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RecruitingNCT03107520Updated Apr 15, 2026

Intraoperative Contrast-Enhanced Ultrasound Evaluation of Blood Flow at the Time of Surgical Hip Reduction for DDH

An Early Phase 1 interventional study of Intraoperative contrast-enhanced ultrasound (CEUS) and Lumason in Developmental Dysplasia of the Hip, sponsored by Children's Hospital of Philadelphia. Recruiting at 1 site in United States. Open to participants aged 4 Months to 24 Months. Per ClinicalTrials.gov, last updated 2026-04-15.

Sponsored by Children's Hospital of Philadelphia · Early Phase 1, Interventional, and Diagnostic

Phase
Early Phase 1
Study type
Interventional
Enrollment
125
Allocation
Not applicable
Ages
4 Months to 24 Months
Sex
All
01

Study summary

This study evaluates the feasibility and utility of contrast-enhanced ultrasound to provide real-time assessment of blood flow to the femoral head in infants undergoing surgical reduction for developmental dysplasia of the hip.

Read the detailed description

For children presenting with late-diagnosed developmental dysplasia of the hip, a closed or open hip reduction followed by hip spica casting may be indicated if conservative treatment fails. Although closed or open reduction and casting is largely successful for relocating a hip, iatrogenic avascular necrosis remains a major source of morbidity as a result of the surgical procedure.

Although recent evidence has demonstrated that postoperative gadolinium-enhanced magnetic resonance (MR) studies may be useful in assessing perfusion of the hip after surgery, these studies are not performed until after the cast is placed and they do not elucidate the specific intraoperative steps that increase risk for osteonecrosis. Contrast-enhanced ultrasound (CEUS) may be a reliable and effective alternative.

02

Conditions studied

  • Developmental Dysplasia of the Hip

Keywords

  • contrast-enhanced ultrasound
  • Lumason
  • developmental dysplasia of the hip (DDH)
  • avascular necrosis
03

Who can participate

Ages eligible
4 Months to 24 Months
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Males or females between 4 months and up to and including 24 months of age at the time of surgery.
  • Diagnosed with DDH.
  • Failed conservative treatment, or present with late-diagnosed DDH (where conservative treatment would not be appropriate to initiate at their age), and are undergoing closed or open reduction and spica casting.
  • Informed consent (parental permission)

Exclusion criteria

Exclusion Criteria:

  • > 24 months of age at the time of surgery.
  • Subjects with DDH who are successfully treated with conservative measures and do not require surgical reduction.
  • Previous open hip reduction of the affected side
  • Children with known complex congenital heart disease or unstable cardiopulmonary conditions (as noted in the package labeling for Lumason) including acute myocardial infarction, acute coronary artery syndromes, worsening or unstable congestive heart failure or serious ventricular arrhythmias will be excluded.
  • History of allergic reaction to Lumason, sulfur hexafluoride, sulfur hexafluoride lipid microsphere components, or other ingredients in Lumason (polyethylene glycol, distearoylphosphatidylcholine (DSPC), dipalmitoylphosphatidylglycerol sodium (DPPG-Ns), palmitic acid).Parental/guardian permission (informed consent) and if appropriate, child assent.
04

Study design

Phase
Early Phase 1
Primary purpose
Diagnostic
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
125 participants (estimated)

Study arms

  • Experimental
    DDH Surgical Reduction Patients

    Infants treated for DDH who failed conservative measures and are undergoing intraoperative open or closed hip reduction. Intraoperative contrast-enhanced ultrasound using Lumason contrast agent will be administered to improve visualization of the epiphyseal vascularity after hip reduction and during placement of the spica cast.

    Diagnostic Test: Intraoperative contrast-enhanced ultrasound (CEUS) · Drug: Lumason

Interventions

  • Diagnostic testIntraoperative contrast-enhanced ultrasound (CEUS)

    An intraoperative CEUS of the dysplastic femoral head will be performed after surgical reduction of the femoral head and during placement of the spica cast.

  • DrugLumason

    Administration of Lumason contrast agent to improve visualization of epiphyseal vascularity in the femoral head.

05

What researchers measure

Primary outcomes

  1. Visualization of epiphyseal vascularity in the femoral head

    The visualization of epiphyseal vascularity on the sonogram from intraoperative CEUS will be assessed by a trained sonographer and musculoskeletal radiologist administering the CEUS and reviewing the images.

    Time frame: 1 day

Secondary outcomes

  1. Comparison of CEUS and Post-Operative Imaging

    The images obtained via intraoperative CEUS will be compared to standard-of-care postoperative perfusion MR imaging and 1-year follow-up radiographs.

    Time frame: Approximately 3 years

  2. Estimate and predict the likelihood of developing avascular necrosis

    To estimate the relationship and predict the likelihood of developing avascular necrosis (outcome variable) and CEUS performance (explanatory variable) as measured by CEUS score

    Time frame: Approximately 3 years

06

Study locations

1 of 1 sites recruiting
  • The Children's Hospital of Philadelphia
    Philadelphia, Pennsylvania 19014, United States
    Recruiting
07

References and documents

Publications

  • Darge K, Papadopoulou F, Ntoulia A, Bulas DI, Coley BD, Fordham LA, Paltiel HJ, McCarville B, Volberg FM, Cosgrove DO, Goldberg BB, Wilson SR, Feinstein SB. Safety of contrast-enhanced ultrasound in children for non-cardiac applications: a review by the Society for Pediatric Radiology (SPR) and the International Contrast Ultrasound Society (ICUS). Pediatr Radiol. 2013 Sep;43(9):1063-73. doi: 10.1007/s00247-013-2746-6. Epub 2013 Jul 11. PubMed 23843130 ↗
  • Rosenbaum DG, Servaes S, Bogner EA, Jaramillo D, Mintz DN. MR Imaging in Postreduction Assessment of Developmental Dysplasia of the Hip: Goals and Obstacles. Radiographics. 2016 May-Jun;36(3):840-54. doi: 10.1148/rg.2016150159. Epub 2016 Apr 1. PubMed 27035836 ↗
  • Tiderius C, Jaramillo D, Connolly S, Griffey M, Rodriguez DP, Kasser JR, Millis MB, Zurakowski D, Kim YJ. Post-closed reduction perfusion magnetic resonance imaging as a predictor of avascular necrosis in developmental hip dysplasia: a preliminary report. J Pediatr Orthop. 2009 Jan-Feb;29(1):14-20. doi: 10.1097/BPO.0b013e3181926c40. PubMed 19098638 ↗
  • Gornitzky AL, Georgiadis AG, Seeley MA, Horn BD, Sankar WN. Does Perfusion MRI After Closed Reduction of Developmental Dysplasia of the Hip Reduce the Incidence of Avascular Necrosis? Clin Orthop Relat Res. 2016 May;474(5):1153-65. doi: 10.1007/s11999-015-4387-6. PubMed 26092677 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03107520
Lead sponsor
Children's Hospital of Philadelphia
Collaborators
Bracco Diagnostics, Inc, Pediatric Orthopaedic Society of North America
Responsible party
Sponsor
First posted
Apr 11, 2017
Start date
May 22, 2017
Primary completion
Apr 2027 (estimated)
Completion
Apr 2030 (estimated)
Last update
Apr 15, 2026

Study contacts

Wudbhav N Sankar, MD
Contact
sankarw@chop.edu
215-590-1527
Susan Back, MD
Contact
backs@chop.edu
215-590-7000
Wudbhav N Sankar, MD
principal investigator · Children's Hospital of Philadelphia
Susan Back, MD
principal investigator · Children's Hospital of Philadelphia

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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