Current evidence on the safety and efficacy of combined bony and soft tissue reconstruction for hip joint stabilisation in proximal focal femoral deficiency (PFFD) is inadequate in quantity, quality and consistency. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
Clinicians wishing to undertake combined bony and soft tissue reconstruction for hip joint stabilisation in PFFD should take the following actions.
Inform the clinical governance leads in their Trusts.
Ensure that parents or carers understand the uncertainty about the procedure's safety and efficacy. They should understand that multiple procedures may be needed and that the procedure may not result in a fully functioning limb. Parents or carers should be provided with clear written information. In addition, the use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having combined bony and soft tissue reconstruction for hip joint stabilisation in PFFD (see section 3.1).
The procedure should only be carried out in units that specialise in limb reconstruction, by surgeons with specialist knowledge of neonatal hip dysplasias and expertise in limb lengthening procedures.