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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02040714
Registration number
NCT02040714
Ethics application status
Date submitted
2/01/2014
Date registered
20/01/2014
Titles & IDs
Public title
Multicenter Prospective Cohort Study on Current Treatments of Legg-Calvé-Perthes Disease
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Scientific title
Multicenter Prospective Cohort Study on Current Treatments of Legg-Calvé-Perthes Disease
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Secondary ID [1]
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IPSG 001
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Universal Trial Number (UTN)
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Trial acronym
IPSG1
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Legg Calve Perthes Disease
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Condition category
Condition code
Musculoskeletal
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Treatment: Surgery - Osteotomy + Long Term Non-Weight Bearing
Treatment: Surgery - Osteotomy + Short Term Non-Weight Bearing
Treatment: Surgery - Nonoperative Observation
Treatment: Surgery - Multiple Epiphyseal Drilling
Nonoperative management between ages 6-8 in early stage - The choice of non-osteotomy management without containment or surgical containment would be solely governed by the current practice of the participating surgeons (i.e. the current practice of the individual surgeon would be followed within the broad framework of the study).
Operative management between age 6-8 in early stage - Operative containment treatment (femoral or pelvic osteotomy or Shelf acetabuloplasty) rendered in the early stage of the disease process
Nonoperative management between age 8-11 in early stage - Patients who do not undergo some form of containment surgery because of medical, social, or other reasons will receive no surgical treatment.
Operative containment with short-term non-weightbearing in early stage - As per the current standard practice for patients between age 8-11 in developed countries, all patients will undergo some form of containment surgery (pelvic or femoral osteotomy) in order to better "contain" the femoral head underneath the acetabulum. Post-operative treatment will include 6 weeks of non-weight bearing on the operated leg.
Operative containment with prolonged non-weightbearing in early stage - As per the current standard practice for patients between age 8-11, all patients will undergo some form of containment surgery (pelvic or femoral osteotomy) in order to better "contain" the femoral head underneath the acetabulum. Post-operative treatment will include 6 months of non-weight bearing on the operated leg.
Operative containment for over 11 age group - Patients presenting over age 11 may receive multiple drilling and be non weight bearing for up to 6 months according to the treating physician's preference. Patients with application of fixator (arthrodiastasis) will be studied in this cohort arm as well, which typically involved 3-4 months followed by 8-12 weeks of non-weight bearing after fixator removal. Other surgical techniques may be included, however these are the most common for this age group.
Nonoperative management in over 11 age group - Patients will be non-weight bearing and receive physical therapy according to the physician preferences.
Nonoperative management in 1-6 age group - The choice of non-osteotomy management without containment or surgical containment would be solely governed by the current practice of the participating surgeons (i.e. the current practice of the individual surgeon would be followed within the broad framework of the study).
Operative management in 1-6 age group - The choice of osteotomy management with containment would be solely governed by the current practice of the participating surgeons (i.e. the current practice of the individual surgeon would be followed within the broad framework of the study).
Late Stage Bracing group - Patients presenting with \<= 20 degrees of abduction on a maximum abduction x-ray treated with bracing who also present in the late stages of the disease (Waldenstrom Stage IIb or IIIa).The choice of management with or without containment or surgical containment would be solely governed by the current practice of the participating surgeons (i.e. the current practice of the individual surgeon would be followed within the broad framework of the study).
Late Stage Symptomatic treatment group - Patients presenting in the late stages of the disease (defined as Waldenstrom stage IIb or IIIa) who are treated symptomatically. The choice of management with or without containment or surgical containment would be solely governed by the current practice of the participating surgeons (i.e. the current practice of the individual surgeon would be followed within the broad framework of the study).
Late Stage Surgical Containment group - Patients presenting in the late stages of the disease (defined as Waldenstrom stage IIb or IIIa) who are treated with surgical containment. The choice of management with or without containment or surgical containment would be solely governed by the current practice of the participating surgeons (i.e. the current practice of the individual surgeon would be followed within the broad framework of the study).
Treatment: Surgery: Osteotomy + Long Term Non-Weight Bearing
Surgical procedure that improves femoral head containment, plus a post-operative protocol that requires patient to maintain non-weight bearing for 6 months.
Treatment: Surgery: Osteotomy + Short Term Non-Weight Bearing
Surgical procedure that improves femoral head containment, plus a post-operative protocol that allows early return to function after 6 weeks of non-weight bearing.
