Early Treatment of Developmental Trochlear Dysplasia With Modified Pavlik Harness: A Proof-of-Concept Pilot Study.

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<0.05 considered significant. RESULTS: Both knees demonstrated a statistically significant reduction in sulcus angle. Mean sulcus angle decreased from 152.36±2.39 to 146.43±2.20 degrees (MD: 5.93 degrees, 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.