Intraoperative Contrast-Enhanced Ultrasound Evaluation of Blood Flow After Surgical Hip Reduction for DDH

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.

Inclusion Criteria:

- Males or females < 24 months of age at the time of surgery

- Diagnosed with developmental dysplasia of the hip

- Failed conservative treatment and will undergo closed or open reduction and spica
casting

- Informed consent

Exclusion Criteria:

- 24 months of age or older at the time of surgery

- Subjects with DDH who are successfully treated with conservative measures and do not
require surgery

- Known heart or pulmonary condition

- History of hypersensitivity reactions to sulfur hexafluoride lipid microsphere
components