Computer-Assisted Comparison of Hip Socket Volume and Surface Shape After Pediatric Acetabular Osteotomies

NCT07581717 | Recruiting

• 1 other identifier: 2025/1914
• Study Type: observational
• Target: 12
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this observational study is to learn how four acetabular osteotomy techniques change the shape of the hip socket in children and adolescents with developmental dysplasia of the hip or residual acetabular dysplasia. The main questions it aims to answer are: How do virtual Salter, Dega, San Diego, and Pemberton osteotomies differ in acetabular volume and surface shape on participant-specific three-dimensional models? How closely does the virtual result of the osteotomy actually performed match the early postoperative magnetic resonance imaging (MRI)? Participants will have a three-dimensional pelvis-acetabulum model created from preoperative MRI. Researchers will perform virtual Salter, Dega, San Diego, and Pemberton osteotomies on that model and measure the resulting acetabular morphology. The virtual result of the osteotomy actually performed will then be compared with the participant's early postoperative MRI.

Conditions

Developmental Dysplasia of the Hip (DDH); Developmental Dysplasia of the Hip; Acetabular Dysplasia

Keywords

Salter osteotomy; Dega osteotomy; San Diego osteotomy; Pemberton osteotomy; Developmental dysplasia of the hip; Acetabular dysplasia; Magnetic resonance imaging; Three dimensional modeling; Acetabular morphometry; Methodological validation

Outcome Measures

Primary Outcomes (2)

• Osteotomy-type differences in simulated acetabular morphometry

  Comparison across virtual Salter, Dega, San Diego, and Pemberton osteotomies of predefined morphometric outputs on participant-specific preoperative 3-dimensional models, including acetabular volume (mm3), surface area (mm2), and angular parameters such as version and inclination (degrees).

  Baseline (preoperative MRI-based virtual simulation, within 6 weeks before surgery)

• Virtual-to-actual agreement of postoperative acetabular morphometry for the clinically performed osteotomy

  Agreement between the matched virtual osteotomy and the actual postoperative morphology, assessed using predefined morphometric outputs including acetabular volume (mm3), surface area (mm2), and angular parameters such as version and inclination (degrees); summarized using absolute difference, bias, and Bland-Altman limits of agreement.

  Baseline and early postoperative MRI (3 to 8 weeks after surgery)

Secondary Outcomes (5)

• Osteotomy-type differences in virtual-to-actual prediction error

  Baseline and early postoperative MRI (3 to 8 weeks after surgery)

• Interobserver reliability of MRI-based segmentation and morphometric measurements

  Baseline and early postoperative MRI (3 to 8 weeks after surgery)

• Intraobserver reliability of MRI-based segmentation and morphometric measurements

  Baseline and early postoperative MRI (3 to 8 weeks after surgery)

• Workflow processing time

  From baseline MRI acquisition to completion of early postoperative MRI analysis, up to 14 weeks

• Workflow completion rate

  From baseline MRI acquisition to completion of early postoperative MRI analysis, up to 14 weeks

Study Arms (4)

Salter Osteotomy Cohort

Participants with DDH or residual acetabular dysplasia undergoing primary Salter acetabular osteotomy as part of routine clinical care, with preoperative MRI-based 3D modeling and early postoperative MRI comparison.

Procedure: Salter osteotomy

Dega Osteotomy Cohort

Participants with DDH or residual acetabular dysplasia undergoing primary Dega acetabular osteotomy as part of routine clinical care, with preoperative MRI-based 3D modeling and early postoperative MRI comparison.

Procedure: Dega osteotomy

San Diego Osteotomy Cohort

Participants with DDH or residual acetabular dysplasia undergoing primary San Diego acetabular osteotomy as part of routine clinical care, with preoperative MRI-based 3D modeling and early postoperative MRI comparison.

