Hip Osteoarthritis
Conditions
Keywords
arthroplasty
Brief summary
The goal of this Prospective Randomized Study is to confirm presence or absence of differences in gait mechanics in direct anterior and lateral approaches for total hip arthroplasty. and to compare the clinical outcomes of both approaches. The main questions it aims to answer are: if the anterior approach to the hip is faster recovery than lateral approach? if the anterior approach to the hip has better gait mechanics than lateral approach? Participants will: undergo one of the two approaches for total hip arthroplasty. All patients will be followed up at 2 weeks, 6 weeks, 3 months and 18 months. gait analysis will be done at 6wks, 3m, and 18months.
Interventions
PROCEDUREtotal hip replacement using lateral approach
In the lateral approach partial detachment of the anterior one-third of the gluteus medius muscle.
PROCEDUREtotal hip replacement using anterior approach
the anterior approach using an internervous plane between the tensor fascia latae and the sartorius muscle.
DEVICEgait analysis at 6wks, 3 months and 18 months
gait analysis done in the gait lab at the mentioned postoperative periods
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
DOUBLE (Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Patients with primary osteoarthritis or osteonecrosis of the hip who consented for treatment with a total hip arthroplasty (THA) through an anterior or lateral approach. * Age between 20 - 60 years of age. * The participant had to be independent and physically active, which characterized as having the capacity to carry out daily tasks, ascend two flights of stairs, and able to walk for 15 minutes.
Exclusion criteria
* Patients with bilateral hip affection. * Body mass index (BMI) greater than 40. * Diagnosis other than primary osteoarthritis or osteonecrosis. * Prior hip or spine surgery. * chronic uncontrolled comorbidities, psychological disorders. * American Society of Anaesthesiologists score (ASA) higher than 2 * chronic neurological deficits that influence gait. * any limb length discrepancy more than 1 cm. * Any postoperative complication that will lead to delay in weight bearing.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| surgery time | intraoperative time starting from skin incision to skin closure | by ''Minute'' as the unit, no special description. |
| hemoglobin drop | postoperative day one | hemoglobin drop level between pre and postoperative. |
| hospital stays | immediately after the procedure | by ''Day'' as the unit, no special description. postoperative stay days from operation day to discharge day. |
| pain score | 2 weeks 6 weeks 3 months 18 months | using visual analogue scale (VAS) from 0-10 the more scale the worst the pain |
| Harris hip score | 2 weeks 6 weeks 3 months 18 months | for measuring hip function from 0-100 the more the score the better hip function |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| gait analysis | at 6 weeks, 3 months, 18 months | A single experienced physical medicine specialist will perform the gait analysis in a gait lab. Three-dimensional kinematic and kinetic data will be collected using eight high-speed infrared cameras (Quality motion analysis system, oqus 1 cameras), which can capture 240 frames per second, two force plates (Advanced Mechanical Technology Incorporated, AMTI), and 26 ten-millimeter passive retroreflective markers fixed on the subject using a double-face tape in specific landmarks on the subject in accordance to the modified institute Orthopedic Rizzoli (IOR ) model for full body marker set. |
Countries
Egypt
Outcome results
None listed