Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Jun 15;10(1):9647.
doi: 10.1038/s41598-020-66634-1.

Abduction treatment in stable hip dysplasia does not alter the acetabular growth: results of a randomized clinical trial

V Pollet  1 , R M Castelein  2 , M van de Sande  3 , M Witbreuk  4 , A K Mostert  5 , A Besselaar  6 , C van Bergen  2 , E Beek  7 , C S P M Uiterwaal  8 , R J B Sakkers  2
Affiliations
Randomized Controlled Trial

Abduction treatment in stable hip dysplasia does not alter the acetabular growth: results of a randomized clinical trial

V Pollet et al. Sci Rep. .

Abstract

Background The effect of bracing over natural history of stable dysplastic hips is not well known. This multicenter randomized trial aimed at objectifying the effect of abduction treatment versus active surveillance in infants of 3 to 4 months of age. Methods Patients were randomized to either Pavlik harness or active surveillance group. Ultrasound was repeated at 6 and 12 weeks post randomization. The primary outcome was the degree of dysplasia using the Graf α-angle at 6 months of age. The measurement of the acetabular index (AI) on plain pelvis X-rays was used to identify persistent dysplasia after 9 months and walking age (after 18 months). Findings The Pavlik harness group (n = 55) and active surveillance group (n = 49) were comparable for predictors of outcome. At 12 weeks follow-up the mean α-angle was 60.5° ± 3.8° in the Pavlik harness group and 60.0° ± 5.6° in the active surveillance group. (p = 0.30). Analysis of secondary outcomes (standard of care) showed no treatment differences for acetabular index at age 10 months (p = 0.82) and walking age (p = 0.35). Interpretation Pavlik harness treatment of stable but sonographic dysplastic hips has no effect on acetabular development. Eighty percent of the patients will have a normal development of the hip after twelve weeks. Therefore, we recommend observation rather than treatment for stable dysplastic hips.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study flow diagram. *After randomization, 33 hips were excluded after parents refused the allocated treatment plan. The included 104 hips were assessed by Intention-To-Treat analysis.
See this image and copyright information in PMC

References

    1. Patel H. Preventive health care, 2001 update: screening and management of developmental dysplasia of the hip in newborns. CAMJ. 2011;164:1669–77. - PMC - PubMed
    1. Dezateux C, Rosendahl K. Developmental dysplasia of the hip. Lancet. 2007;369:1541–52. doi: 10.1016/S0140-6736(07)60710-7. - DOI - PubMed
    1. Tonnis D. Congenital dysplasia and dislocation of the hip in children and adults. Berlin, Springer- Verlag 1987.
    1. Graf R. The diagnosis of congenital hip-joint dislocation by ultrasonic Combound treatment. Arch Orthop Trauma Surg. 1980;97:117–33. doi: 10.1007/BF00450934. - DOI - PubMed
    1. Harcke HT. Hip ultrasonography in clinical practice. Pediatr Radiol. 2017;47:1155–59. doi: 10.1007/s00247-017-3879-9. - DOI - PubMed

Publication types