Hip Arthrosis
Conditions
Keywords
capsulectomy, capsulotomy
Brief summary
The purpose of our study is to evaluate the differences in functional activities and proprioception after surgery in subjects who underwent hip prosthesis implant with capsulotomy or capsulectomy.
Detailed description
Concerning hip arthroplasty surgery, in patients affected by coxarthrosis, there are two different techniques: one is capsulectomy and the second one is capsulotomy with repairing the capsule at the end of the procedure. Both preserving and excising the capsule are accepted methods and the choice whether repairing the capsule or not is up to the surgeon, since studies have not yet demonstrated the superiority of one of the two techniques. Articular capsule has a physiological role in joint stability and proprioception. The presence of proprioceptive nerve endings in hip joint capsule has been observed both in healthy patients and in those affected by coxarthrosis. If capsulectomy is performed during primary hip arthroplasty, the pseudocapsule that is formed in place of the native capsule will not have any active neurophysiological role in the hip. For this reason, investigators compare the two surgical techniques with the purpose of highlighting, if existing, the superiority of one technique on the other in terms of better functional recovery and proprioceptive sensibility.
Interventions
Surgical intervention in which the surgeon will perform anterior capsulectomy during total hip arthroplasty.
Surgical intervention in which the surgeon will perform anterior capsulotomy during total hip arthroplasty. Surgeon will repair the joint capsule.
Sponsors
IRCCS San Raffaele
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Elective unilateral primary hip prosthesis utilizing direct anterior approach * Age ≥ 18 * Signature of the informed consent
Exclusion criteria
* Documented peripheral neuropathies * Documented central nervous system diseases that may compromise the balance and/or proprioception * Presence of other joint prosthesis in the lower limbs * Revision hip arthroplasty * Symptomatic osteoarthritis of other joints in the lower limbs (including the controlateral hip) or the spine * BMI \> 35 * Systemic diseases or clinical conditions that could interfere with the clinical study * Neuromuscular diseases
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in Hip disability and Osteoarthritis Outcome Score (HOOS) | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in 30 seconds chair stand test | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) | — |
| Hip Proprioception Evaluation Flexion - Measure of the absolute difference between the actual and the subject-replicated target positions. | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) | Measures of hip flexion repositioning error (active and passive repositioning) |
| Hip Proprioception Evaluation Abduction - Measure of the absolute difference between the actual and the subject-replicated target positions. | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) | Measures of hip abduction repositioning error (active and passive repositioning) |
| Hip Proprioception Evaluation External Rotation- Measure of the absolute difference between the actual and the subject-replicated target positions. | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) | Measures of hip external rotation repositioning error (active and passive repositioning) |
| Hip Proprioception Evaluation Flexion- Measure of the absolute difference between the actual and the subject-replicated target positions. | Before surgery (T0), 90 days (plus or minus 3 days) after surgery (T2) | Measures of hip flexion repositioning error (active and passive repositioning) |
| Change in Six minutes walk test distance | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) | — |
| Active hip Range Of Motion Abduction- degree | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) | Measures of hip abduction maximal active Range of Motion |
| Active hip Range Of Motion External Rotation- degree | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) | Measures of hip external rotation maximal active Range of Motion |
| Surgical time- minutes | The day of the surgical procedure | This will be measured from the time of incision to the time the dressing is applied |
| Percent hemoglobin drop | Up to 2 weeks after surgery (during inpatient stay) | Percent hemoglobin drop will be measured by comparing the preoperative hemoglobin to the inpatient nadir hemoglobin. |
| Active hip Range Of Motion Flexion- degree | Before surgery (T0), 50 days (plus or minus 3 days) after surgery (T1) | Measures of hip flexion maximal active Range of Motion |
Countries
Italy
Outcome results
None listed