Analysis of the Biomechanical Impact of Lower Limb Length Inequality in PEDiatrics

NCT07254351 | Recruiting

• 2 other identifiers: 69HCL25_07462025-A01923-46
• Study Type: observational
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

Lower limb length discrepancy (LLD) is a frequent condition in pediatric orthopedics. Even moderate discrepancies can induce pelvic obliquity and compensatory scoliosis, modifying the distribution of joint loads at the hips and lumbar spine. These biomechanical imbalances are suspected to contribute to early degenerative conditions such as osteoarthritis or chronic low back pain. The aim of this study is to quantify the biomechanical impact of LLD in children aged 10 to 15 years, using a combination of low dose biplanar EOS imaging (EOS Imaging System) and synchronized ground reaction force (GRF) measurements from integrated force platforms. These data will be used in musculoskeletal models developed in collaboration with the Biomechanics and Impact Mechanics Laboratory (LBMC, Laboratoire de Biomécanique et Mécanique des Chocs), enabling the estimation of hip joint and lumbar intervertebral disc loads. This is the first pediatric study integrating EOS imaging, force platforms, and personalized musculoskeletal modeling to explore the mechanical consequences of LLD. The findings are expected to improve clinical reasoning and guide early therapeutic strategies.

Conditions

Lower Limb Length Discrepancy (LLD) in Children

Keywords

EOS imaging; Biomechanics; Lower limb length discrepancy (LLD); Pediatric orthopedics; Force platform; limb length

Outcome Measures

Primary Outcomes (1)

• Asymmetry of Hip Joint Contact Forces (%) in Static Standing

  Hip joint contact force asymmetry index (%): calculated as AI (%) = 100 × (F\_long - F\_short) / \[(F\_long + F\_short)/2\], where F\_long and F\_short are side-specific resultant hip joint contact forces (estimated by musculoskeletal modeling from EOS imaging and ground reaction force data). Units: percent (%).Higher values indicate greater asymmetry.

  At baseline (Day 0, without compensation)

Study Arms (1)

Children with lower limb length discrepancy (LLD)

Pediatric patients aged 10-15 years with an anatomical LLD \> 5 mm, evaluated in the routine pediatric orthopedic care pathway.

Radiation: EOS Imaging System; Device: Force Platform (Bertec®, integrated into EOS cabin)

Interventions

EOS Imaging System RADIATION

Low-dose biplanar radiographs of the whole body in standing position (EOS Imaging System). At baseline, two EOS acquisitions will be performed in static standing position : one without compensation (natural position) and one with temporary orthopedic compensation (shoe lift under the shorter limb). At 24 months, one EOS acquisition will be performed without compensation. Each acquisition lasts a few seconds, with radiation exposure 5 to 10 times lower than conventional radiographs.

Children with lower limb length discrepancy (LLD)

Force Platform (Bertec®, integrated into EOS cabin) DEVICE

Ground reaction force (GRF) measurements obtained from a force platform integrated in the EOS cabin. The platform records weight distribution and center of pressure during static standing posture. Measurements are fully synchronized with EOS acquisitions, without additional time or discomfort for participants. At baseline, GRF measurements will be collected in two conditions (with and without orthopedic compensation). At 24 months, GRF measurements will be collected in the non-compensated condition.

Children with lower limb length discrepancy (LLD)

Eligibility Criteria

• Age: 10 Years - 15 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)
• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of approximately 100 pediatric patients (aged 10 to 15 years) presenting with an anatomical lower limb length discrepancy (LLD) greater than 5 mm, confirmed by clinical evaluation. Participants will be recruited consecutively during routine outpatient visits at the Pediatric Orthopedics Department of Hôpital Femme-Mère-Enfant (HFME), Hospices Civils de Lyon, Bron, France. This hospital is a tertiary referral center in pediatric orthopedics, receiving children from the Rhône-Alpes region and beyond. All included patients will undergo EOS imaging as part of their standard clinical assessment for LLD, ensuring that the study is fully integrated within the regular care pathway. The cohort therefore represents a specialized clinical sample of children with LLD, rather than a general population or community-based sample.

You may qualify if:

• Children aged 10-15 years
• Anatomical LLD \> 5 mm, clinically measured
• EOS imaging indicated by the pediatric orthopedic surgeon in routine care
• Ability to stand still for 30 seconds without assistance
• Covered by social security
• Parental consent and non-opposition obtained

You may not qualify if:

• \- Functional or postural LLD without true anatomical discrepancy
• History of major pelvic or spinal surgery
• Severe neurological or orthopedic condition preventing standing (e.g. cerebral palsy, progressive myopathy)
• Fixed equinus deformity preventing plantar support
• Major lower limb deformity (severe genu varum/valgum)
• Contraindication or inability to undergo EOS imaging

Sponsors & Collaborators

• Hospices Civils de Lyon: lead

Study Sites (1)

Hospices Civils de Lyon Service d'Orthopédie et de Traumatologie

Bron, 69500, France

RECRUITING

MeSH Terms

Conditions

Leg Length Inequality

Condition Hierarchy (Ancestors)

Bone Diseases, Developmental; Bone Diseases; Musculoskeletal Diseases; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms

Study Officials

• Thierry HAUMONT, MD

  Hospices Civils de Lyon

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Thierry HAUMONT, MD, PhD

CONTACT

4 27 85 57 88; thierry.haumont@chu-lyon.fr

Dimitri HERRERA-NATIVI

CONTACT

dimitri.herrera-nativi01@chu-lyon.fr

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 19, 2025
• First Posted: November 28, 2025
• Study Start: April 7, 2026
• Primary Completion (Estimated): June 7, 2029
• Study Completion (Estimated): June 7, 2029
• Last Updated: April 17, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)