Early Treatment of Developmental Trochlear Dysplasia With Modified Pavlik Harness: A Proof-of-Concept Pilot Study
- 25 May 2026
- journal article
- Published by Wolters Kluwer Health in Journal of Pediatric Orthopaedics
Abstract
Background: This pilot study assessed whether a modified Pavlik harness (mPH) could safely and feasibly influence trochlear morphology in newborns with developmental trochlear dysplasia (DTD). Methods: Seven consecutive newborns (14 knees) with breech presentation and ultrasound-confirmed DTD (sulcus angle ≥150 degrees) were prospectively enrolled in this proof-of-concept study. Bilateral knee ultrasound measured sulcus angle before and after 8-week continuous mPH treatment. Pre- and post-treatment measurements were compared using paired t tests, with P P =0.001) when combining bilateral measurements. Six of 7 newborns with DTD (85.70%) showed improvements ≥4 degrees. All newborns demonstrated high compliance with mPH, with no complications or adverse events reported. Conclusion: This preliminary study clearly demonstrates that early mPH treatment can safely influence trochlear morphology in newborns with DTD. These encouraging anatomic changes establish a strong foundation; however, this proof-of-concept study must be validated in larger, controlled trials with long-term follow-up to determine the clinical significance and facilitate its potential integration into screening protocols. Level of Evidence: Level IV—therapeutic case series.Keywords
This publication has 29 references indexed in Scilit:
- Risk factors of developmental dysplasia of the hip in infants: A meta-analysis based on cohort studiesOrthopaedics & Traumatology: Surgery & Research, 2024
- Trochlear Dysplasia as Shown by Increased Sulcus Angle Is Associated With Osteochondral Damage in Patients With Patellar InstabilityArthroscopy, 2021
- Medial Patellofemoral Reconstruction Using Quadriceps Tendon Autograft, Tibial Tubercle Osteotomy, and Sulcus‐Deepening Trochleoplasty for Patellar InstabilityArthroscopy Techniques, 2021
- Trochleoplasty techniques provide good clinical results in patients with trochlear dysplasiaKnee Surgery, Sports Traumatology, Arthroscopy, 2017
- Success of Pavlik Harness Treatment Decreases in Patients ≥ 4 Months and in Ultrasonographically Dislocated Hips in Developmental Dysplasia of the HipClinical Orthopaedics and Related Research, 2016
- Imaging of Individual Anatomical Risk Factors for Patellar InstabilitySeminars in Musculoskeletal Radiology, 2016
- Can 3D ultrasound identify trochlea dysplasia in newborns? Evaluation and applicability of a techniqueEuropean Journal of Radiology, 2015
- Evaluation of trochlear dysplasia using MRI: correlation between the classification system of Dejour and objective parameters of trochlear dysplasiaKnee Surgery, Sports Traumatology, Arthroscopy, 2012
- CT changes after trochleoplasty for symptomatic trochlear dysplasiaKnee Surgery, Sports Traumatology, Arthroscopy, 2006
- Factors of patellar instability: An anatomic radiographic studyKnee Surgery, Sports Traumatology, Arthroscopy, 1994