Key result
Staged weaning of the Pavlik harness compared to immediate cessation showed no statistically significant difference in the rates of reintervention, avascular necrosis, or acetabular index.
Why the study?
Does staged weaning of the Pavlik harness reduce reintervention or avascular necrosis compared to immediate cessation in children with developmental dysplasia of the hip?
Cohort (n=128)
Yes
Does staged weaning of the Pavlik harness reduce reintervention or avascular necrosis compared to immediate cessation in children with developmental dysplasia of the hip?
There is no significant difference in clinical outcomes between staged weaning and immediate cessation of Pavlik harness treatment for developmental dysplasia of the hip.
Answers are grounded in this paper and cite their sources.
Immediate cessation appears comparable to staged weaning; leaves open whether RCTs would confirm equivalence in DDH.
Outcomes of nonoperative treatment for developmental dysplasia of the hip were compared between two centres. Eighty children in Centre A underwent staged weaning of the Pavlik harness once three consecutive weekly ultrasounds showed Graf Grade I hips, whereas in 48 children in Centre B, the harness was removed immediately. No statistically significant difference was found in the rate of reintervention (repeat harness treatment, closed or open reduction), avascular necrosis or acetabular index between the two methods, although there was a nonsignificant trend towards higher reintervention rate and lower avascular necrosis rate with immediate harness removal. Age at start of treatment significantly impacted upon initial harness success, reinterventions and avascular necrosis.
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Westacott et al. (2013) conducted a cohort in Developmental dysplasia of the hip (n=128). Staged weaning of the Pavlik harness vs. Immediate cessation of the Pavlik harness was evaluated on Rate of reintervention, avascular necrosis, or acetabular index. Staged weaning of the Pavlik harness compared to immediate cessation showed no statistically significant difference in the rates of reintervention, avascular necrosis, or acetabular index.
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