Procedure: San Diego osteotomy

Pemberton Osteotomy Cohort

Participants with DDH or residual acetabular dysplasia undergoing primary Pemberton acetabular osteotomy as part of routine clinical care, with preoperative MRI-based 3D modeling and early postoperative MRI comparison.

Procedure: Pemberton osteotomy

Interventions

Salter osteotomy PROCEDURE

Redirectional innominate osteotomy performed to improve acetabular orientation and femoral head coverage in children and adolescents with developmental dysplasia of the hip or residual acetabular dysplasia. The acetabulum is reoriented as a single fragment to increase primarily anterolateral coverage. The procedure is performed as routine clinical care, with technique selection based on the treating surgeon's indication and preoperative deformity pattern.

Also known as: Salter innominate osteotomy

Salter Osteotomy Cohort

Dega osteotomy PROCEDURE

Incomplete transiliac acetabuloplasty performed to reshape the acetabular roof and improve femoral head coverage in children and adolescents with developmental dysplasia of the hip or residual acetabular dysplasia. The osteotomy preserves a hinge at the triradiate cartilage, allowing tailored correction of acetabular deficiency according to the morphology of the dysplastic socket. The procedure is performed as routine clinical care, with technique selection based on the treating surgeon's indication and preoperative deformity pattern.

Also known as: Dega acetabuloplasty

Dega Osteotomy Cohort

Pemberton osteotomy PROCEDURE

Pericapsular acetabuloplasty performed to reshape and redirect the acetabulum in children and adolescents with developmental dysplasia of the hip or residual acetabular dysplasia. The osteotomy uses the triradiate cartilage as a hinge and increases femoral head coverage by altering acetabular shape and orientation. The procedure is performed as routine clinical care, with technique selection based on the treating surgeon's indication and preoperative deformity pattern.

Also known as: Pemberton pericapsular osteotomy

Pemberton Osteotomy Cohort

San Diego osteotomy PROCEDURE

Incomplete transiliac acetabuloplasty performed to improve acetabular coverage in children and adolescents with developmental dysplasia of the hip or residual acetabular dysplasia. The procedure preserves a triradiate cartilage hinge and allows directional correction according to the location of acetabular deficiency, including posterolateral or lateral deficiency when appropriate. The procedure is performed as routine clinical care, with technique selection based on the treating surgeon's indication and preoperative deformity pattern.

Also known as: San Diego acetabuloplasty

San Diego Osteotomy Cohort

Eligibility Criteria

• Age: 2 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Children and adolescents with developmental dysplasia of the hip or residual acetabular dysplasia who are scheduled for primary Salter, Dega, San Diego, or Pemberton acetabular osteotomy at Istanbul University, Istanbul Faculty of Medicine

You may qualify if:

• Age 2 to 18 years
• Developmental dysplasia of the hip or residual acetabular dysplasia
• Primary Salter, Dega, San Diego, or Pemberton acetabular osteotomy planned at Istanbul University, Istanbul Faculty of Medicine
• Preoperative hip MRI available within 6 weeks before surgery
• Early postoperative hip MRI available 3 to 8 weeks after surgery
• MRI quality adequate for three-dimensional morphometric analysis
• Unilateral or bilateral cases eligible

You may not qualify if:

• Hip pathology not related to developmental dysplasia of the hip, including Perthes disease, slipped capital femoral epiphysis, neuromuscular dysplasia, or infection/trauma sequelae
• Previous surgery on the same hip that significantly alters anatomy, including prior pelvic or femoral osteotomy or open reduction, or current metal implant/fusion
• MRI contraindication or safety issue, including MR-incompatible implant/device, severe claustrophobia, or a medical barrier to sedation/anesthesia
• MRI not compatible with protocol or inadequate for analysis

Sponsors & Collaborators

• Istanbul University: lead

Study Sites (1)

Istanbul University, Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology

Istanbul, 34093, Turkey (Türkiye)

RECRUITING

Related Publications (7)

• du Cluzel de Remaurin X, Khouri N, Georges S, Gajny L, Vergari C, Badina A. Methods for three-dimensional characterization of the acetabulum prior to pelvic reorientation osteotomy: a scoping review. EFORT Open Rev. 2024 Aug 1;9(8):762-772. doi: 10.1530/EOR-22-0126.

