Developmental Dysplasia of the Hip
Conditions
Brief summary
Developmental Dysplasia of the Hip (DDH) is a common diagnosis in children that if untreated may lead to degeneration and arthritis of the hip joint at a young age. Ultrasound imaging is used to monitor progress of the developing hip joint during treatment. Initial data from our practice suggests that interim ultrasounds do not alter the course or outcome of treatment. Additionally, these ultrasounds add significant time to clinic visits and carry a substantial cost to the health care system. The goal of this study is to determine if limiting the number of ultrasounds during treatment results in the same outcomes while also evaluating the amount of time and money saved by omitting the ultrasounds.
Interventions
OTHERLimited Ultrasound Imaging
Ultrasound imaging will not be performed at the 2, 5 and 8 week clinic visits
OTHERStandard Ultrasound Imaging
Ultrasound imaging will be performed at all clinic visits
Sponsors
The Hospital for Sick Children
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
No minimum to 6 Months
Healthy volunteers
No
Inclusion criteria
* Aged 0-6 months at time of diagnosis * Clinical and Ultrasound diagnosis of stable developmental dysplasia of the hip * Children with dislocated/ unstable DDH will be included once the hip becomes stable * Treated with Pavlik harness * Assessed and treated at the SickKids Baby Hip Clinic
Exclusion criteria
* Underlying neuromuscular disease * Teratologic hip dysplasia * Prior treatment at other institutions * Non-compliance with treatment protocol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Acetabular Index | When patient reaches 1 year of age | Acetabular Index will be measured on a supine anteroposterior (AP) radiograph of the pelvis |
| International Hip Dysplasia Institute Score | When patient reaches 1 year of age | The International Hip Dysplasia Institute (IHDI) grade will be measured from a radiograph of the pelvis. The score classifies hips into one of four groups based on the position of the proximal femoral metaphysis in relation to the acetabulum. The scores grade severity from Grade 1 as the mildest type to Grade 4 as the most severe type of hip dislocation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Complication Rate | Through study completion, an average of two years | The frequency of complications between the treatment groups will be compared |
| Health Care Costs | Through study completion, an average of two years | The difference in cost between the two treatment arms will be the cost of 3 diagnostic ultrasounds |
| Hospital Appointment Duration | Through study completion, an average of two years | Calculating time between registering at Ultrasound and registering at the Orthopaedic clinic will provide a measurement of time savings in the limited ultrasound protocol group |
Countries
Canada
Outcome results
None listed