Multiple epiphyseal drilling is a procedure that creates small holes in the femoral head growth plate to increase blood flow into the femoral head.

Late Stage Bracing group

Patients presenting with \<= 20 degrees of abduction on a maximum abduction x-ray treated with bracing who also present in the late stages of the disease (Waldenstrom Stage IIb or IIIa).The choice of management with or without containment or surgical containment would be solely governed by the current practice of the participating surgeons (i.e. the current practice of the individual surgeon would be followed within the broad framework of the study).

Nonoperative Observation

Intervention Type PROCEDURE

Group will not undergo any surgical or invasive procedures during course of treatment.

Late Stage Symptomatic treatment group

Patients presenting in the late stages of the disease (defined as Waldenstrom stage IIb or IIIa) who are treated symptomatically. The choice of management with or without containment or surgical containment would be solely governed by the current practice of the participating surgeons (i.e. the current practice of the individual surgeon would be followed within the broad framework of the study).

Nonoperative Observation

Intervention Type PROCEDURE

Group will not undergo any surgical or invasive procedures during course of treatment.

Late Stage Surgical Containment group

Patients presenting in the late stages of the disease (defined as Waldenstrom stage IIb or IIIa) who are treated with surgical containment. The choice of management with or without containment or surgical containment would be solely governed by the current practice of the participating surgeons (i.e. the current practice of the individual surgeon would be followed within the broad framework of the study).

Osteotomy + Long Term Non-Weight Bearing

Intervention Type PROCEDURE

Surgical procedure that improves femoral head containment, plus a post-operative protocol that requires patient to maintain non-weight bearing for 6 months.

Osteotomy + Short Term Non-Weight Bearing

Intervention Type PROCEDURE

Surgical procedure that improves femoral head containment, plus a post-operative protocol that allows early return to function after 6 weeks of non-weight bearing.

Multiple Epiphyseal Drilling

Intervention Type PROCEDURE

Multiple epiphyseal drilling is a procedure that creates small holes in the femoral head growth plate to increase blood flow into the femoral head.

Interventions

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Osteotomy + Long Term Non-Weight Bearing

Surgical procedure that improves femoral head containment, plus a post-operative protocol that requires patient to maintain non-weight bearing for 6 months.

Intervention Type PROCEDURE

Osteotomy + Short Term Non-Weight Bearing

Surgical procedure that improves femoral head containment, plus a post-operative protocol that allows early return to function after 6 weeks of non-weight bearing.

Intervention Type PROCEDURE

Nonoperative Observation

Group will not undergo any surgical or invasive procedures during course of treatment.

Intervention Type PROCEDURE

Multiple Epiphyseal Drilling

Multiple epiphyseal drilling is a procedure that creates small holes in the femoral head growth plate to increase blood flow into the femoral head.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Diagnosed with Legg-Calvé-Perthes disease
* Between age 1-18
* Patients with possible secondary femoral osteonecrosis if over the age of 11 due to trauma or corticosteroid therapy are also eligible.

Exclusion Criteria

* Patients with previous surgical treatment on the affected hip
Minimum Eligible Age

1 Year

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Alberta Children's Hospital

OTHER

Sponsor Role collaborator

Alfred I. duPont Hospital for Children

OTHER

Sponsor Role collaborator

Le Bonheur Children's Hospital

OTHER

Sponsor Role collaborator

Children's Hospital Colorado

OTHER

Sponsor Role collaborator

Children's Hospital Los Angeles

OTHER

Sponsor Role collaborator

Children's National Research Institute

OTHER

Sponsor Role collaborator

Children's Healthcare of Atlanta

OTHER

Sponsor Role collaborator

Children's Hospital of Philadelphia

OTHER

Sponsor Role collaborator

Children's Hospital Medical Center, Cincinnati

OTHER

Sponsor Role collaborator

Columbia University

OTHER

Sponsor Role collaborator

Connecticut Children's Medical Center

OTHER

Sponsor Role collaborator

Gillette Children's Specialty Healthcare

OTHER

Sponsor Role collaborator

Boston Children's Hospital

OTHER

Sponsor Role collaborator

Johns Hopkins University

OTHER

Sponsor Role collaborator

Kaiser Permanente

OTHER

Sponsor Role collaborator

Kasturba Medical College

OTHER

Sponsor Role collaborator

Montefiore Medical Center

OTHER

Sponsor Role collaborator

Nationwide Children's Hospital

OTHER

Sponsor Role collaborator

NYU Langone Health

OTHER

Sponsor Role collaborator

OrthoCarolina Research Institute, Inc.

