None listed
Conditions
Brief summary
The purpose of the study will be to assess the impact of frontal, intra-muscular operating access on the biomechanical gait image and the functional outcome of the lower limb in patients after hip replacement. The studies will involve 60 patients aged 40-65 years, of both sexes, with coxarthrosis, qualified for hip replacement surgery. The control group will be the healthy people, aged 40 - 65 years of both sexes. Patients will be divided into two research groups. The first group is the patients who will have a frontal intramuscular operation during surgery, while the second group will have side-access surgery. The first research session will take place one week before the procedure. Each patient will have a locomotive test combined with EMG registration. Each patient will also have a functional test (measurement of range of motion).The Harris and WOMAC scales will also be used. After 6 and 12 weeks, locomotion test, EMG registration and clinical scale scans will be performed again.
Interventions
The purpose of the study will be to assess the impact of frontal, intra-muscular operating access on the biomechanical gait image and the functional outcome of the lower limb in patients after hip replacement. The alternative solution for lateral access that is gaining an increasing number of followers is minimally invasive access from the frontal accession. Minimally invasive access is defined as the absence of muscle and / or bone damage combined with short cutaneous cut. Minimally invasive does not mean a short scar, but as little damage to soft tissues, especially muscles and their attachment. Muscle protection accelerates movement improvement, allowing for a faster discharge from the surgical ward The advantage of front access is the maintenance of undamaged muscles and their attachment to the pelvis and femur. This access uses the space between the iliotibial band and the gluteus medius. This allows them to return to their correct tension immediately after the operation. No damage to muscles and their attachment increases the dynamic, muscular stabilization of the operated hip. The qualification for research will be based on the simple randomisation of research group. Allocation of patients to the research group will be decided upon the coin-tossing. Heads – patient is participating in the research, tails – patient does not take part in the research. After the surgery, patients were randomly divided into two groups. Patients for particular groups will be always qualified by the same person - first researcher. The first group is the patients who will have a frontal, intramuscular operation access during surgery, while the second group will have lateral surgical access. The first test session will take place one week before the procedure. After 6 and 12 weeks, the examination will be re-performed. All procedures will be carried out by first researcher. Surgery will be performed by orthopaedic surgeon Research will include: 1. Analysis of the medical documentation of the patient. 2. Measurement of kinematic and kinetic parameters of gait based on three-dimensional motion analysis using the BTS Smart system in conjunction with the torque platform. The analysis will include: - angular changes in the three planes of knee, hip, and ankle joints, - changes in the length of selected muscles, - changes in ground-reaction forces - time-spatial parameters: number of steps per minute, time of single and double support, length and duration of full cycle, and speed of walk. 3. Registration of biopotentialities arising in the gluteus muscles (bilateral for maximus and medium gluteus muscles). Duration of the surgical procedure: 2 hours Overall duration of the assessments – 2 hours: 1. 1 hour for clinical examination, 2. 1 hour for gait and EMG test,
Sponsors
Study design
Eligibility
Inclusion criteria
Eligibility criteria for the study group: 1. Requires hip replacement, as determined by the treating doctor for degenerative changes. 2. Ability to move independently before and after surgery (without orthopedic support), 3. No other locomotive organs or neurological diseases affecting the locomotion, 4. Written consent for participation in research Control group: 1. Lack of injuries and diseases of the musculoskeletal system and neurological diseases. 2. Written consent of the patient to participate in research,
Exclusion criteria
Study and control group 1. Age below 40 and above 65 years 2. 30 < BMI <19 3. Identified coexisting diseases such. neurological, cardiac, advanced diabetes, uncontrolled high blood pressure and other diseases that may affect the gait pattern, 3. acute injuries and inflammation within the motor organs, 4. the overall poor health of the test,