None listed
Conditions
Brief summary
Hip replacement is the most commonly recommended intervention in Australia for people with severe hip arthritis, pain or fractures of hip. There are 3 different surgical approaches to replace the hip & based on the side of the hip is cut . These are from the front (anterior), back (posterior) & side (lateral). Although all 3 approaches have been proven to improve pain & function after surgery, it is still not know which approach has better muscle strength & better performance results in functional tasks like walking, stair , sit to stand etc after the surgery. Additionally some studies still report abnormalities in these functional activities regardless of which approach is used. Currently the evidence suggests the approach based on surgeon's experience & comfort. The proposed research will study patient’s muscle strength and mobility outcomes at 5 timepoints including - before surgery and after surgery at 3, 6, 12, & 24 months. The strength testing for all hip and knee muscle groups along with performance of functional tasks like walking , sit to stand , step up and down etc will be analysed using a 3D gait analysis setup. The study will also compare these outcomes between the 3 different hip replacement approaches at different mentioned at these timepoints. As a secondary outcome measure the study will compare the results of strength and functional assessment with patient reported outcome measures routinely collected as a part of normal care at the same timepoints. The results of the study will assist future clinical decisions before and after hip replacement. It may help optimising the rehabilitation and management and thus the economic costs of patients undergoing hip replacement by informing the clinicians better about muscle strength changes and its affect on functional performance at different stages following hip replacement.
Interventions
Summary : This study is a pragmatic observational study comparing different muscle strength, 3D motion analysis parameters and performance in results obtained in commonly conducted clinical tests between three different primary total hip arthroplasty approaches over various time points including pre-operative assessment and 4 post operative assessments including 3 months, 6 month, 12 months and 24 months. The study is conducted in conjunction with Western Health Hospitals ( Melbourne, Victori
Summary : This study is a pragmatic observational study comparing different muscle strength, 3D motion analysis parameters and performance in results obtained in commonly conducted clinical tests between three different primary total hip arthroplasty approaches over various time points including pre-operative assessment and 4 post operative assessments including 3 months, 6 month, 12 months and 24 months. The study is conducted in conjunction with Western Health Hospitals ( Melbourne, Victoria, Australia). The all 3 surgical approaches are offered to all patients presenting to Western health by the surgeon as per normal care regardless of whether they participate in the study. The decision as to which approach is selected for patients is decided by the surgeons as per routine care and decision making process. All patients undergoing unilateral primary THA ( By anterior , posterior or lateral approach ) who meet the eligibility criteria will be invited to participate in this study. a) The Anterior approach is defined by the use of an inter-nervous plane between sartorius and tensor fascia latae. It involves the elevation of tensor fascia latae iliac origin and retraction of rectus femoris from its origin, along with elevation of fibres of illiocapsularis during the total hip replacement / arthroplasty. b) The Posterior Approach : is defined by the split of gluteus maximus, division of tendons of piriformis / superior and interior gemellus and obturator internus. c) The Lateral approach : Surgically this involves split in the line of fibres of gluteus medius and vastus lateralis, along with elevation of Gluteus Medius and minimus from the Greater Trochanter The testing will be conduced at Swinburne university of technology (Hawthorn campus ) by a a qualified Physiotherapist ( Lakshmi Varma ) . The testing involves 1) 3D motion analysis of functional tasks like - normal walking , 40 meter fast pace walking, 30 second sit to stand, single leg balance, step up and down and change of direction 2) Isokinetic Muscle strength testing of hip and knee muscles bilaterally Piloting at university estimates a time of 2 to 2.5 hours for each subject . Questionnaires (Oxford hip sore , EQ-5D-5L and a general health history or physical activity record) will be used in the study for analysis and comparison. These are collected as a part of routine care for total hip replacements at Western health and done through the secure hospital system.
Sponsors
Meducta Australia
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Healthy controls - Over the age of 18 years. - Consents to this study after receiving the information statement. For Total hip arthroplasty groups ( 3 groups ) - Over the age of 18 years. - Is a primary THA candidate at Western health hospital in one of the three THA groups - Consents to this study after receiving the information statement.
Exclusion criteria
• Insufficient English comprehension to provide informed consent, complete simple, written questionnaires and/or understand simple, verbal instructions. • Inability to participate in testing methods or following instructions, including PROMS, muscle strength, and functional testing. • Have no authority or is incapable to give written consent. • Medically unstable as determined by their respective surgeons/teams pre-operatively or post-operatively. • Impaired cognition or in a confused state thus preventing them from being able to provide informed consent, complete simple written questionnaires and/or understand simple, verbal instructions e.g. patients with dementia, suffering an intellectual disabilities, psychological disorders, under the influence of drugs or alcohol. • Physical impairment that prevents them from participating in muscle and functional tests e.g. acute trauma / fractures/injuries/ pain, who are bed/wheelchair bound. • Previous history of hip or knee joint replacement
Outcome results
None listed