Arthroscopically Assisted Versus Open Surgical Reduction of the Hip in Patients With Irreducible DDH Before the Walking Age

NCT ID: NCT06408987

Last Updated: 2024-05-10

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-05-15

Study Completion Date

2025-12-15

Brief Summary

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To determine the role of arthroscopy in treatment of the DDH.

Detailed Description

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* The term developmental dysplasia of the hip (DDH) is composed of a spectrum of pathologies from stable acetabular dysplasia (femoral head centered in acetabulum but acetabulum is shallow) to concentric hips that are unstable (femoral head can be moved in and out of the confines of the acetabulum) and frankly dislocated hips in which there is a complete loss of contact between the femoral head and acetabulum.
* Open reduction , traditionally through a Smith - Peterson approach should be considered only if closed reduction cannot be performed.
* Medial open surgical reduction is a choice for the management of patients younger than 18 months with DDH. The minimal incision and minimal blood loss are advantages of this approach. Limited exposure of the hip joint is a disadvantage.
* The arthroscopic procedure was reported to represent a meaningful alternative to the open procedure due to a lower complication rate, a safe setting, a lower rate of residual dysplasia, no observed redislocation and low rate occurrence of osteonecrosis.
* All the intra-articular structures (hypertrophic ligamentum teres, transverse acetabular ligament, and pulvinar tissue) in the acetabulum that impede the reduction of the femoral head could be eliminated by using the arthroscopic technique.

Conditions

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Developmental Dysplasia of the Hip

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1 .Arthroscopically assisted

Arthroscopically assisted in surgical reduction of the hip in patients with irreducible DDH before the walking age arm 1

Group Type ACTIVE_COMPARATOR

arthroscopically assisted

Intervention Type PROCEDURE

Arthroscopically-Assisted reduction through anterolateral portal for visualization and other accessory portals for instrumentation to achieve reduction and postoperative immobilization in a hip spica.

2.open surgical reduction arm 2

open surgical reduction of the hip in patients with irreducible DDH before the walking age arm 2

Group Type ACTIVE_COMPARATOR

open surgical reduction

Intervention Type PROCEDURE

Open reduction through a bikini incision anterior approach and postoperative immobilization in a hip spica.

Interventions

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arthroscopically assisted

Arthroscopically-Assisted reduction through anterolateral portal for visualization and other accessory portals for instrumentation to achieve reduction and postoperative immobilization in a hip spica.

Intervention Type PROCEDURE

open surgical reduction

Open reduction through a bikini incision anterior approach and postoperative immobilization in a hip spica.

Intervention Type PROCEDURE

Other Intervention Names

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arthroscopically assisted surgical reduction

Eligibility Criteria

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Inclusion Criteria

* Age: - from nine months to 18 months.
* Irreducible Hip Dislocation.

Exclusion Criteria

* Patient age: below 9 months or above 18 months.
* Teratologic hip dislocation
Minimum Eligible Age

9 Months

Maximum Eligible Age

18 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Mohamed Mahmoud Ebrahim Abd Allah

doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nariman aboloyoun, Ass.Prof

Role: STUDY_DIRECTOR

Orthopedic and Trauma surgery at assiut university hospital

Hatem Galal El-Din Zaki, prof

Role: STUDY_DIRECTOR

Orthopedic and Trauma surgery at assiut university hospital

Central Contacts

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mohamed ebrahim, resident

Role: CONTACT

01050707974

mohamed Abd El- Radi, dr

Role: CONTACT

01225338766

References

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Roof AC, Jinguji TM, White KK. Musculoskeletal screening: developmental dysplasia of the hip. Pediatr Ann. 2013 Nov;42(11):229-35. doi: 10.3928/00904481-20131022-10.

Reference Type BACKGROUND
PMID: 24168117 (View on PubMed)

Jenner EA, Chauhan GS, Burahee A, Choudri J, Gardner A, Bache CE. Comparison of clinical and radiological outcomes for the anterior and medial approaches to open reduction in the treatment of bilateral developmental dysplasia of the hip: a systematic review protocol. Syst Rev. 2024 Feb 23;13(1):72. doi: 10.1186/s13643-023-02444-6.

Reference Type BACKGROUND
PMID: 38396003 (View on PubMed)

Duman S, Camurcu Y, Sofu H, Ucpunar H, Akbulut D, Yildirim T. Arthroscopic versus open, medial approach, surgical reduction for developmental dysplasia of the hip in patients under 18 months of age. Acta Orthop. 2019 Jun;90(3):292-296. doi: 10.1080/17453674.2019.1599775. Epub 2019 Apr 2.

Reference Type BACKGROUND
PMID: 30938234 (View on PubMed)

Presch C, Eberhardt O, Wirth T, Fernandez FF. Comparison of arthroscopic and open reduction of conservatively irreducible dislocated hips of children. J Child Orthop. 2019 Aug 1;13(4):377-384. doi: 10.1302/1863-2548.13.190057.

Reference Type BACKGROUND
PMID: 31489043 (View on PubMed)

Bulut O, Ozturk H, Tezeren G, Bulut S. Arthroscopic-assisted surgical treatment for developmental dislocation of the hip. Arthroscopy. 2005 May;21(5):574-9. doi: 10.1016/j.arthro.2005.01.004.

Reference Type BACKGROUND
PMID: 15891724 (View on PubMed)

Other Identifiers

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hip arthroscopy in DDH

Identifier Type: -

Identifier Source: org_study_id

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