Arthroscopically Assisted Versus Open Surgical Reduction of the Hip in Patients With Irreducible DDH Before the Walking Age
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
- 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.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: mohamed ebrahim, resident
- Phone Number: 01050707974
- Email: Mohamed.15259277@med.aun.edu.eg
Study Contact Backup
- Name: mohamed Abd El- Radi, dr
- Phone Number: 01225338766
- Email: mradi@aun.edu.eg
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
Accepts Healthy Volunteers
Description
- 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
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: 1 .Arthroscopically assisted
Arthroscopically assisted in surgical reduction of the hip in patients with irreducible DDH before the walking age arm 1
|
Arthroscopically-Assisted reduction through anterolateral portal for visualization and other accessory portals for instrumentation to achieve reduction and postoperative immobilization in a hip spica.
Other Names:
|
|
Active Comparator: 2.open surgical reduction arm 2
open surgical reduction of the hip in patients with irreducible DDH before the walking age arm 2
|
Open reduction through a bikini incision anterior approach and postoperative immobilization in a hip spica.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Determination the success of reduction and incidence of redislocation rate
Time Frame: immediately postoperative
|
Documentation of concentric reduction of the hip in immediate postoperative MRI as an assessment tool for the success of the procedure.
|
immediately postoperative
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Assessment of the cosmetic appearance .
Time Frame: 3 month follow up
|
Documentation the wound size after 3 months follow up in clinical examination as an assessment tool of cosmotic appearance
|
3 month follow up
|
|
Assessment of the shortening
Time Frame: 1 year follow up
|
Assessment the incidence of leg length discrepancy and shortening that affect walking after one year follow up in clinical examination and x-ray as an assessment tool of shortening
|
1 year follow up
|
|
Assessment the incidence stiffness and decrease range of motion of the affected hip
Time Frame: 1 year follow up
|
documentation the range of motion of the affected hip and incidence of stiffness after 6 months follow up in clinical examination as an assessment tool of stiffness.
|
1 year follow up
|
|
Assessment the incidence of avascular necrosis in the affected hip
Time Frame: 1 year follow up
|
documentation the incidence of avascular necrosis of the affected head of hip after one year follow up in clinical examination and x-ray
|
1 year follow up
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Nariman aboloyoun, Ass.Prof, Orthopedic and Trauma surgery at assiut university hospital
- Study Director: Hatem Galal El-Din Zaki, prof, Orthopedic and Trauma surgery at assiut university hospital
Publications and helpful links
General Publications
- 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.
- 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.
- 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.
- 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.
- 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.
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- hip arthroscopy in DDH
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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