Osteoarthritis, Hip
Conditions
Keywords
Primary Osteoarthritis, Hip, Total Hip Arthroplasty, Anterior Approach, Posterior Approach, Anterolateral Approach, Cohort Study, Outcomes, Complication Rate, Outcomes, Quality of Life
Brief summary
Osteoarthritis disables approximately 10% of people who are 60 years or older and compromises the quality of life of more than 20 million Americans every year. Osteoarthritis is caused by the breakdown of cartilage that lines the bones at your joints from daily wear and tear and results in pain and restricted function. Total hip arthroplasty (THA) or total hip replacement, is currently one of the most successful and cost-effective treatments used to eliminate pain and restore function in those suffering from osteoarthritis. There are multiple ways to perform a THA. The main difference between each type is the point of incision in relation to a muscle on the outer surface of your hip bone: gluteus medius. The incision performed can be anterior (in front of the muscle), anterolateral (in front and to the side of the muscle), or posterior (from the back). Each of these approaches has its own advantages and disadvantages, but there is no evidence available that makes one better than the other. The purpose of this study is to determine which of the three approaches to THA is the most effective. The main outcome that will determine the most effective approach is the functional ability of the patients included in this study at 52 weeks. The investigators will also compare whether the patient's: length of hospital stay, use of assistive devices, need for revision surgery, ability to return to work, ability to relieve pain, complication rate, and quality of life. The investigators hypothesize that the anterior approach will be the most effective approach in reducing the rate of post-operative complications after THA.
Interventions
None listed
Sponsors
DePuy Orthopaedics
McMaster University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Men or women who are 18 years of age or older. 2. Primary diagnosis of hip arthritis (radiographically and clinically). 3. Patients undergoing an unilateral THA. 4. Provision of informed consent by patient.
Exclusion criteria
1. Patients being managed with alternative approaches (other than anterior, anterolateral or posterior THA) will be excluded. 2. Patients undergoing a revision THA. 3. Patients undergoing a bilateral THA. 4. Patients with infection around the hip (soft tissue or bone). 5. Patients who have had previous major hip surgery (hip arthroscopy is permitted) or hardware implanted in their hip. 6. Patients who are currently enrolled in another surgical intervention trial. 7. Patient has cognitive or language barriers that would limit completion of quality of life, pain, and function questionnaires in English. 8. Anticipated problems, in the judgment of the investigators, with maintaining follow-up. We will, for example, exclude patients with no fixed address, those who report a plan to move out of town in the next year, or intellectually challenged patients without adequate family support.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient Functional Ability | 52 Weeks | Measured by the Hip Disability and Osteoarthritis Outcome Score (HOOS) questionnaire. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Technical Parameters | 1 day - measured during and post-operatively | Length of Incision (cm), Blood Loss (mL), Fluoroscopy Time (s), Operative Time (Min) |
| Length of Hospital Stay | 4 weeks | Duration of time patient is in hospital post-operatively. |
| Use of Assistive Device | 52 weeks | Presence of an assistive device(s) provided to patients at discharge and the length of time it takes the patient to discard the assistive device(s). |
| Revision Surgery | 52 weeks | Occurrence and type of revision surgery required (if any) |
| Return to Work | 52 Weeks | Measured by the Work Limitations Questionnaire (WLQ)- short form format |
| Complication Rate | 52 Weeks | We will define complications in patients as a constellation of clinical symptoms and laboratory examinations. These will include (but are not limited to) both intraoperative and postoperative complications; More specifically, musculoskeletal, cardiovascular, psychological, neurological, genitourinary, and wound-related complications. |
| Pain | 52 Weeks | Measured by the EuroQol-5d (EQ-5D) and Hip Disability and Osteoarthritis Outcome Score (HOOS) questionnaires. |
| Quality of Life | 52 Weeks | Measured by the EuroQol-5d (EQ-5D) and Hip Disability and Osteoarthritis Outcome Score (HOOS) questionnaires. |
| Ability to participate in sports activities | 52 weeks | Subjectively reported. |
Countries
Canada
Outcome results
None listed