Early Outcomes of Arthroscopic Versus Open Reduction for Developmental Dysplasia of the Hip in Children

Early Outcomes of Arthroscopic Versus Open Reduction for Developmental Dysplasia of the Hip in Children: A Randomized Controlled Trial

This study was designed to determine whether arthroscopic-assisted reduction offers better early surgical outcomes than open reduction for treating developmental dysplasia of the hip in children. By comparing these two approaches, the researchers sought to find out if using an arthroscopic-assisted method could lower redislocation rates, shorten operative time, reduce blood loss, maintain acceptable acetabular alignment, and potentially decrease the risk of complications such as avascular necrosis, thereby improving the quality of care and long-term hip function for affected children.

Study Overview

• Status: Completed
• Conditions: Developmental Dysplasia of the Hip (DDH)
• Intervention / Treatment: Procedure: Arthroscopy; Procedure: Open reduction

Detailed Description

This investigation evaluates two distinct surgical strategies for managing developmental dysplasia of the hip (DDH) in young children using a comparative, parallel-group design. The technical approach under consideration involves an arthroscopic-assisted procedure, which provides direct visualization of the hip joint structures through minimally invasive portals. By employing specialized instruments and an arthroscopic camera system, surgeons can assess ligamentous and capsular integrity, identify obstacles to proper femoral head positioning, and address intra-articular pathologies with potentially less disruption to the vascular supply and surrounding soft tissues than is typical in conventional open surgery. The surgical team implemented stringent measures to maintain uniformity in anesthesia protocols, operative setup, and postoperative immobilization strategies, ensuring that any observed differences would more likely be attributable to the surgical technique rather than confounding variables. Additionally, advanced imaging modalities, including fluoroscopic guidance where appropriate, were used intraoperatively to confirm adequate reduction and optimize acetabular coverage. The study's procedural protocols were developed in consultation with senior pediatric orthopedic surgeons experienced in both techniques and piloted to establish feasibility before patient enrollment commenced. In this manner, the investigation aims to refine the understanding of arthroscopic-assisted hip reconstruction in the pediatric population, providing insights that may influence future surgical guidelines, training curricula, and patient care pathways.

• Study Type: Interventional
• Enrollment (Actual): 43
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Iraq
  • Erbil, Iraq, 44001
    • Erbil Teaching Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Children diagnosed with DDH (Tönnis grade II-IV)
• Age range: 12 to 24 months at the time of the first surgical reduction
• A documented failed attempt at conservative reduction (e.g., closed reduction) prior to enrollment

Exclusion Criteria:

• Presence of neuromuscular disorders
• Teratologic hip dislocation
• Prior surgical intervention on the affected hip
• Incomplete radiographic documentation (missing radiographs at any of the required assessment intervals)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Arthroscopy; Arthroscopic Reduction for Developmental Dysplasia of the Hip in Children	Procedure: Arthroscopy; Arthroscopy
Experimental: Open Reduction; Open Reduction for Developmental Dysplasia of the Hip in children	Procedure: Open reduction; Open reduction

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
rate of hip redislocation documented clinically and radiographically at 6, 12, and 24 months postoperatively.	2 years

Collaborators and Investigators

• Sponsor: Hawler Medical University

Study record dates

Study Major Dates

• Study Start (Actual): January 15, 2022
• Primary Completion (Actual): December 10, 2024
• Study Completion (Actual): December 10, 2024

Study Registration Dates

• First Submitted: December 18, 2024
• First Submitted That Met QC Criteria: December 18, 2024
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: December 26, 2024
• Last Verified: December 1, 2024

More Information

Terms related to this study

• Keywords: Developmental dysplasia of the hip; Avascular necrosis; Arthroscopic-assisted reduction; Open surgical reduction; Pediatric orthopedic surgery
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Pathologic Processes; Joint Diseases; Musculoskeletal Abnormalities; Congenital Abnormalities; Joint Dislocations; Hip Dislocation; Developmental Dysplasia of the Hip; Hyperplasia; Hip Dislocation, Congenital
• Other Study ID Numbers: 6

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No