Treatment: Surgery: Nonoperative Observation
Group will not undergo any surgical or invasive procedures during course of treatment.
Treatment: Surgery: Multiple Epiphyseal Drilling
Multiple epiphyseal drilling is a procedure that creates small holes in the femoral head growth plate to increase blood flow into the femoral head.
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Intervention code [1]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Sphericity deviation score of the femoral head
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Assessment method [1]
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The primary outcome for each age group will be a quantitative estimate of the sphericity of the femoral head as a measure of femoral head deformity. A more deformed head will be less spherical. Greater deformity leads to an increased risk of arthritis early in life.
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Timepoint [1]
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5 years post intervention
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Secondary outcome [1]
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Perfusion percentage
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Assessment method [1]
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The perfusion percentage is a measure of the amount of blood flow in the femoral head relative to the volume of the whole head. This measure is calculated from the perfusion MRI images that are collected just prior to the application of the intervention.
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Timepoint [1]
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Just after diagnosis of Perthes disease
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Eligibility
Key inclusion criteria
* Diagnosed with Legg-Calvé-Perthes disease
* Between age 1-18
* Patients with possible secondary femoral osteonecrosis if over the age of 11 due to trauma or corticosteroid therapy are also eligible.
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Minimum age
1
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Maximum age
18
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Patients with previous surgical treatment on the affected hip
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Study design
Purpose
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Duration
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Selection
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
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Recruiting
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Other reasons
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Date of first participant enrolment
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Actual
1/08/2012
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Date of last data collection
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1/09/2032
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Actual
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Sample size
Target
1500
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
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Women and Children's Hospital of Adelaide - Adelaide
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5006 - Adelaide
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Texas Scottish Rite Hospital for Children
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Alberta Children's Hospital
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Alfred I. duPont Hospital for Children
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Le Bonheur Children's Hospital
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Children's Hospital Colorado
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Children's Hospital Los Angeles
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Children's National Research Institute
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Children's Healthcare of Atlanta
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Children's Hospital of Philadelphia
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Children's Hospital Medical Center, Cincinnati
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Columbia University
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Connecticut Children's Medical Center
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Gillette Children's Specialty Healthcare
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Boston Children's Hospital
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Johns Hopkins University
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Kaiser Permanente
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Kasturba Medical College
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Montefiore Medical Center
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Nationwide Children's Hospital
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NYU Langone Health
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OrthoCarolina Research Institute, Inc.
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University of Sao Paulo General Hospital
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Seoul National University Childrens Hospital
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Shriners Hospitals for Children
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University Hospital Southampton NHS Foundation Trust
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Baylor College of Medicine
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Universitätsklinikum Hamburg-Eppendorf
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Ann & Robert H Lurie Children's Hospital of Chicago
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Children's of Alabama
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Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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University of Oklahoma
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Oregon Health and Science University
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Rady Children's Hospital, San Diego
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San Jorge Children's Hospital (Puerto Rico)
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University College Dublin
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Tianjin Children's Hospital
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University Hospital Schleswig-Holstein
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University of California, San Francisco
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University of Haifa
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Uppsala University
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Medical University of Lodz
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Oslo University Hospital
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Seattle Children's Hospital
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Mayo Clinic
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Ethics approval
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Summary
Brief summary
Legg-Calvé-Perthes disease is a childhood hip disorder which is common enough to be a significant public health problem (affects 1 in 740 boys between ages 0-14), but uncommon enough to have a sufficient number of patients from a single institution to perform a definitive prospective study comparing the results of current treatments. The present study will establish a database of prospectively identified patients with Legg-Calvé-Perthes (LCP) Disease and collect information regarding their presentation, treatment, and outcomes in the course of receiving currently available treatments. This study seeks to compare the outcomes of current treatments in the management of different age groups (ages 1-6, 6-8, 8-11, \>11) of patients with Perthes disease at two- and five-year followup and at skeletal maturity. For each age group, two to three common treatment regimens currently used by practicing pediatric orthopaedic surgeons will be compared. The intervention a patient receives is determined through physician treatment expertise, and is not pre-determined by the study.
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Trial website
https://clinicaltrials.gov/study/NCT02040714
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Trial related presentations / publications
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Contacts
Principal investigator
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Harry KW Kim, MD, MS
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Texas Scottish Rite Hospital for Children
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Patient enrolled in study will be deidentified (a specific ID will be assigned to participants) in each respective site, Each site will be in charge of entering their respective data in a main database. Data analysis of this collective data will be done mainly through the host site.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT02040714