Is Periacetabular Osteotomy Superior to Progressive Resistance Training?

NCT ID: NCT03941171

Last Updated: 2025-12-18

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

COMPLETED

Clinical Phase

NA

Total Enrollment

69 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-07-01

Study Completion Date

2025-09-15

Brief Summary

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The primary aim of this study is to examine if Periacetabular Osteotomy (PAO) followed by 4 months of usual care followed by 8 months of progressive resistance training (PRT) is superior to 12 months of a PRT intervention in patients with hip dysplasia eligible for PAO in terms of self-reported pain on the HAGOS questionnaire. Secondary aims are to investigate changes in patient-reported symptoms, physical function in daily living, physical function in sport and recreation, hip and/or groin-related quality of life, generic health status, functional performance, muscle strength, physical activity and adverse events between PAO followed by usual care+PRT compared to PRT only. We hypothesise that in patients with hip dysplasia, PAO followed by usual care+PRT, results in significantly less pain at 12 months follow-up, compared to PRT only.

Detailed Description

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Group 1 (PAO+usual+PRT):

PAO will be performed as the trans-sartorial approach or the anterior pelvic approach. Patients commence post-operative rehabilitation as usual and follow the rehabilitation program guided by a physiotherapist specialized in hip problems until 4 months after the operation. 4 months postoperative the patients complete usual care and continue with the same PRT intervention program as the PRT group, with 4 months of supervised sessions (see description below).

Group 2 (PRT):

The PRT group receives 4 months of supervised PRT 2 times per week. A physiotherapist or students will supervise all training sessions the first 4 weeks. The following 4 weeks, 6 out of 8 training sessions are supervised and from week 9-16, half of the training sessions (8 out of 16) are supervised. After these 4 months (16 weeks), patients receive a free membership to a fitness center near their home address and are encouraged to train on their own 2 times per week until 12 months follow-up with one supervised session per month. The PRT program involves 10-min of warm up followed by 50-min of bilateral resistance exercises including sets of loaded squats, hip extension, hip flexion, and hip abduction. The absolute training load will be individually adjusted on a set-by-set basis, using the plus two principle (if the patient is able to perform two or more repetitions than required, the load is increased). Hip related pain levels up to 5 on the VAS is considered acceptable during exercise.

The study is a multicentre randomised controlled and assessor blinded trial. Primary endpoint will be 12 months after initiation of surgical/non-surgical treatment. Secondary endpoints will be measured at 4 months after the start of the treatment (surgical/non-surgical). In addition, 5-year and 10-year follow-up with questionnaires is planned.

Conditions

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Hip Dysplasia

Keywords

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Periacetabular Osteotomy Progressive resistance training PAO

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized controlled trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Blinding

Study Groups

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Group 1

PAO+usual+PRT

Group Type EXPERIMENTAL

PAO

Intervention Type PROCEDURE

PAO will be performed as the trans-sartorial approach or the anterior pelvic approach.

Usual care after PAO

Intervention Type OTHER

Patients commence post-operative rehabilitation as usual and follow the rehabilitation program guided by a physiotherapist specialized in hip problems until 4 months after the operation.

PRT

Intervention Type OTHER

4 months of partly supervised progressive resistance training 2 times per week. After these 4 months (16 weeks), patients receive a free membership to a fitness center near their home address and are encouraged to train on their own 2 times per week until 12 months follow-up with one supervised session per month. The PRT program involves 10-min of warm up followed by 50-min of bilateral resistance exercises including sets of squats, hip extension, hip flexion, and hip abduction.

Group 2

PRT

Group Type ACTIVE_COMPARATOR

PRT

Intervention Type OTHER

4 months of partly supervised progressive resistance training 2 times per week. After these 4 months (16 weeks), patients receive a free membership to a fitness center near their home address and are encouraged to train on their own 2 times per week until 12 months follow-up with one supervised session per month. The PRT program involves 10-min of warm up followed by 50-min of bilateral resistance exercises including sets of squats, hip extension, hip flexion, and hip abduction.

Interventions

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PAO

PAO will be performed as the trans-sartorial approach or the anterior pelvic approach.

Intervention Type PROCEDURE

Usual care after PAO

Patients commence post-operative rehabilitation as usual and follow the rehabilitation program guided by a physiotherapist specialized in hip problems until 4 months after the operation.