OTHER

Sponsor Role collaborator

University of Sao Paulo General Hospital

OTHER

Sponsor Role collaborator

Seoul National University Childrens Hospital

OTHER

Sponsor Role collaborator

Shriners Hospitals for Children

OTHER

Sponsor Role collaborator

University Hospital Southampton NHS Foundation Trust

OTHER

Sponsor Role collaborator

Baylor College of Medicine

OTHER

Sponsor Role collaborator

Universitätsklinikum Hamburg-Eppendorf

OTHER

Sponsor Role collaborator

Ann & Robert H Lurie Children's Hospital of Chicago

OTHER

Sponsor Role collaborator

British Columbia Children's Hospital

OTHER

Sponsor Role collaborator

Children's of Alabama

OTHER

Sponsor Role collaborator

Hospital Infantil Universitario Niño Jesús, Madrid, Spain

OTHER

Sponsor Role collaborator

University of Oklahoma

OTHER

Sponsor Role collaborator

Oregon Health and Science University

OTHER

Sponsor Role collaborator

Rady Children's Hospital, San Diego

OTHER

Sponsor Role collaborator

San Jorge Children's Hospital (Puerto Rico)

UNKNOWN

Sponsor Role collaborator

University College Dublin

OTHER

Sponsor Role collaborator

Tianjin Children's Hospital

OTHER

Sponsor Role collaborator

University Hospital Schleswig-Holstein

OTHER

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role collaborator

University of Haifa

OTHER

Sponsor Role collaborator

Uppsala University

OTHER

Sponsor Role collaborator

Medical University of Lodz

OTHER

Sponsor Role collaborator

Oslo University Hospital

OTHER

Sponsor Role collaborator

Seattle Children's Hospital

OTHER

Sponsor Role collaborator

Mayo Clinic

OTHER

Sponsor Role collaborator

Texas Scottish Rite Hospital for Children

OTHER

Sponsor Role lead

Responsible Party

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Harry Kim, MD

Director of Research

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Harry KW Kim, MD, MS

Role: STUDY_CHAIR

Texas Scottish Rite Hospital for Children

Locations

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Children's Hospital of Alabama

Birmingham, Alabama, United States

Site Status

Children's Hospital of Los Angeles

Los Angeles, California, United States

Site Status

Kaiser Permanente Hospital

Los Angeles, California, United States

Site Status

Rady Children's Hospital California

San Diego, California, United States

Site Status

UCSF Benioff Children's Hospitals

San Francisco, California, United States

Site Status

Children's Hospital Colorado

Aurora, Colorado, United States

Site Status

Connecticut Children's Medical Center

Hartford, Connecticut, United States

Site Status

Alfred I. DuPont Hospital for Children of the Nemours Foundation

Wilmington, Delaware, United States

Site Status

Children's National Medical Center

Washington D.C., District of Columbia, United States

Site Status

Children's Orthopaedics of Atlanta

Atlanta, Georgia, United States

Site Status

Ann & Robert H. Lurie Children's Hospital of Chicago

Chicago, Illinois, United States

Site Status

Johns Hopkins

Baltimore, Maryland, United States

Site Status

Children's Hospital Boston

Boston, Massachusetts, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

Gillette Children's Specialty Healthcare

Saint Paul, Minnesota, United States

Site Status

NYU Langone/Hospital for Joint Disease

New York, New York, United States

Site Status

New York Presbyterian Hospital (Columbia Campus)

New York, New York, United States

Site Status

Children's Hospital at Montefiore

The Bronx, New York, United States

Site Status

OrthoCarolina

Charlotte, North Carolina, United States

Site Status

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, United States

Site Status

Nationwide Children's Hospital

Columbus, Ohio, United States

Site Status

Oklahoma University Health Science Center

Oklahoma City, Oklahoma, United States

Site Status

Oregon Health and Science University

Portland, Oregon, United States

Site Status

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

University of Tennessee-Campbell Clinic

Germantown, Tennessee, United States

Site Status

Texas Scottish Rite Hospital for Children

Dallas, Texas, United States

Site Status

Texas Children's Hospital

Houston, Texas, United States

Site Status

Seattle Children's Hospital

Seattle, Washington, United States

Site Status

Women and Children's Hospital of Adelaide

Adelaide, South Australia, Australia

Site Status

Universidade de São Paulo

São Paulo, , Brazil

Site Status

Alberta Children's Hospital, Division of Paediatric Surgery

Calgary, Alberta, Canada

Site Status

British Columbia Children's Hospital

Vancouver, British Columbia, Canada

Site Status

Tianjin Hospital Pediatric Orthopedics

Tianjin, , China

Site Status

Children's Hospital Hamburg-Altona

Hamburg, , Germany

Site Status

Hospital of Schleswig-Holstein

Lübeck, , Germany

Site Status

University Hospital of Schleswig-Holstein (Campus Lubeck)

Lübeck, , Germany

Site Status

Kasturba Medical College (KMC), Manipal

Udupi, Karnataka, India

Site Status

Children's Health Ireland at Temple Street

Dublin, , Ireland

Site Status

Oslo University Hospital

Oslo, , Norway

Site Status

Medical University of Lodz

Lodz, , Poland

Site Status

San Jorge Children's Hospital

San Juan, , Puerto Rico

Site Status

Hospital Infantil Universitario Nino Jesus

Madrid, , Spain

Site Status

Uppsala University

Uppsala, , Sweden

Site Status

Centre hopsitalier universitaire Vaudois

Lausanne, , Switzerland

Site Status

Alder Hey Children's Hosopital (University of Oxford)

Liverpool, , United Kingdom

Site Status

Southampton Children's Hospital

Southampton, , United Kingdom

Site Status

Countries

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United States Australia Brazil Canada China Germany India Ireland Norway Poland Puerto Rico Spain Sweden Switzerland United Kingdom

Related Links

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Other Identifiers

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IPSG 001

Identifier Type: -

Identifier Source: org_study_id

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