  PMID: 39087510 BACKGROUND

• Badrinath R, Jeffords ME, Bomar JD, Ahmed SI, Pennock AT, Upasani VV. 3D Characterization of Acetabular Deficiency in Children with Developmental Dysplasia of the Hip. Indian J Orthop. 2021 Jul 23;55(6):1576-1582. doi: 10.1007/s43465-021-00458-7. eCollection 2020 Dec.

  PMID: 34987728 BACKGROUND

• van Bosse H, Wedge JH, Babyn P. How are dysplastic hips different? A three-dimensional CT study. Clin Orthop Relat Res. 2015 May;473(5):1712-23. doi: 10.1007/s11999-014-4103-y. Epub 2014 Dec 19.

  PMID: 25524428 BACKGROUND

• Caffrey JP, Jeffords ME, Farnsworth CL, Bomar JD, Upasani VV. Comparison of 3 Pediatric Pelvic Osteotomies for Acetabular Dysplasia Using Patient-specific 3D-printed Models. J Pediatr Orthop. 2019 Mar;39(3):e159-e164. doi: 10.1097/BPO.0000000000001271.

  PMID: 30300278 BACKGROUND

• Zeng G, Schmaranzer F, Degonda C, Gerber N, Gerber K, Tannast M, Burger J, Siebenrock KA, Zheng G, Lerch TD. MRI-based 3D models of the hip joint enables radiation-free computer-assisted planning of periacetabular osteotomy for treatment of hip dysplasia using deep learning for automatic segmentation. Eur J Radiol Open. 2020 Dec 18;8:100303. doi: 10.1016/j.ejro.2020.100303. eCollection 2021.

  PMID: 33364259 BACKGROUND

• Nakamura T, Wada A, Natori T, Kawaguchi K, Takamura K, Yanagida H, Yamaguchi T. A Novel Method for Assessing the 3-dimensional Morphology of Cartilaginous Acetabulum Via Childhood Magnetic Resonance Imaging. J Pediatr Orthop. 2023 Nov-Dec 01;43(10):640-648. doi: 10.1097/BPO.0000000000002510. Epub 2023 Sep 8.

  PMID: 37681305 BACKGROUND

• Bellova P, Blum S, Hartmann A, Thielemann F, Gunther KP, Goronzy J. MRI-based assessment of acetabular version and coverage after previous Pemberton osteotomy in skeletally mature patients. J Child Orthop. 2021 Jun 1;15(3):223-231. doi: 10.1302/1863-2548.15.210010.

  PMID: 34211598 BACKGROUND

MeSH Terms

Conditions

Developmental Dysplasia of the Hip; Hip Dislocation

Condition Hierarchy (Ancestors)

Joint Dislocations; Joint Diseases; Musculoskeletal Diseases; Musculoskeletal Abnormalities; Congenital Abnormalities; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Wounds and Injuries; Hip Injuries

Study Officials

• Yavuz Sağlam, M.D.

  Istanbul University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Yavuz Sağlam, M.D.

CONTACT

+90 536 320 5005; yavuzsaglam84@istanbul.edu.tr

İsmail T. Atasoy, M.D.

CONTACT

+90 534 632 0870; tarik.atasoy@istanbul.edu.tr

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Orthopedics and Traumatology

Study Record Dates

• First Submitted: March 28, 2026
• First Posted: May 12, 2026
• Study Start: May 10, 2026
• Primary Completion (Estimated): September 30, 2026
• Study Completion (Estimated): October 15, 2026
• Last Updated: June 26, 2026

Record last verified: 2026-06

Locations

TU (1)