Intraarticular Corticosteroid Therapy in Perthes Disease.

Seattle Children's Healthcare System

Status: Terminated

Conditions: Legg-Calve Perthes Disease

Treatments: Drug: Aristospan 20mg

Study type: Interventional

Funder types: Other

Identifiers

NCT01026909

AEF-24812

Details and patient eligibility

About

Legg-Calve-Perthes disease (LCP) represents the loss of blood flow to the head of the femur, resulting in significant hip pain and potential long term disability. This study represents a single center, randomized, prospective, controlled study comparing the treatment of LCP with an intraarticular corticosteroid (triamcinolone hexacetonide) injection with traditional nonoperative treatment.

Full description

Legg-Calve-Perthes disease (LCP) represents the loss of blood flow to the head of the femur, resulting in significant hip pain and potential long term disability. The cause of LCP is still unknown, but tends to occur predominantly in boys from ages 4-12. For the majority of those affected, observation and symptomatic treatment with oral antiinflammatories, such as ibuprofen, is indicated. This study represents a single center, randomized, prospective, controlled study comparing the treatment of LCP with an intraarticular corticosteroid (triamcinolone hexacetonide) injection with traditional nonoperative treatment. The investigators will test for improved outcomes by measuring functional outcomes (PODCI and ASKp questionnaires, StepWatch activity monitor), hip range of motion and visual-analog pain scales. The investigators hypothesize that injections of corticosteroids (potent, injectable antiinflammatories) will result in improved overall function through decreased pain and increased hip range of motion in this patient population.Additional biological research will be performed. There is no human information on the inflammatory response that occurs in the hip joint of children with Perthes disease, and there are no true animal models of Perthes disease. To better understand the pathobiology of Perthes disease, the collection of joint fluid from both hips may provide insight into the treatment of a disease for which we currently have no explanation of cause, and consequently no therapies

Enrollment: 3 patients

Sex: All

Ages: 4 to 13 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• age of 4 to 12 years
• diagnosed with Idiopathic osteonecrosis of the femoral head
• symptoms less than 12 months old.

Exclusion criteria

• Symptoms for more than 12 months

• Previous treatment other than anti-inflammatories, crutches or bed rest

• Subjects more than 8 years old or have a hand bone age greater than 6 years old and lateral pillar B or B/C disease.

• Bilateral hip disease

• Personal or family history of problems with general anesthesia

• Prior steroid treatment

• Previous diagnosis of:

  • Asthma
  • Identifiable rheumatologic condition
  • Metabolic Diseases (including but not limited to Gaucher's disease or congenital hypothyroidism)
  • Sickle cell disease
  • Known pain syndrome
  • Hip sepsis
  • Prior malignancy (solid organ or bone marrow transplant)
  • Blood Clotting disorder

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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3 participants in 2 patient groups

Injection

Experimental group

Description:

Patients in this arm receive one single dose of Triamcinolone hexacetonide injectable suspension (Aristopan), USP, 20mg/mL Parenteral. They will aso be enrolled in physical therapy.

Treatment:

Drug: Aristospan 20mg

Control

No Intervention group

Description:

Patients will be enrolled in physical therapy