Clinical trial NCT06747767: Early Outcomes of Arthroscopic Versus Open Reduction for Developmental Dysplasia of the Hip in Children
Official title: Early Outcomes of Arthroscopic Versus Open Reduction for Developmental Dysplasia of the Hip in Children: A Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Developmental Dysplasia of the Hip (DDH)
Keywords: Arthroscopic-assisted reduction
Developmental dysplasia of the hip
Open surgical reduction
Pediatric orthopedic surgery
Avascular necrosis
Lead sponsor: Hawler Medical University
Sponsor class: OTHER
First posted: 2024-12-24
Enrollment: 43
Sex: ALL
Minimum age (years): 1
Maximum age (years): 2
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: 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.

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.

Eligibility criteria: 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)

Primary outcomes:
measure: rate of hip redislocation documented clinically and radiographically at 6, 12, and 24 months postoperatively.
timeFrame: 2 years
Secondary outcomes:
Other outcomes:
Locations:
city: Erbil
country: Iraq
facility: Erbil Teaching Hospital
Study officials:
References: