Hip Arthroscopy Versus Conservative Treatment for Borderline Hip Dysplasia

ConditionDevelopmental Dysplasia of the Hip

Trial statusNot yet recruiting

Trial phaseNot applicable

Trial typeInterventional

Biological sexAll

Age18-42

SponsorChunBao Li

About this trial

The goal of this clinical trial is to compare the efficacy of hip arthroscopy versus individualized conservative treatment in patients with borderline developmental dysplasia of the hip (BDDH), defined by a lateral center-edge angle (LCEA) of 18-25°. The main question it aims to answer is: which treatment approach, surgical or conservative, provides superior pain relief, functional recovery, and quality of life improvement at 12 and 24 months post randomization? Participants will be randomly assigned (1:1) to either standardized hip arthroscopy, comprising capsular management, acetabular rim limited trimming, labral repair, and Cam deformity correction when indicated; or a 3-month individualized conservative protocol including patient education, nonsteroidal anti-inflammatory drugs (NSAIDs) for 2-4 weeks, chondroprotective supplementation for 8 weeks, and supervised progressive exercise training. All participants will undergo follow-up assessments at baseline, 12, and 24 months. The primary outcome is the modified Harris Hip Score (mHHS). Secondary outcomes include patient-reported outcome measures (VAS pain, iHOT-12, SF-12, and patient satisfaction), clinical assessments, and safety monitoring.

Eligibility criteria

Qualifiers

Age 18-42 years (studies have reported age ≥42 years as a risk factor for hip arthroscopy in BDDH: HR=11.6, 95% CI: 2.5-53.9), either sex;

Symptoms (anterior-lateral groin, lateral, or posterolateral hip pain or discomfort), physical examination findings (limp, clicking, locking, and limited range of motion), and imaging findings consistent with BDDH diagnosis (standing anteroposterior pelvic radiograph with Wiberg lateral center-edge angle [LCEA] 18-25°);

Surgeon's assessment that the patient with BDDH will benefit from hip arthroscopy or conservative treatment;

Full understanding of trial benefits and risks, willingness to participate in the intervention and complete follow-up, and signed informed consent.

Disqualifiers

Standing anteroposterior pelvic radiograph showing Tönnis grade ≥2 and/or joint space <2 mm;

Standing anteroposterior pelvic radiograph showing FEAR index >5°;

Positive physical examination for joint instability: anterior apprehension test (HEER test), abduction-extension-external rotation test in lateral decubitus position (AB-HEER test), or prone external rotation test;

History of high-energy hip trauma, previous ipsilateral or contralateral hip surgery, avascular necrosis of the femoral head, slipped capital femoral epiphysis, Perthes disease, severe osteoporosis, tumor, acetabular stress fracture, or hypertrophic or inflammatory hip disease;

Trial design

Treatments tested in this trial

Hip arthroscopy
Individualized conservative treatment

Treatment groups

248 Participants

are divided into 2 treatment groups

Locations

This trial has no locations

Sponsors and collaborators

ChunBao Li

Lead sponsor

Chinese PLA General Hospital

Sponsor institution

Source ClinicalTrials.gov