Arthroscopically Assisted Versus Open Surgical Reduction of the Hip in Patients With Irreducible DDH Before the Walking Age

Assiut University

Status: Not yet enrolling

Conditions: Developmental Dysplasia of the Hip

Treatments: Procedure: arthroscopically assisted; Procedure: open surgical reduction

Study type: Interventional

Funder types: Other

Identifiers

NCT06408987

hip arthroscopy in DDH

Details and patient eligibility

About

To determine the role of arthroscopy in treatment of the DDH.

Full 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.

Enrollment: 32 estimated patients

Sex: All

Ages: 9 to 18 months old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

• 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

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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32 participants in 2 patient groups

1 .Arthroscopically assisted

Active Comparator group

Description:

Arthroscopically assisted in surgical reduction of the hip in patients with irreducible DDH before the walking age arm 1

Treatment:

Procedure: arthroscopically assisted

2.open surgical reduction arm 2

Active Comparator group

Description:

open surgical reduction of the hip in patients with irreducible DDH before the walking age arm 2

Treatment:

Procedure: open surgical reduction