- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03941171
Is Periacetabular Osteotomy Superior to Progressive Resistance Training?
The Effect of PAO Followed by Progressive Resistance Training Versus Progressive Resistance Training in Patients With Hip Dysplasia. A Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
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.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Lisa CU Reimer, MSc
- Phone Number: +45 26474080
- Email: lisareimer@clin.au.dk
Study Contact Backup
- Name: Inger Mechlenburg, DMSc, PhD
- Phone Number: +45 21679062
- Email: inger.mechlenburg@clin.au.dk
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 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.
- Considered eligible for PAO by a surgeon.
- Radiographic verified hip dysplasia (CE-angle <25 degrees and AI-angle >10 degrees) and clinical symptoms.
- Range of motion: internal rotation >15 degrees, external rotation >15 degrees, hip flexion >110 degrees.
- Able to commute to training sessions.
Exclusion Criteria:
- OA degree ≥1 on classification of Tönnis'.
- CE-angle <10 degrees.
- Previous pelvic surgery for hip dysplasia (affected side).
- Calvé Legg Perthes or epifysiolysis.
- Simultaneous bilateral PAO.
- Previous surgery for herniated disc, spondylodesis, arthroplasty of hip, knee or ankle.
- Previous surgery of the hip (tenotomy of iliopsoas tendon, z-plastic of the iliotibial tract or hip arthroscopy) in index leg.
- Neurological or rheumatoid diseases that affect the hip function.
- Inadequacy in written and spoken Danish or Norwegian.
- Body Mass Index (BMI) >25 in Aarhus and BMI >30 in Oslo and Odense
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 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 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.
|
Active Comparator: Group 2
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.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in pain related to hip function, between baseline and 12 months follow-up
Time Frame: Measured at baseline, 4 month follow-up and 12 month follow-up
|
The pain subscale of the patient reported questionnaire Copenhagen Hip and Groin Outcome Score (HAGOS), were the total score ranges from 0 (worst) to 100 (best).
|
Measured at baseline, 4 month follow-up and 12 month follow-up
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in self-reported hip function
Time Frame: Measured at baseline, 4 month follow-up and 12 month follow-up
|
The subscales; Symptoms, Physical function in daily living, Physical function in Sport and Recreation, Participation in Physical Activities and hip and/or groin-related Quality of Life of the patient reported questionnaire Copenhagen Hip and Groin Outcome Score (HAGOS), where the total score ranges from 0 (worst) to 100 (best).
|
Measured at baseline, 4 month follow-up and 12 month follow-up
|
Change in hip function
Time Frame: Measured at baseline, 4 month follow-up and 12 month follow-up
|
Single leg hop for distance is a test that measure functional performance requiring both strength, power and balance.
The distance from start to landing is measured in cm. and height adjusted by dividing the distance of the hop with the height of the patient.
|
Measured at baseline, 4 month follow-up and 12 month follow-up
|
Change in balance function
Time Frame: Measured at baseline, 4 month follow-up and 12 month follow-up
|
The Y balance test require strength, flexibility, neuromuscular control, stability, range of movement, balance and proprioception.
These elements are tested and the maximal reach distance is recorded for each direction (anterior, posteromedial and posteroladeral).
The composite reach is calculated and normalized to limb length for analysis of the overall performance on the test.
|
Measured at baseline, 4 month follow-up and 12 month follow-up
|
Number of patients with adverse events and serious adverse events after PAO
Time Frame: Reported within 12 months after surgery
|
Adverse events:
Serious adverse events:
|
Reported within 12 months after surgery
|
Change in usage of painkillers
Time Frame: Measured at baseline, 4 month follow-up and 12 month follow-up
|
Usage of painkillers (yes/no), including type of painkillers (Paracetamol, NSAID, Morfin/opiods and/other type of medicine)
|
Measured at baseline, 4 month follow-up and 12 month follow-up
|
Change in self-reported pain
Time Frame: Measured at baseline, 4 month follow-up and 12 month follow-up
|
Pain reported by the Visual Analogue Scale (VAS).
A scale where pain is marked from 0-100, and 0 is no pain and 100 is worst imaginable pain.
|
Measured at baseline, 4 month follow-up and 12 month follow-up
|
Change in hip awareness
Time Frame: Measured at baseline, 4 month follow-up and 12 month follow-up
|
Hip awareness is measured with the Forgotten Joint Score questionnaire (FJS), where each patient completes the 12 questions regarding awareness of their affected hip.
Each question is answered with one of the following options; never, almost never, seldom, sometimes and mostly, corresponding to a score of 1-5.
The sum of the scores will be converted into a score between 0-100.
A high score will indicate lack of awareness and a low score will indicate great awareness of the affected hip.
|
Measured at baseline, 4 month follow-up and 12 month follow-up
|
Change in muscle strength
Time Frame: Measured at baseline, 4 month follow-up and 12 month follow-up
|
Muscle strength in hip-abduction, hip-flexion and hip-extension is measured isometrically, with a dynamometer.
|
Measured at baseline, 4 month follow-up and 12 month follow-up
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in physical activity
Time Frame: Measured at baseline and 12 month follow-up
|
Tri-axial accelerometer
|
Measured at baseline and 12 month follow-up
|
Change in patient-reported health
Time Frame: Measured at baseline, 4 month follow-up and 12 month follow-up
|
Change in patient-reported health will be measured with the EuroQol Group 5-dimension patient-reported questionnaire (EQ-5D-5L), where each dimension has five response levels; ranging from no problems to extreme problems (level 1 to level 5).
The scores will be combined, using one level from each dimension, ranging from 11111 (best health) to 55555 (worst health).
The instrument also includes a visual analogue scale (VAS) where self-perceived health is scored on a 0 to 100 mm scale representing "the worst health you can imagine" and "the best health you can imagine".
|
Measured at baseline, 4 month follow-up and 12 month follow-up
|
Collaborators and Investigators
Sponsor
Investigators
- Study Director: Inger Mechlenburg, DMSc, PhD, Department of Clinical Medicine, Aarhus University, Denmark
- Study Director: Ulrik Dalgas, MSc, PhD, Department of Public Health - Sport, Aarhus University, Denmark
- Study Director: Stig S Jakobsen, PhD, Department of Orthopedic Surgery, Aarhus University Hospital, Denmark
- Study Director: Kjeld Søballe, DMSc, Department of Orthopedic Surgery, Aarhus University Hospital, Denmark
- Study Director: Julie S Jacobsen, MSc, Department of Physiotherapy & Research Centre in Health and Welfare Technology, VIA University College, Denmark
- Study Director: Jan E Madsen, MD, PhD, Department of Orthopedic Surgery, Oslo University Hospital, Norway
- Study Director: Lars Nordsletten, PhD, Division of Orthopaedic Surgery, Oslo University Hospital, Oslo; Faculty of Medicine, University of Oslo, Norway
- Study Chair: Tone Bere, PT, PhD, Department of Orthopedics, Oslo University Hospital Ullevaal, Norway
- Study Director: May A Risberg, PhD, Department of Orthopedics, Oslo University Hospital Ullevaal, Norway
- Principal Investigator: Lisa U Tønning, MSc, Department of Orthopedic Surgery, Aarhus University Hospital, Denmark
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- PreserveHIP
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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