None listed
Conditions
Brief summary
Hip replacement is a commonly performed procedure for the treatment of arthritic conditions of the hip joint and since 2003 the number of hip replacement procedures has significantly increased by 46.5% in Australia. The procedure is intended to relieve pain, restore function to the hip joint and ensure maximal longevity of the implant. Different surgical approaches to hip replacement have been developed over many years with various levels of clinical support. However, anteriorly-based surgical approaches, which open the joint capsule from the front of the joint, have been increasingly used in recent times. The main aim of this study is to assess whether the surgical approach to hip replacement surgery impacts patient outcome. Three different surgical approaches will be assessed across a large patient sample, regardless of prosthesis type or surgeon. This will be assessed primarily by patient satisfaction with the surgery, following the collection of longitudinal functional (patient-reported outcomes), radiological data and gait analyses. The secondary aim of the study will be to define preoperative patient characteristics as predictors of outcome following different surgical approaches to THA. To illustrate any potential identifying criteria for future surgical approach selection.
Interventions
Arm 1: Posterior lateral surgical approach (PLA)
PLA involves blunt dissection of the gluteus maximus, detachment of the external rotators and incision of the posterior part of the hip capsule. The hip is dislocated by internal rotation and flexion.
Arm 2: Anterior lateral surgical approach (ALA)
ALA involves detachment of the anterior one-third of the gluteus medius insertion and gluteus minimus insertion. Excision of the hip capsule is performed on the anterior side of the joint and the hip is
Arm 1: Posterior lateral surgical approach (PLA) PLA involves blunt dissection of the gluteus maximus, detachment of the external rotators and incision of the posterior part of the hip capsule. The hip is dislocated by internal rotation and flexion. Arm 2: Anterior lateral surgical approach (ALA) ALA involves detachment of the anterior one-third of the gluteus medius insertion and gluteus minimus insertion. Excision of the hip capsule is performed on the anterior side of the joint and the hip is dislocated by external rotation, adduction and flexion. Arm 3: Direct anterior surgical approach (DAA) DAA approaches the hip joint from the front of the joint, through a natural interval between the rectus femoris and gluteus medius muscles. There is no detachment of the gluteal muscles that attach to the posterior and lateral pelvis and femur. Functional assessments and questionnaires on function and satisfaction will be completed at various timepoints up to 24 months post surgery.
Sponsors
The International Musculoskeletal Research Institute Incorporated
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Any osteo-arthritic patient that presents to an Investigator for a routine hip replacement surgery and is able to provide informed consent. Any patient able to complete the required patient reported outcome measures. Any patient able to undergo the required radiological examinations.
Exclusion criteria
Participants with difficulty in comprehending study protocol through written or verbal English Participants who, in the opinion of the Investigator, have an existing condition that would compromise their participation and follow-up. Concurrent pregnancy. Participants who are known drug or alcohol abusers or with psychological disorders that could affect follow-up care or treatment outcomes. Participants who are currently involved in any injury litigation claims. Participants with chronic gait affecting neurological conditions (e.g. stroke, Parkinson’s, Multiple sclerosis). Participants with congenital hip defects.
Outcome results
None listed