Mild Hip Dysplasia

Not Applicable

Withdrawn

• Conditions: Hip Dysplasia
• Interventions: Procedure: Hip Arthroscopy

• Registration Number: NCT03530878
• Lead Sponsor: Mayo Clinic

Brief Summary

Hip dysplasia is a complex problem that exists on a spectrum from mild to severe disease. Periacetabular osteotomy (PAO) remains the gold standard for most patients with dysplasia; however, the procedure is quite invasive making the decision to proceed in cases of mild disease difficult. Hip arthroscopy (HA) is an alternative minimally invasive technique that can be used to address mild dysplasia. Nevertheless, HA has less capability for correction and in rare instances can exacerbate instability in the dysplastic hip. There is a paucity of data examining outcomes between these two treatment strategies for this challenging problem.

Detailed Description

The Bernese periacetabular osteotomy (PAO) remains the gold standard for treatment of symptomatic developmental dysplasia of the hip (DDH) in most patients with closed triradiate cartilage. First developed by Ganz in 1984, this technique utilizes 4 osteotomies to completely mobilize the acetabular fragment 1. Although a technically demanding procedure, it allows optimal correction in all planes and maintains integrity of the posterior column, enabling early weight bearing and mobilization. Several groups have confirmed the long-term efficacy of this joint preservation procedure with a recent report from the inventing institution documented impressive survivorship up to 30 years after surgery 2. Treatment with PAO is more controversial for mild forms of dysplasia where the lateral center-edge angle (LCEA) is 18° - 25° and/or the Tӧnnis angle is 8° - 15°. In these patients the delta correction is more limited, thus creating a more unpredictable result with equally invasive surgery.

Study Timeline

• Study First Submitted: 2018-04-09
• Study First Submitted QC: 2018-05-18
• Study First Posted: 2018-05-21
• Study Start: 2018-06-01
• Primary Completion: 2019-01-11
• Study Completion: 2019-01-11
• Status Verified: 2019-02
• Last Update Submitted: 2019-02-23
• Last Update Posted: 2019-02-26

Recruitment & Eligibility

• Status: WITHDRAWN
• Sex: All
• Target Recruitment: Not specified

Inclusion Criteria

• Diagnosis of symptomatic mild DDH
• Lateral center-edge angle 18° - 25° and/or Tӧnnis angle 8° - 15°
• Skeletally mature
• Age 18 - 45
• Tonnis Grade 0 or 1 osteoarthritis (minimal or no arthritis)
• Ability to receive a standard of care preoperative MRI arthrogram of the hip

Exclusion Criteria

• Pregnant women
• Neurogenic dysplasia
• Legg-Calvé-Perthes disease
• Previous surgery about the hip including previous hip arthroscopy to address intra-articular pathology

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Hip Arthroscopy (HA)	Hip Arthroscopy	This approach addresses intraarticular pathology in the form of labral tears and cartilage that are often concomitant with DDH 3. Furthermore, capsular plication can be performed through HA to reduce instability of the joint.

Primary Outcome Measures

Name	Time	Method
The Forgotten Joint Score-12 (FJS-12)	1 year	Outcome