Osteoarthritis (OA) of the Hip
Conditions
Brief summary
The purpose of this study is to examine the extent to which spinopelvic exercises may affect either sagittal spinal deformity or spinopelvic mobility and identifying patients at risk for hip instability following a total hip replacement.
Interventions
OTHERSpinopelvic mobility exercise
Participants will complete a 15-20 min session of therapeutic exercises performed by patients with assistance of a pre-recorded video. The exercise regimen has been developed by the investigators of this study to incorporate exercises to increase a patient's spinopelvic mobility. Study staff that has been properly trained will be present to guide the patient through the exercise regimen and ensure the exercises are being performed accurately.
Sponsors
Colorado Joint Replacement
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
1. Patients aged 18-90 scheduled for total hip arthroplasty 2. Patients with primary hip osteoarthritis 3. Patients with or without history of prior spinal injections
Exclusion criteria
1. Patients undergoing revision total hip arthroplasty. 2. Patients with spinal fusion. 3. Patients who exercised prior to radiographic analysis. 4. Patients unable to complete imaging at the designated time of day. 5. Symptomatic contralateral hip osteoarthritis. 6. Patients unwilling or unable to perform therapeutic exercise program as instructed. This includes patients requiring use of assistive devices or who would be deemed unsafe to perform the exercises without a 1- or 2-person assist.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Spinopelvic radiographic measurements | Change from baseline to up to 1 hour after spinopelvic exercises same day. | Spinopelvic parameter measurements on pre- and post-exercise radiographs including pelvic incidence, pelvic tilt, sacral slope and lumbar lordosis. All measurements are angles calculated in degrees. |
| Lumbar mobility | Change from baseline to up to 1 hour after spinopelvic exercises same day | Calculated as the change in angle of lumbar lordosis between neutral standing and flexed-forward seated radiographs. |
| Spinopelvic mobility | Change from baseline to up to 1 hour after spinopelvic exercises same day | Calculated as the change in angle of pelvic tilt between neutral standing and flexed-forward seated radiographs. |
| Patient risk classification for THA instability | Change from baseline to up to 1 hour after spinopelvic exercises same day | Risk classification based on previously published risk factors for THA instability (lumbar stiffness, abnormal pelvic mobility, standing pelvic tilt greater than 13, sagittal spinal deformity) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Use of medication for hip/back pain | Baseline | Assessed by standard of care questionnaire prior to the pre-operative visit with provider for a total hip replacement. |
| Oswestry Disability Index score | Baseline | Patient reported outcome for pre-existing back pain and disability. The questionnaire is comprised of 10 sections, where each section is scored on a scale from 0 to 5 and summed. Higher score totals indicates worse disability. |
| Adverse events | Day 1 | Any adverse events sustained from therapeutic exercises |
| Severity of hip arthritis | Baseline | Graded using Kellgren-Lawrence scale for osteoarthritis on AP radiographs. Grades are between 0-4, where 0 indicates an absence of osteoarthritis and a 4 indicates severe osteoarthritis. |
| Hip Society Score | Baseline | Patient reported outcome, scored from 0 to 100. Higher scores indicate better outcomes. |
| Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS, JR) | Baseline | Patient reported outcome, scored from 0 to 100. Higher scores indicate better outcomes. |
| The Veterans Rand 12-Item Health Survey scores (VR-12) | Baseline | Patient reported outcome. Scores are reported as a Z-score that is based on the United States population average of 50. Higher scores indicate better outcomes. |
Contacts
Primary ContactMakenna Hemmerle, MS
Outcome results
None listed