Intervention Type OTHER

PRT

4 months of partly supervised progressive resistance training 2 times per week. After these 4 months (16 weeks), patients receive a free membership to a fitness center near their home address and are encouraged to train on their own 2 times per week until 12 months follow-up with one supervised session per month. The PRT program involves 10-min of warm up followed by 50-min of bilateral resistance exercises including sets of squats, hip extension, hip flexion, and hip abduction.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Patients aged 18-45 years and diagnosed with hip dysplasia referred from primary care to the Department of Orthopaedic Surgery at one of the two participating hospitals.
2. Considered eligible for PAO by a surgeon.
3. Radiographic verified hip dysplasia (CE-angle \<25 degrees and AI-angle \>10 degrees) and clinical symptoms.
4. Range of motion: internal rotation \>15 degrees, external rotation \>15 degrees, hip flexion \>110 degrees.
5. Able to commute to training sessions.

Exclusion Criteria

1. OA degree ≥1 on classification of Tönnis'.
2. CE-angle \<10 degrees.
3. Previous pelvic surgery for hip dysplasia (affected side).
4. Calvé Legg Perthes or epifysiolysis.
5. Simultaneous bilateral PAO.
6. Previous surgery for herniated disc, spondylodesis, arthroplasty of hip, knee or ankle.
7. Previous surgery of the hip (tenotomy of iliopsoas tendon, z-plastic of the iliotibial tract or hip arthroscopy) in index leg.
8. Neurological or rheumatoid diseases that affect the hip function.
9. Inadequacy in written and spoken Danish or Norwegian.
10. Body Mass Index (BMI) \>25 in Aarhus and BMI \>30 in Oslo and Odense
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Aarhus University Hospital

OTHER

Sponsor Role collaborator

VIA University College

OTHER

Sponsor Role collaborator

University of Aarhus

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lisa U Tønning, MSc

Role: PRINCIPAL_INVESTIGATOR

Department of Orthopedic Surgery, Aarhus University Hospital, Denmark

Inger Mechlenburg, DMSc, PhD

Role: STUDY_DIRECTOR

Department of Clinical Medicine, Aarhus University, Denmark

Ulrik Dalgas, MSc, PhD

Role: STUDY_DIRECTOR

Department of Public Health - Sport, Aarhus University, Denmark

Stig S Jakobsen, PhD

Role: STUDY_DIRECTOR

Department of Orthopedic Surgery, Aarhus University Hospital, Denmark

Kjeld Søballe, DMSc

Role: STUDY_DIRECTOR

Department of Orthopedic Surgery, Aarhus University Hospital, Denmark

Julie S Jacobsen, MSc

Role: STUDY_DIRECTOR

Department of Physiotherapy & Research Centre in Health and Welfare Technology, VIA University College, Denmark

Jan E Madsen, MD, PhD

Role: STUDY_DIRECTOR

Department of Orthopedic Surgery, Oslo University Hospital, Norway

Lars Nordsletten, PhD

Role: STUDY_DIRECTOR

Division of Orthopaedic Surgery, Oslo University Hospital, Oslo; Faculty of Medicine, University of Oslo, Norway

Tone Bere, PT, PhD

Role: STUDY_CHAIR

Department of Orthopedics, Oslo University Hospital Ullevaal, Norway

May A Risberg, PhD

Role: STUDY_DIRECTOR

Department of Orthopedics, Oslo University Hospital Ullevaal, Norway

Locations

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Lisa Urup Tønning

Aarhus N, Central Jutland, Denmark

Site Status

Odense University Hospital

Odense, Fyn, Denmark

Site Status

Oslo University Hospital

Oslo, , Norway

Site Status

Countries

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Denmark Norway

References

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Reimer LCU, Jakobsen SS, Mortensen L, Dalgas U, Jacobsen JS, Soballe K, Bere T, Madsen JE, Nordsletten L, Risberg MA, Mechlenburg I. Efficacy of periacetabular osteotomy followed by progressive resistance training compared to progressive resistance training as non-surgical treatment in patients with hip dysplasia (PreserveHip) - a protocol for a randomised controlled trial. BMJ Open. 2019 Dec 23;9(12):e032782. doi: 10.1136/bmjopen-2019-032782.

Reference Type DERIVED
PMID: 31874882 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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PreserveHIP

Identifier Type: -

Identifier Source: org_study_id